Vertebroplasty is a common and effective treatment for symptomatic osteoporotic vertebral compression fractures. However, the cemented and adjacent vertebras have a risk of recollapse due to largely unassured mechanisms, among which excessive stiffness of bone cement may be an important risk factor. This study aimed to find the most appropriate range of bone cement stiffness by analyzing its biomechanical effects on the augmented and adjacent vertebras of individual patient after vertebroplasty. A three-dimensional finite element model of T11-L1 osteoligamentous vertebras was reconstructed according to individual computed tomography data and validated by post mortem human subject experiment in literatures. Bone cement of varying stiffness was injected into the trabecular core of the T12 vertebra simulatively. The maximum von Mises stresses on cancellous and cortical bones of T11-L1 vertebras were analyzed under the loading conditions of flexion, extension, bending, and torsion. For the adjacent T11 and L1 vertebras, the stepwise elevation of the bone cement elastic modulus increased the maximum von Mises stress on the cancellous bone, but its effect on cortical bone was negligible. For the augmented T12 vertebra, the stresses on cancellous bone increased slightly under the loading condition of lateral bending and remained no impact on cortical bone. The linear interpolation revealed that the most suitable range of cement elastic modulus is 833.1 and 1408.1 Mpa for this patient. Increased elastic modulus of bone cement may lead to a growing risk of recollapse for the cemented vertebra as well as the adjacent vertebras. Our study provides a fresh perspective in clinical optimization of individual therapy in vertebroplasty. Graphical abstract ᅟ.
A lower limb-pelvis finite element (FE) model with active three-dimensional (3D) muscles was developed in this study for biomechanical analysis of human body. The model geometry was mainly reconstructed from a male volunteer close to the anthropometry of a 50th percentile Chinese male. Tissue materials and structural features were established based on the literature and new implemented experimental tests. In particular, the muscle was modeled with a combination of truss and hexahedral elements to define its passive and active properties as well as to follow the detailed anatomy structure. Both passive and active properties of the model were validated against the experiments of Post-Mortem Human Surrogate (PMHS) and volunteers, respectively. The model was then used to simulate driver's emergency braking during frontal crashes and investigate Knee-Thigh-Hip (KTH) injury mechanisms and tolerances of the human body. A significant force and bending moment variance was noted for the driver's femur due to the effects of active muscle forces during emergency braking. In summary, the present lower limb-pelvis model can be applied in various research fields to support expensive and complex physical tests or corresponding device design.
Various cognitive disorders have been reported for mild traumatic brain injury (mTBI) patients during the acute stage. This acute stage provides an opportunity for clinicians to optimize treatment protocols, which are based on the evaluation of brain structural connectivity. So far, most brain functional magnetic resonance imaging studies are focused on moderate to severe traumatic brain injuries (TBIs). In this study, we prospectively collected resting state data on 50 mTBI within 3 days of injury and 50 healthy volunteers and analyzed them using Amplitude of low-frequency fluctuation (ALFF), Regional Homogeneity (ReHo), graph theory methods and behavior measure, to explore the dysfunctional brain regions in acute mTBI. In our study, a total of 50 patients suffering <3 days mTBI and 50 healthy subjects were tested in rs-fMRI, as well as under neuropsychological examinations including the Wechsler Intelligence Scale and Stroop Color and Word Test. The correlation analysis was conducted between graph theoretic parameters and neuropsychological results. For the mTBI group, the ReHo of the inferior temporal gyrus and the cerebellum superior are significantly lower than in the control group, and the ALFF of the left insula, the cerebellum inferior, and the middle occipital gyrus were significantly higher than in the control group, which implies the dysfunctionality usually observed in Parkinson's disease. Executive function disorder was significantly correlated with the global efficiencies of the dorsolateral superior frontal gyrus and the anterior cingulate cortex, which is consistent with the literature: the acute mTBI patients demonstrate abnormality in terms of motor speed, association, information processing speed, attention, and short-term memory function. Correlation analysis between the neuropsychological outcomes and the network efficiency for the mTBI group indicates that executive dysfunction might be caused by local brain changes. Our data support the idea that the cerebral internal network has compensatory reactions in response to sudden pathological and neurophysiological changes. In the future, multimode rs-fMRI analysis could be a valuable tool for evaluating dysfunctional brain regions after mTBI.
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