Effects of nucleus pulposus location on spinal loads and joint centers of rotation and reaction during forward flexion: A combined finite element and Musculoskeletal study

Cervical anatomy and its relation to foraging habits in aquatic birds (Aves: Neornithes: Neoaves)

Birds have extremely flexible necks, which help in their search for food. However, studies on the variation in bird cervical anatomy and its relationship with foraging are rare, despite the different habits presented between species. Here, we analyze the anatomy of the neck of aquatic birds and relate it to their foraging strategies. We dissected specimens representing four species of Charadriiformes, 11 species of Phaethoquornithes, and two specimens belonging to the outgroup Telluraves. We chose to emphasize Charadriiformes and Phaethoquornithes because they present several strategies that require cervical mobility and stability. We note that vertebral anatomy and dimensions vary, which affects the shape and size of the soft tissues attached throughout the neck. The synovial cartilage present in the articulatio intercorporalis represents an additional length in the neck, however, this is not longer than that observed in animals with intervertebral discs. Our analysis indicates that birds have a prevalence of dorsoventral movements in the middle of the neck and lateral and rotational movements near the base of the neck, while the region near the head presents a wide range of movement in all directions. Cervical ligaments and muscles throughout the neck provide stability in all segments, although the robustness of the soft tissues indicates that the most caudal portion of the neck is the most stable. The vertebral and soft tissue anatomy is consistent with the extensive mobility in pitching, yaw, and roll movements performed mainly by the head and first segment of the neck during the different foraging of the analyzed birds. Furthermore, the muscles closer to the skull are robust and allow the execution of a variety of habits to capture food in different species. The subsequent cervical segments present differences that explain their reduction in mobility, but they are equally stable.

Development of a finite element full spine model with active muscles for quantitatively analyzing sarcopenia effects on lumbar load

BACKGROUND AND OBJECTIVE

The musculoskeletal imbalance caused by disease is one of the most critical factors leading to spinal injuries, like sarcopenia. However, the effects of musculoskeletal imbalances on the spine are difficult to quantitatively investigate. Thus, a complete finite element spinal model was established to analyze the effects of musculoskeletal imbalance, especially concerning sarcopenia.

METHODS

A finite element spinal model with active muscles surrounding the vertebrae was established and validated from anatomic verification to the whole spine model in dynamic loading at multiple levels. It was then coupled with the previously developed neuromuscular model to quantitatively analyze the effects of erector spinae (ES) and multifidus (MF) sarcopenia on spinal tissues. The severity of the sarcopenia was classified into three levels by changing the physiological cross-sectional area (PCSA) of ES and MF, which were mild (60% PCSA of ES and MF), moderate (48% PCSA of ES and MF), and severe (36% PCSA of ES and MF).

RESULTS

The stress and strain levels of most lumbar tissues in the sarcopenia models were more significant than those of the normal model during spinal extension movement. The sarcopenia caused load concentration in several specific regions. The stress level of the L4-L5 intervertebral disc and L1 vertebra significantly increased with the severity of sarcopenia and showed relatively larger values than other segments. From the normal model to a severe sarcopenia model, the stress value of the L4-L5 intervertebral disc and L1 vertebra increased by 128% and 113%, respectively. The strain level of L5-S1 also inclined significantly with the severity of sarcopenia, and the relatively larger capsule strain values occurred at lower back segments from L3 to S1.

CONCLUSIONS

In summary, the validated spinal coupling model can be used for spinal injury risk analysis caused by musculoskeletal imbalance. The results suggested that sarcopenia can primarily lead to high injury risk of the L4-L5 intervertebral disc, L1 vertebrae, and L3-S1 joint capsule regarding significant stress or strain variance.

Sensitivity of subject-specific upper body musculoskeletal model predictions to mass scaling methods

Accurate predictions of spinal loads in subject-specific musculoskeletal models require precise body segment parameters, including segment mass and center of mass (CoM) locations. Existing upper body models often assume a constant percentage of total body mass to calculate segmental masses, disregarding inter-individual variability and limiting their predictive capacity. This study evaluated the sensitivity of subject-specific upper body musculoskeletal model predictions to body mass scaling methods. The upper body segmental masses and corresponding CoM of six male subjects with varying body mass indices were computed using two mass scaling methods: the constant-percentage-based (CPB) scaling method, commonly used in AnyBody software; and our recently developed body-shape-based (BSB) method. Subsequently, these values were used by a validated musculoskeletal model to predict the muscle and disc forces in upright and flexed postures. The discrepancies between the results of the two scaling methods were compared across subjects and postures. Maximum deviations in thorax masses reached up to 7.5% of total body weight (TBW) in overweight subjects, while maximum CoM location differences of up to 35 mm were observed in normal weight subjects. The root mean squared errors (RMSE) of the CPB results, calculated with the BSB results as baseline, showed that the muscle and shear forces of the two scaling methods were quite similar (<4.5% of TBW). Though, there were small to moderate differences in compressive forces (6.5-16.0% of TBW). Thus, the compressive forces predicted with CPB method should be used with caution, particularly for overweight and obese subjects.

Automatic generation of subject-specific finite element models of the spine from magnetic resonance images

The generation of subject-specific finite element models of the spine is generally a time-consuming process based on computed tomography (CT) images, where scanning exposes subjects to harmful radiation. In this study, a method is presented for the automatic generation of spine finite element models using images from a single magnetic resonance (MR) sequence. The thoracic and lumbar spine of eight adult volunteers was imaged using a 3D multi-echo-gradient-echo sagittal MR sequence. A deep-learning method was used to generate synthetic CT images from the MR images. A pre-trained deep-learning network was used for the automatic segmentation of vertebrae from the synthetic CT images. Another deep-learning network was trained for the automatic segmentation of intervertebral discs from the MR images. The automatic segmentations were validated against manual segmentations for two subjects, one with scoliosis, and another with a spine implant. A template mesh of the spine was registered to the segmentations in three steps using a Bayesian coherent point drift algorithm. First, rigid registration was applied on the complete spine. Second, non-rigid registration was used for the individual discs and vertebrae. Third, the complete spine was non-rigidly registered to the individually registered discs and vertebrae. Comparison of the automatic and manual segmentations led to dice-scores of 0.93-0.96 for all vertebrae and discs. The lowest dice-score was in the disc at the height of the implant where artifacts led to under-segmentation. The mean distance between the morphed meshes and the segmentations was below 1 mm. In conclusion, the presented method can be used to automatically generate accurate subject-specific spine models.

Recent Advances in Coupled MBS and FEM Models of the Spine—A Review

How back pain is related to intervertebral disc degeneration, spinal loading or sports-related overuse remains an unanswered question of biomechanics. Coupled MBS and FEM simulations can provide a holistic view of the spine by considering both the overall kinematics and kinetics of the spine and the inner stress distribution of flexible components. We reviewed studies that included MBS and FEM co-simulations of the spine. Thereby, we classified the studies into unidirectional and bidirectional co-simulation, according to their data exchange methods. Several studies have demonstrated that using unidirectional co-simulation models provides useful insights into spinal biomechanics, although synchronizing the two distinct models remains a key challenge, often requiring extensive manual intervention. The use of a bidirectional co-simulation features an iterative, automated process with a constant data exchange between integrated subsystems. It reduces manual corrections of vertebra positions or reaction forces and enables detailed modeling of dynamic load cases. Bidirectional co-simulations are thus a promising new research approach for improved spine modeling, as a main challenge in spinal biomechanics is the nonlinear deformation of the intervertebral discs. Future studies will likely include the automated implementation of patient-specific bidirectional co-simulation models using hyper- or poroelastic intervertebral disc FEM models and muscle forces examined by an optimization algorithm in MBS. Applications range from clinical diagnosis to biomechanical analysis of overload situations in sports and injury prediction.

A novel coupled musculoskeletal finite element model of the spine - Critical evaluation of trunk models in some tasks

Spine musculoskeletal (MS) models make simplifying assumptions on the intervertebral joint degrees-of-freedom (rotational and/or translational), representation (spherical or beam-like joints), and properties (linear or nonlinear). They also generally neglect the realistic structure of the joints with disc nuclei/annuli, facets, and ligaments. We aim to develop a novel MS model where trunk muscles are incorporated into a detailed finite element (FE) model of the ligamentous T12-S1 spine thus constructing a gold standard coupled MS-FE model. Model predictions are compared under some tasks with those of our earlier spherical joints, beam joints, and hybrid (uncoupled) MS-FE models. The coupled model predicted L4-L5 intradiscal pressures (R² ≅ 0.97, RMSE ≅ 0.27 MPa) and L1-S1 centers of rotation (CoRs) in agreement to in vivo data. Differences in model predictions grew at larger trunk flexion angles; at the peak (80°) flexion the coupled model predicted, compared to the hybrid model, much smaller global/local muscle forces (~38%), segmental (~44%) and disc (~22%) compression forces but larger segmental (~9%) and disc (~17%) shear loads, ligament forces at the lower lumbar levels (by up to 57%) and facet forces at all levels. The spherical/beam joints models predicted much greater muscle forces and segmental loads under larger flexion angles. Unlike the spherical joints model with fixed CoRs, the beam joints model predicted CoRs closer (RMSE = 2.3 mm in flexion tasks) to those of the coupled model. The coupled model offers a great potential for future studies towards improvement of surgical techniques, management of musculoskeletal injuries and subject-specific simulations.