Abstract
Scoliosis is a three-dimensional spinal deformity which requires surgical correction in progressive cases. In order to optimize correction and avoid complications following scoliosis surgery, patient-specific finite element models (FEM) are being developed and validated by our group. In this paper, the modeling methodology is described and two clinically relevant load cases are simulated for a single patient. Firstly, a pre-operative patient flexibility assessment, the fulcrum bending radiograph, is simulated to assess the model’s ability to represent spine flexibility. Secondly, intra-operative forces during single rod anterior correction are simulated. Clinically, the patient had an initial Cobb angle of 44 degrees, which reduced to 26 degrees during fulcrum bending. Surgically, the coronal deformity corrected to 14 degrees. The simulated initial Cobb angle was 40 degrees, which reduced to 23 degrees following the fulcrum bending load case. The simulated surgical procedure corrected the coronal deformity to 14 degrees. The computed results for the patient-specific FEM are within the accepted clinical Cobb measuring error of 5 degrees, suggested that this modeling methodology is capable of capturing the biomechanical behaviour of a scoliotic human spine during anterior corrective surgery.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Aubin, C.E., et al.: Biomechanical modeling of posterior instrumentation of the scoliotic spine. Comp. Meth. Biomech. Biomed. Eng. 6(1), 27–32 (2003)
Dumas, R., et al.: Personalized body segment parameters from biplanar low-dose radiography. IEEE Trans. Biomed. Eng. 52(10), 1756–1763 (2005)
Little, J.P., Adam, C.J.: The effect of soft tissue properties on spinal flexibility in scoliosis: biomechanical simulation of fulcrum bending. Spine (Phila Pa 1976) 34(2), E76–E82 (2009)
Lu, Y.M., Hutton, W.C., Gharpuray, V.M.: Do bending, twisting, and diurnal fluid changes in the disc affect the propensity to prolapse? A viscoelastic finite element model. Spine 21(22), 2570–2579 (1996)
Little, J.P.: Finite element modelling of anular lesions in the lumbar intervertebral disc, in School of Mechanical, Manufacturing and Medical Engineering. Queensland University of Technology, Brisbane, Australia, p. 361 (2004)
Kumaresan, S., et al.: Finite element modeling of the cervical spine: role of intervertebral disc under axial and eccentric loads. Med. Eng. Phys. 21(10), 689–700 (1999)
Nachemson, A.: Lumbar Intradiscal Pressure: experimental studies on post-mortem material. Acta Orthopaedica Scandinavica, 43 (1960)
Lemosse, D., et al.: Characterization of the mechanical behaviour parameters of the costo-vertebral joint. Eur. Spine J. 7(1), 16–23 (1998)
Chazal, J., et al.: Biomechanical properties of spinal ligaments and a histological study of the supraspinal ligament in traction. J. Biomech. 18(3), 167–176 (1985)
Nolte, L.P., Panjabi, M., Oxland, T.: Biomechanical properties of lumbar spinal ligaments. In: Heimke, G., Soltesz, U., Lee, A.J.C. (eds.) Clin. implant mat., pp. 663–668. Elsevier Science Publishing, Amsterdam (1990)
Cheung, K.M., Luk, K.D.: Prediction of correction of scoliosis with use of the fulcrum bending radiograph. J. Bone Joint Surg. 79(8), 1144–1150 (1997)
Erdmann, W.S.: Geometric and inertial data of the trunk in adult males. J. Biomech. 30(7), 679–688 (1997)
Cunningham, H., Little, J.P., Adam, C.J.: The measurement of applied forces during anterior single rod correction of adolescent idiopathic scoliosis. In: ACSR Annual Meeting, Adelaide, Australia (2009)
Torell, G., et al.: Standing and supine Cobb measures in girls with idiopathic scoliosis. Spine 10, 425–427 (1985)
Vrtovec, T., Pernus, F., Likar, B.: A review of methods for quantitative evaluation of spinal curvature. Eur. Spine J. 18, 593–607 (2009)
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Little, J.P., Adam, C. (2010). Development of a Computer Simulation Tool for Application in Adolescent Spinal Deformity Surgery. In: Bello, F., Cotin, S. (eds) Biomedical Simulation. ISBMS 2010. Lecture Notes in Computer Science, vol 5958. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-11615-5_10
Download citation
DOI: https://doi.org/10.1007/978-3-642-11615-5_10
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-642-11614-8
Online ISBN: 978-3-642-11615-5
eBook Packages: Computer ScienceComputer Science (R0)