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Objective To investigate the biomechanical effects of interbody cage height on cervical spine during anterior cervical discectomy and fusion (ACDF) surgery,so as to provide references for selection of interbody cage.Metheds The finite element model of normal cervical spine (C2-7) was built and validated,and the cages with different height (5,6,7,8 mm) were implanted into C5-6 disc (cage 5,6,7,8 model).All the models were loaded with pure moment of 1.5 N · m to produce flexion,extension,lateral bending and axial rotation motions on cervical spine,and the effects of cage height on range of motion (ROM),facet joint stress,intervertebral pressure in cervical spine were investigated.Results The intervertebral angle at the fusion segment increased by 0.68° with per 1 mm-increase in height.The ROM in C5-6 after cage implantation was smaller than 0.44°.The influence of cage height on ROM in C4-5 was greater than that in C6-7,and the changes of ROM in non-fusion segments were smaller than 7.3％.The cage height variation had a smaller impact on the facet joint stress and intervertebral pressure.The stresses in the capsular ligament,cage and screw-plate system increased gradually with the increase of cage height,and the stresses in cage 6,7,8 models were much higher than those in cage 5 model.Conclusions For patients who need implanting fusion cage,the cage height should be 0-1 mm greater than the original intervertebral space height.
ABSTRACT
Objective To investigate the biomechanical effects of interbody cage height on cervical spine during anterior cervical discectomy and fusion (ACDF) surgery,so as to provide references for selection of interbody cage.Metheds The finite element model of normal cervical spine (C2-7) was built and validated,and the cages with different height (5,6,7,8 mm) were implanted into C5-6 disc (cage 5,6,7,8 model).All the models were loaded with pure moment of 1.5 N · m to produce flexion,extension,lateral bending and axial rotation motions on cervical spine,and the effects of cage height on range of motion (ROM),facet joint stress,intervertebral pressure in cervical spine were investigated.Results The intervertebral angle at the fusion segment increased by 0.68° with per 1 mm-increase in height.The ROM in C5-6 after cage implantation was smaller than 0.44°.The influence of cage height on ROM in C4-5 was greater than that in C6-7,and the changes of ROM in non-fusion segments were smaller than 7.3％.The cage height variation had a smaller impact on the facet joint stress and intervertebral pressure.The stresses in the capsular ligament,cage and screw-plate system increased gradually with the increase of cage height,and the stresses in cage 6,7,8 models were much higher than those in cage 5 model.Conclusions For patients who need implanting fusion cage,the cage height should be 0-1 mm greater than the original intervertebral space height.
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Objective To study the influence of follower load on contact force of facet joints under various postures of lumbar spine. Methods A 3D nonlinear finite element model of lumbar spine (L1-S1) was developed, with consideration of the non-uniform thickness and nonlinear material properties of the cartilage layer in facet joints. The model was then applied with different follower preload (0, 0.5, 0.8, 1.2 kN), under pure moment of 7.5 N•m in different directions (flexion, extension, lateral bending, extension and torsion). The contact forces of facet joints on the two sides of each segment under different loading conditions were compared. The asymmetry influence of follower load on contact force of facet joints was also quantitatively studied. Results The follower preload increased the facet force under flexion-extension and bending (ipsilateral), while decreased the force on the contralateral facet under lateral bending. All the effects of follower load on facet force became weaker with the increase of preload. For torsion loading, the preload had almost no effect on facet force. The greatest asymmetry influence of follower load on facet force was under bending (the ipsilateral side), followed by flexion, bending (contralateral side), extension and torsion. Conclusions The follower load shows obviously different effects on contact force of facet joints with different postures. The asymmetry of facet joints should be fully considered in biomechanical studies of lumbar spine, especially in studies on post-structures of lumbar spine under physiological loads.
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Objective To investigate the pattern of load transfer in cervical spine treated with Hybrid surgery using total disc replacement (TDR) and spinal fusion, so as to deepen the understanding of Hybrid surgery from the biomechanical view. Methods A finite element model of cervical spine C3-7 (INTACT model) was built to simulate three types of fusion surgeries at C4-6 degenerative segments: upper TDR combined with lower bone graft fusion (TDR45 model), upper fusion combined with lower TDR (TDR56 model), two-level fusion (Fusion456 model). Results In all surgical models, mobility of the fused levels was almost lost, while mobility of the TDR levels increased. Under the axial load of 160 N, the entire cervical motion was less than 4° in the INTACT model, while the motion in the TDR45 model and TDR56 model increased to 8.2° and 8.9°, respectively. In the TDR56 model, the force transferred through the C5 vertebra decreased by 20%, while the force transferred through the facet joint force was 3.8 times larger than that of the INTACT model. The facet contact force in the TDR45 model increased by 50%. The maximal stress in the INTACT model was 0.8 MPa, while the facet contact force in the TDR45 model and TDR56 model were almost 2 times as that in the INTACT model. Conclusions Due to the increased mobility at the TDR levels, the cervical curvature after Hybrid surgery changes greatly under the axial load. The alteration of spinal alignment will result in a decrease in anterior vertebral section force at the operative level, as well as an increase in facet joint force and facet cartilage stress.
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Objective To study dynamic characteristics of human lumbar spine using three-dimensional finite element method. Methods Finite element model of lumbar spine (L1~5) was developed and validated based on CT images, and the modal analysis was also conducted. Results A total of top 30-order modal parameters were extracted to obtain dynamic characteristics of the lumbar spine under free boundary conditions. Resonance frequencies of the model were concentrately distributed, but the amplitude of each order varied greatly. Amplitude near L5 segment was much larger, indicating L5 was easily to be injured. This lumbar modal analysis could provide a basis for its further dynamic analysis. Parameters such as natural frequency, modal shape and vibration amplitude of the lumbar spine would be helpful for both lumbar dynamic analysis and optimal design of man-machine interface mechanical equipment.
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Objective To study biomechanical effects of the lumbar spine under different traction conditions by using three-dimensional (3D) finite element method. Methods The CT images of lumbar segment L1-5 were input to the Mimics 10.01 for developing 3D geometrical model of L1-5. Then the mesh model of L1-5 was obtained using Geomagic Studio 12.0 and Hypermesh 11.0. The finite element simulation of the lumbar spine under different traction conditions was made by using Abaqus. Results Head-down titling angle was related to the nucleus pulposus stress. When the head-down tilting angle was smaller than 10°, the nucleus pulposus stress regularly changed with the swing cycle; while the head-down tilting angle exceeded 10°, the stress was decreased. In the swing mode, the annulus inner ring stress was increased to promote intervertebral retraction. Conclusions The traction mode helps to relieve the lumbar pain with the swing helping to coordinate the traction effect in each direction, which can better sort out and relieve the rear facet joint disorders. In addition, patients should be careful to select the appropriate traction force in the treatment to achieve good therapeutic effect.
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Objective To obtain the multi-axis load histories on physiological coordinate of the pilot when performing Herbst maneuver by flight simulation, and make analysis on the obtained typical data. Methods The 3D geometrical model of the aircraft was established in CAD software based on design parameters of the fourth-generation aircraft, 6 key motion parameters of mass center were obtained by flight simulation, and 3D human body model was developed according to anthropometric measurement data of Chinese male pilot; based on the location of cabin and seat in the aircraft, the assembly model with both the aircraft and human body was established and the multi-axis load histories at different locations of human body under Herbst maneuver were obtained through kinematics analysis of the human-aircraft system. An analytic case of Herbst maneuver at altitude of 3 km and flight velocity of 90 m/s was carried out. Results The load histories at chest, foot and head of human body were basically coincided, but Gy histories between the chest and hand were different; the Gy peak value of hand was about 1.6 g; under the multi-axis loads, the +Gx peak value was about 3.0 g, being the maximum. Conclusions The load histories of aircraft mass center cannot be used as those of human body because it may have some deviation, and the Gy histories for hand cannot be replaced by load histories of other locations on human body when they are used for analysis on effects of multi axis load on operating behaviors of the aircraft.
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Objective To study the biomechanical effects of 3 different retention methods (clasp, attachment or zygomatic implants) on repairing unilateral maxillary defects by using 3D finite element analysis method. Methods The maxillary unilateral defect model was reconstructed by the medical image processing software Mimics. The prosthesis was generated by mirroring technology. After processing, the finite element model of maxillary model by the three different retention methods was established to simulate stress distributions of maxilla during occlusion. Results Compared with the other methods, by using zygomatic implant retention method, stresses on affected and unaffected palate were the largest as 7.399 and 4.864 MPa, respectively, while those on affected and unaffected maxilla were the smallest as 10.46 and 10.86 MPa, respectively. Stress on zygomatic implant itself was 15.25 MPa, which was also the smallest. Conclusions Different retention methods had an obvious impact on unilateral maxillary defect restoration. The clasp and attachment retention methods could share the stress on palate by carrying bracket. The zygomatic implant retention method could also share the stress on maxilla by passing the stress to the zygoma.
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<p><b>BACKGROUND</b>The pelvis often needs to be reconstructed after bone tumor resection. A major challenge here for the orthopedic surgeons is to choose a method that gives the best performance which depends upon its biomechanical properties. In this study, a 3-dimensional finite element analysis (FEA) was used to analyze the biomechanical properties of reconstructed pelvis using fibula transplant fixed by four commonly used rod-screw systems.</p><p><b>METHODS</b>A total pelvic finite-element model including the lumbar-sacral spine and proximal femur was constructed based on the geometry of CT image from a healthy volunteer. Three-dimensional finite element models of different implants including fibula, rod and screw were simulated using ways of solid modeling. Then various reconstructed finite element models were assembled with different finite element implant model and type I resected pelvic finite element model. The load of 500 N was imposed vertically onto the superior surface of L3 vertebral body, and the pelvis was fixed in bilateral leg standing positions. FEA was performed to account for the stress distribution on the bones and implants. The pelvis displacement of the different rod-screw fixation methods and the maximum equivalent stress (max EQV) on all nodes and element were figured out to evaluate the advantages and disadvantages of different reconstructive methods.</p><p><b>RESULTS</b>Stress concentration in the fibula transplant was extremely high in the reconstructed pelvis, but could be substantially decreased by internal fixation, which partially transferred the stress from the fibula to the rod-screw systems. High stress concentration was also found in the implants, especially in the connection sites between screw and rod. Among the four methods of fixation, a double rod system with L5-S1 pedicle and ilium screws (L5-S1 HR) produced the best performance: least stress concentrations and least total displacement.</p><p><b>CONCLUSION</b>According to the stability and stress concentration, the method of L5-S1 HR fixation combined with fibula transplantation is better than other fixation methods in pelvic reconstruction after type I resection.</p>