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Kent R, Cormier J, McMurry TL, Johan Ivarsson B, Funk J, Hartka T, Sochor M. Spinal injury rates and specific causation in motor vehicle collisions. ACCIDENT; ANALYSIS AND PREVENTION 2023; 186:107047. [PMID: 37003164 DOI: 10.1016/j.aap.2023.107047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 02/01/2023] [Accepted: 03/23/2023] [Indexed: 06/19/2023]
Abstract
Motor vehicle collisions (MVCs) are a leading cause of acute spinal injuries. Chronic spinal pathologies are common in the population. Thus, determining the incidence of different types of spinal injuries due to MVCs and understanding biomechanical mechanism of these injuries is important for distinguishing acute injuries from chronic degenerative disease. This paper describes methods for determining causation of spinal pathologies from MVCs based on rates of injury and analysis of the biomechanics require to produce these injuries. Rates of spinal injuries in MVCs were determined using two distinct methodologies and interpreted using a focused review of salient biomechanical literature. One methodology used incidence data from the Nationwide Emergency Department Sample and exposure data from the Crash Report Sample System supplemented with a telephone survey to estimate total national exposure to MVC. The other used incidence and exposure data from the Crash Investigation Sampling System. Linking the clinical and biomechanical findings yielded several conclusions. First, spinal injuries caused by an MVC are relatively rare (511 injured occupants per 10,000 exposed to an MVC), which is consistent with the biomechanical forces required to generate injury. Second, spinal injury rates increase as impact severity increases, and fractures are more common in higher-severity exposures. Third, the rate of sprain/strain in the cervical spine is greater than in the lumbar spine. Fourth, spinal disc injuries are extremely rare in MVCs (0.01 occupants per 10,000 exposed) and typically occur with concomitant trauma, which is consistent with the biomechanical findings 1) that disc herniations are fatigue injuries caused by cyclic loading, 2) the disc is almost never the first structure to be injured in impact loading unless it is highly flexed and compressed, and 3) that most crashes involve predominantly tensile loading in the spine, which does not cause isolated disc herniations. These biomechanical findings illustrate that determining causation when an MVC occupant presents with disc pathology must be based on the specifics of that presentation and the crash circumstances and, more broadly, that any causation determination must be informed by competent biomechanical analysis.
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Affiliation(s)
- Richard Kent
- Center for Applied Biomechanics, Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA; Orthopaedic Surgery, University of Virginia, Charlottesville, VA, USA; Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA; Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
| | - Joseph Cormier
- Biomechanics Consulting and Research, Charlottesville, VA, USA
| | - Timothy L McMurry
- Center for Applied Biomechanics, Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA
| | - B Johan Ivarsson
- Biomechanics Consulting and Research, Charlottesville, VA, USA; Forensic Failure Engineering (FFE), LLC, Tempe, AZ, USA
| | - James Funk
- Center for Applied Biomechanics, Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA; Biomechanics Consulting and Research, Charlottesville, VA, USA
| | - Thomas Hartka
- Center for Applied Biomechanics, Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA; Emergency Medicine, University of Virginia, Charlottesville, VA, USA; Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA
| | - Mark Sochor
- Center for Applied Biomechanics, Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA; Emergency Medicine, University of Virginia, Charlottesville, VA, USA; Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, USA
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Jacobs CAM, Kamali SA, Abdelgawad AM, Meij BP, Ghazanfari S, Tryfonidou MA, Jockenhoevel S, Ito K. Mechanical characterization of a novel biomimetic artificial disc for the cervical spine. J Mech Behav Biomed Mater 2023; 142:105808. [PMID: 37087956 DOI: 10.1016/j.jmbbm.2023.105808] [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: 01/26/2023] [Revised: 03/20/2023] [Accepted: 03/24/2023] [Indexed: 04/25/2023]
Abstract
A novel biomimetic artificial intervertebral disc (bioAID) replacement implant has been developed containing a swelling hydrogel representing the nucleus pulposus, a tensile strong fiber jacket as annulus fibrosus and titanium endplates with pins to primarily secure the device between the vertebral bodies. In this study, the design safety of this novel implant was evaluated based on several biomechanical parameters, namely compressive strength, shear-compressive strength, risk of subsidence and device expulsion as well as identifying the diurnal creep-recovery characteristics of the device. The bioAID remained intact up to 1 kN under static axial compression and only 0.4 mm of translation was observed under a compressive shear load of 20 N. No subsidence was observed after 0.5 million cycles of sinusoidal compressive loading between 50 and 225 N. After applying 400 N in antero-posterior direction under 100 N axial compressive preload, approximately 2 mm displacement was found, being within the range of displacements reported for other commercially available cervical disc replacement devices. The diurnal creep recovery behavior of the bioAID closely resembled what has been reported for natural intervertebral discs in literature. Overall, these results indicate that the current design can withstand (shear-compression loads and is able to remain fixed in a mechanical design resembling the vertebral bodies. Moreover, it is one of the first implants that can closely mimic the poroelastic and viscoelastic behavior of natural disc under a diurnal loading pattern.
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Affiliation(s)
- Celien A M Jacobs
- Orthopedic Biomechanics, Dept. of Biomedical Engineering, Eindhoven University of Technology, De Rondom 70, 5612, AP, Eindhoven, the Netherlands.
| | - S Amir Kamali
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584, CM, Utrecht, the Netherlands.
| | - Abdelrahman M Abdelgawad
- Aachen-Maastricht Institute for Biobased Materials, Faculty of Science and Engineering, Maastricht University, Brightlands Chemelot Campus, Urmonderbaan, 226167, RD, Geleen, the Netherlands; Department of Biohybrid and Medical Textiles (BioTex), AME - Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstraβe 55, 52074, Aachen, Germany.
| | - Björn P Meij
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584, CM, Utrecht, the Netherlands.
| | - Samaneh Ghazanfari
- Aachen-Maastricht Institute for Biobased Materials, Faculty of Science and Engineering, Maastricht University, Brightlands Chemelot Campus, Urmonderbaan, 226167, RD, Geleen, the Netherlands; Department of Biohybrid and Medical Textiles (BioTex), AME - Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstraβe 55, 52074, Aachen, Germany.
| | - Marianna A Tryfonidou
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584, CM, Utrecht, the Netherlands.
| | - Stefan Jockenhoevel
- Aachen-Maastricht Institute for Biobased Materials, Faculty of Science and Engineering, Maastricht University, Brightlands Chemelot Campus, Urmonderbaan, 226167, RD, Geleen, the Netherlands; Department of Biohybrid and Medical Textiles (BioTex), AME - Institute of Applied Medical Engineering, Helmholtz Institute, RWTH Aachen University, Forckenbeckstraβe 55, 52074, Aachen, Germany.
| | - Keita Ito
- Orthopedic Biomechanics, Dept. of Biomedical Engineering, Eindhoven University of Technology, De Rondom 70, 5612, AP, Eindhoven, the Netherlands.
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Corrales MA, Bolte J, Malcolm S, Pipkorn B, Cronin DS. Methodology to geometrically age human body models to average and subject-specific anthropometrics, demonstrated using a small stature female model assessed in a side impact. Comput Methods Biomech Biomed Engin 2022:1-12. [PMID: 35980145 DOI: 10.1080/10255842.2022.2112187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The aged population has been associated with an increased risk of injury in car-crash, creating a critical need for improved assessment of safety systems. Finite element human body models (HBMs) have been proposed, but require representative geometry of the aged population and high mesh quality. A new hybrid Morphing-CAD methodology was applied to a 26-year-old (YO) 5th percentile female model to create average 75YO and subject-specific 86YO HBMs. The method achieved accurate morphing targets while retaining high mesh quality. The three HBMs were integrated into a side sled impact test demonstrating similar kinematic response but differing rib fracture patterns.
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Affiliation(s)
- M A Corrales
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Canada
| | - J Bolte
- Injury Biomechanics Research Center, Ohio State University, Columbus, OH, USA
| | - S Malcolm
- Honda R&D Americas, Raymond, OH, USA
| | - B Pipkorn
- Division of Vehicle Safety, Department of Mechanics and Maritime Sciences, Chalmers University of Technology, Gothenburg, Sweden.,Autoliv Research, Vårgårda, Sweden
| | - D S Cronin
- Department of Mechanical and Mechatronics Engineering, University of Waterloo, Waterloo, Canada
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