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Jain P, Khan MR. Selection of suitable pedicle screw for degenerated cortical and cancellous bone of human lumbar spine: A finite element study. Int J Artif Organs 2020; 44:361-366. [PMID: 33045876 DOI: 10.1177/0391398820964483] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Pedicular arthrodesis is the traditional procedure in terms of increase in the biomechanical stability with higher fixation rate. The current work aims to identify the effect of three spinal pedicle screws considering cortical and cancellous degeneracy condition. Lumbar section L2-L3 is utilized and various load and moment conditions were applied to depict the various biomechanical parameters for selection of suitable screw. Three dimensional model is considered in finite element analysis to identify the various responses of pedicle screw at bone screw juncture. Computed tomography (CT) images of a healthy male were considered to generate the finite element vertebral model. Generated intact model was further utilized to develop the other implanted models of degenerated cortical and cancellous bone models. The three fused instrumented models with different cortical and cancellous degeneracy conditions were analyzed in finite element analysis. The results were obtained as stress pattern at bone screw boundary and intervertebral disc stress. FE simulated results represents significant changes in the von Mises stress due to various load and moment conditions on degenerated bones during different body movement conditions. Results have shown that among all pedicle screws, the 6.0 mm diameter screw reflects very less stress values at the juncture. Multiple results on biomechanical aspects obtained during the FE study can be considered to design a new stabilization device and may be helpful to plan surgery of critical sections.
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Affiliation(s)
- Pushpdant Jain
- School of Mechanical Engineering, VIT Bhopal University, Madhya Pradesh, India
| | - Mohammed Rajik Khan
- Department of Industrial Design, National Institute of Technology Rourkela, Odisha, India
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Dillon CF, Weisman MH. US National Health and Nutrition Examination Survey Arthritis Initiatives, Methodologies and Data. Rheum Dis Clin North Am 2018; 44:215-265. [PMID: 29622293 DOI: 10.1016/j.rdc.2018.01.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The US National Health and Nutrition Examination Survey (NHANES) has collected population-based, nationally representative examination, laboratory, and radiographic data for arthritis and musculoskeletal diseases for more than 50 years. The resulting body of data and publications are substantial, yet much data remain unpublished. This review provides a basic understanding of the design and capabilities of the NHANES survey, reviewing the major accomplishments in the area of arthritis and musculoskeletal diseases. Currently available US National Health and Nutrition Examination Survey arthritis-related datasets are identified. Guidelines for using these data, and opportunities for data analysis and designing future studies are presented.
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Affiliation(s)
| | - Michael H Weisman
- Division of Rheumatology, Cedars Sinai Medical Center, 1545 Calmar Court, Los Angeles, CA 90024, USA
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Jarraya M, Guermazi A, Lorbergs AL, Brochin E, Kiel DP, Bouxsein ML, Cupples LA, Samelson EJ. A longitudinal study of disc height narrowing and facet joint osteoarthritis at the thoracic and lumbar spine, evaluated by computed tomography: the Framingham Study. Spine J 2018; 18:2065-2073. [PMID: 29679729 PMCID: PMC6195485 DOI: 10.1016/j.spinee.2018.04.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 02/27/2018] [Accepted: 04/10/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Prevalence and progression of disc height narrowing (DHN) and facet joint osteoarthritis (FJOA) in the thoracic and lumbar regions in non-clinical populations are not well established. PURPOSE The present study aimed to use computed tomography (CT) images to determine the prevalence and progression of DHN and FJOA according to age, sex, and spinal region. STUDY DESIGN This is a 6-year longitudinal study. SAMPLE A total of 1,195 members of the Framingham Study (mean baseline age 61±9 years) were included in the study. OUTCOME MEASURES We compared the prevalence and progression (new or worsening) of moderate-to-severe DHN and FJOA by age, sex, and spinal region. METHODS A musculoskeletal radiologist evaluated DHN and FJOA from T4/T5 to L4/L5 on baseline and follow-up CT images using a semi-quantitative scale: 0=normal, 1=mild, 2=moderate, and 3=severe. RESULTS One-third or more of women and men ages 40-59 years at baseline had imaged-based evidence of prevalent DHN, more than half had prevalent FJOA, and DHN and FJOA prevalence increased approximately two- to fourfold in those age 60-69 and 70-89 years at baseline, respectively (p<.01). Progression of DHN and FJOA occurred more frequently at the lumbar than at the thoracic spine and more in women than in men (DHN: odds ratio [OR]=1.42, 95% confidence interval [CI]=1.07, 1.88; FJOA: OR=1.70, CI=1.33, 2.17). CONCLUSIONS Prevalence and progression of moderate-to-severe DHN and FJOA are common in non-clinical populations of older adults. The high frequency of spinal degeneration observed on CTs in this community-based study may contribute to challenges in interpreting the clinical significance of imaging evidence of DHN and FJOA. Future studies investigating the association of CT-based spinal degenerative features with pain and functional impairments in population-based samples are needed to help determine the clinical significance of imaged-based findings of DHN and FJOA.
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Affiliation(s)
- Mohamed Jarraya
- Quantitative Imaging Center, Boston University School of Medicine, 820 Harrison Ave, 3rd Floor, Boston, MA 02118, USA
| | - Ali Guermazi
- Quantitative Imaging Center, Boston University School of Medicine, 820 Harrison Ave, 3rd Floor, Boston, MA 02118, USA
| | - Amanda L. Lorbergs
- Institute for Aging Research, Hebrew SeniorLife, 1200 Center Street, Boston, MA 02131, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA,Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Elana Brochin
- Institute for Aging Research, Hebrew SeniorLife, 1200 Center Street, Boston, MA 02131, USA
| | - Douglas P. Kiel
- Institute for Aging Research, Hebrew SeniorLife, 1200 Center Street, Boston, MA 02131, USA,Department of Medicine, Harvard Medical School, Boston, MA, USA,Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Mary L. Bouxsein
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, RN115, 330 Brookline Avenue, Boston, MA 02215, USA,Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA
| | - L. Adrienne Cupples
- Department of Biostatistics and Epidemiology, Boston University School of Public Health, Crosstown Building, 801 Massachusetts Avenue 3rd Floor, Boston, MA 02118 USA,Framingham Heart Study, Framingham, MA, USA
| | - Elizabeth J. Samelson
- Corresponding author. Institute for Aging Research, Hebrew SeniorLife, 1200 Centre Street, Boston, MA 02131. Tel.: 617-971-5383; fax: 617-971-5339.
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