A neck compression injury criterion incorporating lateral eccentricity

Whyte, Tom; Melnyk, Angela D.; Toen, Carolyn Van; Yamamoto, Shun; Street, John; Oxland, Thomas R.; Cripton, Peter A.

doi:10.1038/s41598-020-63974-w

Cited by 11 publications

(4 citation statements)

References 36 publications

(70 reference statements)

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“…In scoliosis, the lateral eccentricity at the apex of the curve creates an alternative point of injury susceptibility. 11 In the current case, the apex of the scoliotic curve at T9 was the site of load failure from axial forces to the crown of the helmet in a head-first tackle ( Fig. 4 ).…”

Section: Discussionmentioning

confidence: 68%

Management of thoracic spinal cord injury in a professional American football athlete: illustrative case

Maroon¹,

Agarwal²,

Harrington

et al. 2021

Journal of Neurosurgery: Case Lessons

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BACKGROUND A case of catastrophic thoracic spinal cord injury (SCI) sustained by a professional American football player with severe scoliosis is presented. OBSERVATIONS A 25-year-old professional football player sustained an axial loading injury while tackling. Examination revealed a T8 American Spinal Injury Association Impairment Scale grade A complete SCI. Methylprednisolone and hypothermia protocols were initiated. Computed tomography scan of the thoracic spine demonstrated T8 and T9 facet fractures on the left at the apex of a 42° idiopathic scoliotic deformity. Magnetic resonance imaging (MRI) demonstrated T2 spinal cord hyperintensity at T9. He regained trace movement of his right lower extremity over 12 hours, which was absent on posttrauma day 2. Repeat MRI revealed interval cord compression and worsening of T2 signal change at T7-T8 secondary to hematoma. Urgent decompression and fusion from T8 to T10 were performed. Additional treatment included high-dose omega-3 fatty acids and hyperbaric oxygen therapy. A 2-month inpatient spinal cord rehabilitation program was followed by prolonged outpatient physical therapy. He currently can run and jump with minimal residual distal left lower limb spasticity. LESSONS This is the first known football-related thoracic SCI with idiopathic scoliosis. Aggressive medical and surgical intervention with intensive rehabilitation formed the treatment protocol, with a favorable outcome achieved.

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Section: Discussionmentioning

confidence: 68%

Management of thoracic spinal cord injury in a professional American football athlete: illustrative case

Maroon¹,

Agarwal²,

Harrington

et al. 2021

Journal of Neurosurgery: Case Lessons

View full text Add to dashboard Cite

show abstract

“…The inter-subject variability inherent in testing biomechanical specimens also informed the decision to analyse the specimens together despite being from different levels of the spine. While the mechanical properties of the spine vary from level to level due to variations in geometry and structure, various segments are often grouped for analysis of biomechanical test data of this type [36][37][38][39][40] since inter-subject variability is typically greater than in grouping segment levels.…”

Section: Discussionmentioning

confidence: 99%

Load-Sharing and Kinematics of the Human Cervical Spine Under Multi-Axial Transverse Shear Loading: Combined Experimental and Computational Investigation

Whyte

Barker

Cronin

et al. 2021

Journal of Biomechanical Engineering

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The cervical spine experiences shear forces during everyday activities and injurious events yet there is a paucity of biomechanical data characterizing the cervical spine under shear loading. This study aimed to 1) characterise load transmission paths and kinematics of the subaxial cervical spine under shear loading, and 2) assess a contemporary finite element cervical spine model using this data. Subaxial functional spinal units (FSUs) were subjected to anterior, posterior and lateral shear forces (200 N) applied with and without superimposed axial compression preload (200 N) while monitoring spine kinematics. Load transmission paths were identified using strain gauges on the anterior vertebral body and lateral masses and a disc pressure sensor. Experimental conditions were simulated with cervical spine finite element model FSUs (GHBMC M50 version 5.0). The mean kinematics, vertebral strains and disc pressures were compared to experimental results. The shear force-displacement response typically demonstrated a toe region followed by a linear response, with higher stiffness in anterior shear relative to lateral and posterior shear. Compressive axial preload decreased posterior and lateral shear stiffness and increased initial anterior shear stiffness. Load transmission patterns and kinematics suggest facet joints play a key role in limiting anterior shear while the disc governs motion in posterior shear. The main cervical spine shear responses and trends are faithfully predicted by the GHBMC cervical spine model. These basic cervical spine biomechanics and the computational model can provide insight into mechanisms for facet dislocation in high severity impacts, and tissue distraction in low severity impacts.

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“…Методы вычислительного моделирования позволяют лучше понять процесс деформации, возникающей в тканях шеи человека [2]. Применяются различные способы, такие как двойная система рентгеноскопической визуализации и методов регистрации 3D-to-2D [3], высокоскоростная видеосъемка [4], экспериментальный и вычислительный биомеханический анализ имитируемых столкновений [5]. Все чаще уделяется внимание изучению функций мышц шеи и плечевого пояса.…”

Section: неврологияunclassified

Possibilities of personalized finite element segmental analysis of the cervical spine for predicting the course of dorsopathy

et al. 2022

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Introduction. The use of mathematical modeling methods in clinical practice will make it possible to identify the pathogenetic forms of dorsopathies and thus reasonably use the concept of targeted treatment in the management of patients of this category.Aim. To evaluate the possibilities of finite element segmental analysis of the cervical spine for personalized treatment and prediction of the course of dorsopathies.Material and methods. Based on the combined data of computed and magnetic resonance imaging of the patient (female, born in 1951), a model of the C5 – C7 segment was generated, including: vertebrae C5, C6, C7, IVD, anterior and posterior longitudinal ligaments, two pairs of facet joints, spinal cord, nuchal ligament. Computer modeling and finite element method were used to analyze the stress-strain state of the cervical spine of a patient with degenerative-dystrophic changes in the C2 – C7 segments. In the Abaqus/CAE 6.14 software, finite element analysis of the C5 – C7 stress-strain state was carried out in the state of flexion, rotation and compression. The data obtained during compression were compared with previous experiments in silico and in vitro for the norm.Results. For each state, stress and displacement diagrams, load-displacement curves, stress profiles in the MPD were obtained. The axial mobility of the segment under compressive load is two times lower compared to the norm under the same boundary conditions and material models. The degree of involvement of the spinal cord in conflicts with the surrounding anatomical structures was studied. When the model was rotated to the right, conflicts were observed between the spinal cord roots and the bone structures of the vertebrae in the foraminal zones, as well as at the level of the C5 – C6 and C6 – C7 discs with the left posterolateral surfaces of the fibrous rings. When the model was turned to the left, conflicts of the spinal cord were observed in all foraminal zones, as well as at the level of the C6 – C7 disc with the left posterolateral surface of the fibrous rings. Based on the data on stresses in the studied segment, further development of dorsopathies and degenerative changes in the cervical spine was predicted.Conclusions. The use of finite element segmental analysis of the cervical spine creates objective prerequisites for the formation of a combined personalized treatment and prediction of the course of dorsopathies.

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A neck compression injury criterion incorporating lateral eccentricity

Cited by 11 publications

References 36 publications

Management of thoracic spinal cord injury in a professional American football athlete: illustrative case

Management of thoracic spinal cord injury in a professional American football athlete: illustrative case

Load-Sharing and Kinematics of the Human Cervical Spine Under Multi-Axial Transverse Shear Loading: Combined Experimental and Computational Investigation

Possibilities of personalized finite element segmental analysis of the cervical spine for predicting the course of dorsopathy

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