Phantom -based lumbar spine experimental investigation and validation of a multibody model

Borrelli, Simone; Formaggio, Andrea; Civilini, Vittoria; Lugas, Andrea T.

doi:10.2495/cmem-v9-n3-226-238

Cited by 3 publications

(4 citation statements)

References 75 publications

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“…The biomechanical loads applied to the biomimetic phantom included flexion, extension, and lateral bending as well as clockwise and anticlockwise axial rotation. Tests were performed recurring to a spine-loading apparatus already described in a previous study (Borrelli et al, 2021) and shown in Figure 1. Briefly, this spineloading apparatus orients the phantom to make the L3 inferior endplate horizontal, consistent with the anatomical orientation of lumbar segment (Wilke et al, 1998), and it allows bending through an eccentric vertical load applied to the cranial vertebra Frontiers in Bioengineering and Biotechnology frontiersin.org with S1 fixed to the machine (Patwardhan et al, 1999;Cripton et al, 2000;Marras et al, 2021;Ou et al, 2021;Garavelli et al, 2022).…”

Section: Testing Apparatus and Testing Proceduresmentioning

confidence: 99%

Cross-link augmentation enhances CFR-PEEK short fixation in lumbar metastasis stabilization

Borrelli

Putame²,

Audenino³

et al. 2023

Front. Bioeng. Biotechnol.

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Introduction: Spinal stability plays a crucial role in the success of the surgical treatment of lumbar vertebral metastasis and, in current practice, less invasive approaches such as short constructs have been considered. Concurrently, carbon fiber-reinforced (CFR) poly-ether-ether-ketone (PEEK) fixation devices are expanding in oncologic spinal surgery thanks to their radiotransparency and valid mechanical properties. This study attempts to provide an exhaustive biomechanical comparison of different CFR-PEEK surgical stabilizations through a highly reproducible experimental setup.Methods: A Sawbones biomimetic phantom (T12-S1) was tested in flexion, extension, lateral bending, and axial rotation. An hemisome lesion on L3 vertebral body was mimicked and different pedicle screw posterior fixations were realized with implants from CarboFix Orthopedics Ltd: a long construct involving two spinal levels above and below the lesion, and a short construct involving only the levels adjacent to L3, with and without the addition of a transverse rod-rod cross-link; to provide additional insights on its long-term applicability, the event of a pedicle screw loosening was also accounted.Results: Short construct reduced the overloading onset caused by long stabilization. Particularly, the segmental motion contribution less deviated from the physiologic pattern and also the long-chain stiffness was reduced with respect to the prevalent long construct. The use of the cross-link enhanced the short stabilization by making it significantly stiffer in lateral bending and axial rotation, and by limiting mobiliza-tion in case of pedicle screw loosening.Discussion: The present study proved in vitro the biomechanical benefits of cross-link augmentation in short CFR-PEEK fixation, demonstrating it to be a potential alternative to standard long fixation in the surgical management of lumbar metastasis.

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Section: Testing Apparatus and Testing Proceduresmentioning

confidence: 99%

Cross-link augmentation enhances CFR-PEEK short fixation in lumbar metastasis stabilization

Borrelli

Putame²,

Audenino³

et al. 2023

Front. Bioeng. Biotechnol.

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“…The direction of this load can be either always vertical (M + LL1), or can maintain the same relative orientation with the most cranial vertebra during the motion (M + LL2), or can be defined so that the force acts along the line connecting the cranial vertebra’s center to the caudal vertebra’s center (M + LL3). Configurations M + LL1 and M + LL2 are actually equivalent to vertical eccentric forces generating both a bending moment and a compression force 6 , 19 . Rarely bending moments were obtained by applying a shear force along the construct’s antero-posterior direction 9 .…”

Section: Synthetic View Of Loading Set-ups In Literaturementioning

confidence: 99%

“… Study Spinal levels (No. of samples) Cranial vertebrae DOF Load Preload Classification Belwadi et al (2008) [ 3 ] T12–L2 (10), L4–S1 (9) Sagittal motion Force up to spinal failure – HLsf, M Bennett et al (2013) [ 4 ] L4–L5 (6) Free 8 Nm FL 400 N M, M + LL2 Bennett et al (2015) [ 5 ] L4–-L5 (6) Free 8 Nm FL 400 N M, M + LL1, M + LL2 Borrelli et al (2021) [ 6 ] T12–S1 (1)—synthethic Free 3 Nm (F); 2 Nm (E) LL 1 N M + LL1 Charriere et al (2006) [ 7 ] L5–S1 (7) Free/Sagittal motion 2.5, 5, 7.5, 10 Nm – M Cripton et al (2000) [ 8 ] L1–L2 (1), L2–L3 (3), L3–L4 (1), L4–L5 (1) Free/Sagittal motion 5 Nm LL 200, 400 N M, M + LL1, M + LL2 Demetropoulos et al (1998) [ 9 ] T12–L5 (10) Free Cranial vertebra motion – HLsf Di Angelo et al ...…”

Section: Synthetic View Of Loading Set-ups In Literaturementioning

confidence: 99%

In Silico Meta-Analysis of Boundary Conditions for Experimental Tests on the Lumbar Spine

et al. 2022

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The study of the spine range of motion under given external load has been the object of many studies in literature, finalised to a better understanding of the spine biomechanics, its physiology, eventual pathologic conditions and possible rehabilitation strategies. However, the huge amount of experimental work performed so far cannot be straightforwardly analysed due to significant differences among loading set-ups. This work performs a meta-analysis of various boundary conditions in literature, focusing on the flexion/extension behaviour of the lumbar spine. The comparison among range of motions is performed virtually through a validated multibody model. Results clearly illustrated the effect of various boundary conditions which can be met in literature, so justifying differences of biomechanical behaviours reported by authors implementing different set-up: for example, a higher value of the follower load can indeed result in a stiffer behaviour; the application of force producing spurious moments results in an apparently more deformable behaviour, however the respective effects change at various segments along the spine due to its natural curvature. These outcomes are reported not only in qualitative, but also in quantitative terms. The numerical approach here followed to perform the meta-analysis is original and it proved to be effective thanks to the bypass of the natural variability among specimens which might completely or partially hinder the effect of some boundary conditions. In addition, it can provide very complete information since the behaviour of each functional spinal unit can be recorded. On the whole, the work provided an extensive review of lumbar spine loading in flexion/extension.

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“…It is particularly suitable for biomechanical applications compared to other strain measurement techniques such as strain gauges, which are invasive and only provide a local measurement, or thermoelastic analyses, which in some conditions are not applicable to biological tissues [33,34]. Furthermore, optical measurements can be successfully coupled with finite element method and multibody modeling in order to achieve a complete mechanical characterization [35][36][37][38][39].…”

Section: Introductionmentioning

confidence: 99%

Digital Image Correlation analysis on the bone displacement during split crest: an ex vivo study

Lugas

Terzini²,

Stacchi³

et al. 2022

J. Phys.: Conf. Ser.

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The split crest is an established surgical technique for horizontal bone augmentation. It allows to place implants of adequate diameter in sites where the bone would be too thin for the implantation. In this study, two split crest techniques (using threaded bone expanders or ultrasonic bone surgery) were performed ex vivo on bovine ribs, and dental implants were then inserted in the so prepared implantation sites. Digital image correlation was used to measure the bone external surface displacement throughout the surgical procedures. Both techniques provided an adequate bone volume for implant insertion, and no significant differences were highlighted regarding the displacement. However, bone accidental fracture only occurred during split crest with threaded bone expanders, suggesting differences in the internal strain distribution induced by the two techniques.

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Phantom -based lumbar spine experimental investigation and validation of a multibody model

Cited by 3 publications

References 75 publications

Cross-link augmentation enhances CFR-PEEK short fixation in lumbar metastasis stabilization

Cross-link augmentation enhances CFR-PEEK short fixation in lumbar metastasis stabilization

In Silico Meta-Analysis of Boundary Conditions for Experimental Tests on the Lumbar Spine

Digital Image Correlation analysis on the bone displacement during split crest: an ex vivo study

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