Landinez David, Rodríguez Carlos Francisco, Cifuentes-De la Portilla Christian
Biomedical Engineering Department, Universidad de los Andes, Bogotá, Colombia.
Mechanical Engineering Department, Universidad de los Andes, Bogotá, Colombia.
J Orthop Surg Res. 2025 Jan 10;20(1):39. doi: 10.1186/s13018-024-05417-0.
Scoliosis is an idiopathic three-dimensional spine strain. The orthopedic parameter used to diagnose and evaluate the severity of the strain is Cobb's angle. This study proposes using this clinical parameter to reproduce a digital twin of the spine, calculate biomechanical stress changes, and characterize idiopathic scoliosis deformity through symmetrical degeneration of intervertebral discs, relying on patient-specific radiological measurements of the scoliotic curves.
A three-dimensional computational model of the spine was developed, where patient-specific curves were generated by modifying intervertebral disc mechanical properties via a mathematical model derived from radiological data. Validation of the model was performed by comparing the resultant scoliotic curves with patient radiological images. Finite element analysis was then used to elucidate the biomechanical effects on the spine due to the deformity.
The model successfully replicated patient-specific thoracic scoliotic deformities, revealing a discernible relationship between disc strain and its proximity to the apex, indicating a heightened risk of disc stress closer to the apex. Moreover, "type-C" curves exhibited a greater risk of herniation compared to "type-S" curves due to differences in compressive stress distribution.
This modeling approach enhances the understanding of scoliosis biomechanics, facilitating risk assessment for disc prolapse and aiding in treatment selection, including the design of condition-specific orthotics. Furthermore, it establishes a quantitative link between scoliosis severity and disc strain, integrating Cobb's angle and other orthopedic parameters into computational models to approximate patient-specific conditions.
脊柱侧弯是一种特发性三维脊柱劳损。用于诊断和评估该劳损严重程度的骨科参数是 Cobb 角。本研究建议利用这一临床参数来重建脊柱的数字孪生模型，计算生物力学应力变化，并通过椎间盘的对称性退变来表征特发性脊柱侧弯畸形，这依赖于对脊柱侧弯曲线进行患者特异性的放射学测量。
开发了一个脊柱的三维计算模型，通过从放射学数据推导的数学模型修改椎间盘力学特性来生成患者特异性曲线。通过将所得的脊柱侧弯曲线与患者的放射学图像进行比较来对模型进行验证。然后使用有限元分析来阐明畸形对脊柱的生物力学影响。
该模型成功复制了患者特异性的胸段脊柱侧弯畸形，揭示了椎间盘应变与其靠近顶点的程度之间存在明显的关系，表明靠近顶点处椎间盘应力风险更高。此外，由于压缩应力分布的差异，“C 型”曲线相比“ S 型”曲线表现出更大的椎间盘突出风险。
这种建模方法增强了对脊柱侧弯生物力学的理解，有助于椎间盘突出的风险评估，并辅助治疗选择，包括设计针对具体病情的矫形器。此外，它在脊柱侧弯严重程度和椎间盘应变之间建立了定量联系，将 Cobb 角和其他骨科参数整合到计算模型中以近似患者的具体情况。
