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Chetoui MA, Ambard D, Canãdas P, Kouyoumdjian P, Royer P, Le Floc'h S. Impact of extracellular matrix and collagen network properties on the cervical intervertebral disc response to physiological loads: A parametric study. Med Eng Phys 2022; 110:103908. [PMID: 36564135 DOI: 10.1016/j.medengphy.2022.103908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/03/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022]
Abstract
Current intervertebral disc finite element models are hard to validate since they describe multi-physical phenomena and contain a huge number of material properties. This work aims to simplify numerical validation/identification studies by prioritizing the sensitivity of intervertebral disc behavior to mechanical properties. A 3D fiber-reinforced hyperelastic model of a C6-C7 intervertebral disc is used to carry out the parametric study. 10 parameters describing the extracellular matrix and the collagen network behaviors are included in the parametric study. The influence of varying these parameters on the disc response is estimated during physiological movements of the head, including compression, lateral bending, flexion, and axial rotation. The obtained results highlight the high sensitivity of the disc behavior to the stiffness of the annulus fibrosus extracellular matrix for all the studied loads with a relative increase in the disc apparent stiffness by 67% for compression and by 57% for axial rotation when the annulus stiffness increases from 0.4 to 2 MPa. It is also shown that varying collagen network orientation, stiffness, and stiffening in the studied configuration range have a noticeable effect on rotational motions with a relative apparent stiffness difference reaching 6.8%, 10%, and 22%, respectively, in lateral bending. However, the collagen orientation does not affect disc response to axial load.
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Affiliation(s)
| | | | - Patrick Canãdas
- LMGC UMR5508, Univ. of Montpellier, CNRS, Montpellier, France
| | - Pascal Kouyoumdjian
- Orthopedic Surgery and Trauma Service, Spine Surgery, CHRU of Nîmes, Nîmes, France
| | - Pascale Royer
- LMGC UMR5508, Univ. of Montpellier, CNRS, Montpellier, France
| | - Simon Le Floc'h
- LMGC UMR5508, Univ. of Montpellier, CNRS, Montpellier, France
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In vivo intervertebral disc deformation: intratissue strain patterns within adjacent discs during flexion-extension. Sci Rep 2021; 11:729. [PMID: 33436667 PMCID: PMC7804136 DOI: 10.1038/s41598-020-77577-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 11/10/2020] [Indexed: 01/29/2023] Open
Abstract
The biomechanical function of the intervertebral disc (IVD) is a critical indicator of tissue health and pathology. The mechanical responses (displacements, strain) of the IVD to physiologic movement can be spatially complex and depend on tissue architecture, consisting of distinct compositional regions and integrity; however, IVD biomechanics are predominately uncharacterized in vivo. Here, we measured voxel-level displacement and strain patterns in adjacent IVDs in vivo by coupling magnetic resonance imaging (MRI) with cyclic motion of the cervical spine. Across adjacent disc segments, cervical flexion-extension of 10° resulted in first principal and maximum shear strains approaching 10%. Intratissue spatial analysis of the cervical IVDs, not possible with conventional techniques, revealed elevated maximum shear strains located in the posterior disc (nucleus pulposus) regions. IVD structure, based on relaxometric patterns of T2 and T1ρ images, did not correlate spatially with functional metrics of strain. Our approach enables a comprehensive IVD biomechanical analysis of voxel-level, intratissue strain patterns in adjacent discs in vivo, which are largely independent of MRI relaxometry. The spatial mapping of IVD biomechanics in vivo provides a functional assessment of adjacent IVDs in subjects, and provides foundational biomarkers for elastography, differentiation of disease state, and evaluation of treatment efficacy.
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Zhou C, Li G, Wang C, Wang H, Yu Y, Tsai TY, Cha T. In vivo intervertebral kinematics and disc deformations of the human cervical spine during walking. Med Eng Phys 2020; 87:63-72. [PMID: 33461675 DOI: 10.1016/j.medengphy.2020.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/29/2020] [Accepted: 11/06/2020] [Indexed: 02/06/2023]
Abstract
The kinematics of the cervical spine during various functional neck motions has been widely reported. However, no data has been reported on the cervical intervertebral kinematics during walking, the most frequently performed daily functional activity. In this study, we evaluated cervical kinematics and disc deformation of asymptomatic subjects during a gait cycle using a dual fluoroscopic imaging system. Our measurements showed that the vertical translation of the cervical spine (1.6 ± 0.1 Hz) occurred at twice the frequency of the gait cycle (0.8 ± 0.1 Hz). The overall ranges of motion (ROMs) of the entire (C2-T1) cervical spine were 5.0 ± 3.1° in the flexion-extension rotation, 3.4 ± 1.0° in the lateral-bending rotation, and 5.8 ± 2.1° in the axial-twisting rotation during walking. Each intervertebral disc (measured at the disc centre location) dynamically deformed in its axial direction in a range of 16.2 ± 5.7% ~ 23.7 ± 8.7% (without significant differences among different segment levels, p > 0.05), similar to the ranges of shear deformations of the same disc (p > 0.05, except for the C7-T1 disc, where p = 0.010). These data could be useful for improvements of diagnosis and treatment methods of cervical pathologies.
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Affiliation(s)
- Chaochao Zhou
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, 159 Wells Avenue, Newton, MA 02459, USA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Guoan Li
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, 159 Wells Avenue, Newton, MA 02459, USA.
| | - Cong Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Haiming Wang
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, 159 Wells Avenue, Newton, MA 02459, USA
| | - Yan Yu
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, 159 Wells Avenue, Newton, MA 02459, USA; Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai, China
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Thomas Cha
- Orthopaedic Bioengineering Research Center, Newton-Wellesley Hospital, Harvard Medical School, 159 Wells Avenue, Newton, MA 02459, USA; Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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LeVasseur CM, Wawrose R, Pitcairn S, Donaldson WF, Lee JY, Anderst WJ. Dynamic functional nucleus is a potential biomarker for structural degeneration in cervical spine discs. J Orthop Res 2019; 37:965-971. [PMID: 30747456 DOI: 10.1002/jor.24252] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Accepted: 02/05/2019] [Indexed: 02/04/2023]
Abstract
If intervertebral disc degeneration can be identified early, preventative treatments may be initiated before symptoms become disabling and costly. Changes in disc mechanics, such as the decrease in the compressive modulus of the nucleus, are some of the earliest signs of degeneration. Therefore, in vivo changes in the disc response to compressive load may serve as a biomarker for pending or early disc degeneration. The aim of this study was to assess the potential for using in vivo dynamic disc deformation to identify pathologic structural degeneration of the intervertebral disc. A validated model-based tracking technique determined vertebral motion from biplane radiographs collected during dynamic flexion/extension and axial rotation of the cervical spine. A computational model of the subaxial intervertebral discs was developed to identify the dynamic functional nucleus of each disc, that is, the disc region that underwent little to no additional compression during dynamic movements. The size and location of the dynamic functional nucleus was determined for 10 C5/C6 spondylosis patients, 10 C5/C6/C7 spondylosis patients, and 10 asymptomatic controls. The dynamic functional nucleus size was sensitive (significantly smaller than controls in 5 of 6 measurements at the diseased disc) and specific (no difference from controls in 9 of 10 measurements at non-diseased discs) to pathologic disc degeneration. These results provide evidence to suggest that structural disc degeneration, manifested by changes in the disc response to functional loading, may be identified in vivo from dynamic imaging collected during functional movements. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 9999:1-7, 2019.
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Affiliation(s)
- Clarissa M LeVasseur
- Department of Orthopedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, 15203, Pennsylvania
| | - Richard Wawrose
- Department of Orthopedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, 15203, Pennsylvania
| | - Samuel Pitcairn
- Department of Orthopedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, 15203, Pennsylvania
| | - William F Donaldson
- Department of Orthopedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, 15203, Pennsylvania
| | - Joon Y Lee
- Department of Orthopedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, 15203, Pennsylvania
| | - William J Anderst
- Department of Orthopedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, 15203, Pennsylvania
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John JD, Yoganandan N, Arun MWJ, Saravana Kumar G. Influence of morphological variations on cervical spine segmental responses from inertial loading. TRAFFIC INJURY PREVENTION 2018; 19:S29-S36. [PMID: 29584503 DOI: 10.1080/15389588.2017.1403017] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 11/05/2017] [Indexed: 06/08/2023]
Abstract
OBJECTIVES The objective of this study was to investigate the influence of morphological variations in osteoligamentous lower cervical spinal segment responses under postero-anterior inertial loading. METHODS A parametric finite element model of the C5-C6 spinal segment was used to generate models. Variations in the vertebral body and facet depth (anteroposterior), posterior process length, intervertebral disc height, facet articular process height and slope, segment orientation ranging from lordotic to straight, and segment size were parameterized. These variations included male-female differences. A Latin hypercube sampling method was used to select parameter values for model generation. Forces and moments associated with the inertial loading were applied to the generated model segments. The 7 parameters were grouped as local or global depending on the number of spinal components involved in the shape variation. Four output responses representing overall segmental and soft tissue responses were analyzed for each model variation: response angle of the segment, anterior longitudinal ligament stretch, anterior capsular ligament stretch, and facet joint compression in the posterior region. Pearson's correlation coefficient was used to compute the correlations of these output responses with morphological variations. RESULTS Fifty models were generated from the parameterized model using a Latin hypercube sampling technique. Variation in response angle among the models was 4° and was most influenced by change in the combined dimension of vertebral body and facet depth, followed by size of the segment. The maximum anterior longitudinal ligament stretch varied between 0.1 and 0.3 and was strongly influenced by the change in the segment orientation. The anterior facet joint region sustained tension, whereas the posterior region sustained compression. For the anterior capsular ligament stretch, the most influential global variation was segment orientation, whereas the most influential local variations were the facet height and facet angle parameters. In the case of posterior facet joint compression, segment orientation was again most influential, whereas among the local variations, the facet angle had the most influence. CONCLUSION Shape variations in the intervertebral disc influenced segmental rotation and ligament responses; however, the influence of shape variations in the facet joint was confined to capsular ligament responses. Response angle was most influenced by the vertebral body depth variations, explaining greater segmental rotations in female spines. Straighter spine segments sustained greater posterior facet joint compression, which may offer an explanation for the higher incidence of whiplash-associated disorders among females, who exhibit a straighter cervical spine. The anterior longitudinal ligament stretch was also greater in straighter segments. These findings indicate that the morphological features specific to the anatomy of the female cervical spine may predispose it to injury under inertial loading.
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Affiliation(s)
- Jobin D John
- a Department of Neurosurgery , Medical College of Wisconsin , Milwaukee , Wisconsin
- b Department of Engineering Design , Indian Institute of Technology Madras , Chennai , India
| | - Narayan Yoganandan
- a Department of Neurosurgery , Medical College of Wisconsin , Milwaukee , Wisconsin
- c Department of Orthopedic Surgery, Medical College of Wisconsin , Milwaukee , Wisconsin
| | - Mike W J Arun
- a Department of Neurosurgery , Medical College of Wisconsin , Milwaukee , Wisconsin
| | - G Saravana Kumar
- b Department of Engineering Design , Indian Institute of Technology Madras , Chennai , India
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Yu Y, Mao H, Li JS, Tsai TY, Cheng L, Wood KB, Li G, Cha TD. Ranges of Cervical Intervertebral Disc Deformation During an In Vivo Dynamic Flexion-Extension of the Neck. J Biomech Eng 2017; 139:2613837. [PMID: 28334358 DOI: 10.1115/1.4036311] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Indexed: 12/26/2022]
Abstract
While abnormal loading is widely believed to cause cervical spine disc diseases, in vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in vivo functional flexion-extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system (DFIS) and magnetic resonance imaging (MRI)-based three-dimensional (3D) modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6, and C6/7). Five points (anterior, center, posterior, left, and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all the discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine.
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Affiliation(s)
- Yan Yu
- Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai 2000065, China;Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
| | - Haiqing Mao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China
| | - Jing-Sheng Li
- College of Health and Rehabilitation Sciences, Sargent College, Boston University, Boston, MA 02215
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Liming Cheng
- Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Kirkham B Wood
- Department of Orthopaedic Surgery, Stanford University Medical Center, Redwood City, CA 94063
| | - Guoan Li
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, GRJ 1215, Boston, MA 02114 e-mail:
| | - Thomas D Cha
- Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114
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