Biomechanical Analysis and Simulation of Scoliosis Surgical Correction

Viviani, G R; Ghista, D. N.; Lozada, P J; Subbaraj, K.; Barnes, G.T

doi:10.1097/00003086-198607000-00008

Cited by 15 publications

(10 citation statements)

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“…As mentioned earlier, a series of computer models have previously been developed to simulate the biomechanics of scoliosis surgery [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. These models have used varying approaches to deriving model geometry and material properties, but are all based on the use of 3D elastic beams and springs to provide a lumped parameter representation of the intervertebral joint stiffnesses.…”

Section: Discussionmentioning

confidence: 99%

“…In early models, each spinal motion segment (SMS-incorporating intervertebral discs, anterior and posterior longitudinal ligaments, ligamentum flavum, intertransverse, interspinous and supraspinous ligaments, zygapophyseal joints and capsular ligaments, as well as costovertebral joints for thoracic motion segments) was modelled using a single beam element, e.g. [1,2], however in more recent models the disc and ligaments are still modelled as a 'lumped' stiffness using single elastic beams, but the zygapophyseal joints and costovertebral joints are modelled as separate structures, e.g. [12].…”

Section: Discussionmentioning

confidence: 99%

“…A series of previous studies have applied computer simulation techniques, principally the finite element (FE) method, to the study of scoliosis. In particular, FE models have been used to explore the biomechanics of scoliosis surgery with a range of different implant types [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], the biomechanics of scoliosis progression (worsening of the deformity) during spinal growth [20][21][22][23][24], and the biomechanics of non-surgical scoliosis treatment using orthotic braces [25][26][27][28][29]. These models have convincingly demonstrated the value of FE simulations in developing treatment strategies to optimize deformity correction and reduce complications; however, they are currently limited in their ability to predict the response of individual spinal tissues (bones, discs, ligaments) to treatment, due to the simplified FE representations of the spinal joints.…”

Section: Introductionmentioning

confidence: 99%

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Patient‐specific computational biomechanics for simulating adolescent scoliosis surgery: Predicted vs clinical correction for a preliminary series of six patients

Little

Adam

2010

Numer Methods Biomed Eng

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SUMMARYScoliosis is a spinal deformity that requires surgical correction in progressive cases. In order to optimize surgery outcomes, patient-specific finite element models are being developed by our group. In this paper, a single rod anterior correction procedure is simulated for a group of six scoliosis patients. For each patient, personalized model geometry was derived from low-dose CT scans, and clinically measured intra-operative corrective forces were applied. However, tissue material properties were not patient-specific, being derived from existing literature. Clinically, the patient group had a mean initial Cobb angle of 47.3 • , which was corrected to 17.5 • after surgery. The mean simulated post-operative Cobb angle for the group was 18.1 • . Although this represents good agreement between clinical and simulated corrections, the discrepancy between clinical and simulated Cobb angle for individual patients varied between −10.3 and +8.6 • , with only three of the six patients matching the clinical result to within accepted Cobb measurement error of ±5 • . The results of this study suggest that spinal tissue material properties play an important role in governing the correction obtained during surgery, and that patient-specific modelling approaches must address the question of how to prescribe patient-specific soft tissue properties for spine surgery simulation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient‐specific computational biomechanics for simulating adolescent scoliosis surgery: Predicted vs clinical correction for a preliminary series of six patients

Little

Adam

2010

Numer Methods Biomed Eng

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“…This suggested that the partially reduced spine presented stiffer properties than totally reduced spines. To obtain partial correction resulting from the application of smaller forces than for total correction, the personalised stiffness properties of the spine should be included in the model, as proposed by VIVIANI et al (1986). The overcorrection resulted from the application of higher forces than for total correction, but with equivalent forces to those for partial correction.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of Cheneau-Toulouse-Munster brace in the treatment of scoliosis using optimisation approach and finite element method

Périé

Gauzy

Hobatho

2002

Med. Biol. Eng. Comput.

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The aim of the study was to investigate the mechanisms of the Cheneau-Toulouse-Munster (CTM) brace in the correction of scoliotic curves, at night in the supine position. Magnetic resonance imaging (MRI) and Computer tomography (CT) acquisitions were performed in vivo on eight girls having an idiopathic scoliosis and being treated for the first time using a personalized CTM brace. Personalized 3D finite element models of the spine were developed for each patient, and an optimisation approach was used to quantify the forces generated by each brace on each scoliotic spine. A sensitivity study was undertaken to test the assumptions about intervertebral behaviour and load transmission from the brace to the spine. The computed CTM brace forces were 9-216N in the coronal plane and 2-72N in the sagittal plane. Personalized spinal stiffness properties should be included in spine models because, in this study, partial correction resulted from the application of higher estimated forces than for total correction. Partially reduced spines should be stiffer than totally reduced spines. The sensitivity study showed that the computed brace forces were proportional to the intervertebral Young's modulus and should be analysed as estimated data. Better knowledge of brace forces should be helpful in brace design to achieve the best correction of first scoliotic deformities.

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“…In 1986, Viviani et al [4] first described a twodimensional model, based on the establishment of a linear finite element method, for the analysis of the internal fixation rate with respect to the size of the deformity. There have since been additional reports of AIS orthopedic finite element simulation [5][6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Use of finite element analysis of a Lenke type 5 adolescent idiopathic scoliosis case to assess possible surgical outcomes

Zhang

YongFu

et al. 2013

Computer Aided Surgery

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Objective: To use the finite element model of a Lenke 5 adolescent idiopathic scoliosis (AIS) patient to simulate four corrections (including anterior and posterior correction); to investigate the corrective effect of different surgical protocols; and to analyze the biomechanical stress and strain of the scoliotic spines. Methods: Four surgical strategies were designed and simulated with the model of scoliosis. All the main steps of each strategy, including derotation and compression, were simulated. The stress variation of the spine and the corrective effect were compared among the protocols for different surgical approaches and fusion levels. Results: With the four different surgical protocols, the coronary lumbar deformity was corrected to 22 , 23 , 26 and 26 , respectively, and a physiological sagittal configuration was maintained; however, higher stress was observed with solutions A1 (screw model implanted in the convex side of T12-L3) and A2 (screw model implanted in the convex side of T11-L4), while solution B2 (the posterior approach: T10-L5, fusion to SV) lost too many lumbar movement segments. A similar apical rotational correction was recorded (41.68 and 37.79 ) for solutions A2 and B1 (the posterior approach: T10-L4, fusion to LEV), which both instrumented the lower end vertebrae. Conclusions: The presented model could be used successfully to simulate correction procedures, including 90 derotation and compression, for the first time. The Lenke 5 AIS in this particular case was more rigid, and solution B1 was considered the ideal choice for treatment of this patient.

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Biomechanical Analysis and Simulation of Scoliosis Surgical Correction

Cited by 15 publications

References 0 publications

Patient‐specific computational biomechanics for simulating adolescent scoliosis surgery: Predicted vs clinical correction for a preliminary series of six patients

Patient‐specific computational biomechanics for simulating adolescent scoliosis surgery: Predicted vs clinical correction for a preliminary series of six patients

Biomechanical evaluation of Cheneau-Toulouse-Munster brace in the treatment of scoliosis using optimisation approach and finite element method

Use of finite element analysis of a Lenke type 5 adolescent idiopathic scoliosis case to assess possible surgical outcomes

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