1
|
Jentzsch T, Mantel KE, Slankamenac K, Osterhoff G, Werner CML. CT-based surrogate parameters for MRI-based disc height and endplate degeneration in the lumbar spine. BMC Med Imaging 2024; 24:213. [PMID: 39138416 PMCID: PMC11323600 DOI: 10.1186/s12880-024-01395-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 08/06/2024] [Indexed: 08/15/2024] Open
Abstract
PURPOSE This study investigated potential use of computed tomography (CT)-based parameters in the lumbar spine as a surrogate for magnetic resonance imaging (MRI)-based findings. METHODS In this retrospective study, all individuals, who had a lumbar spine CT scan and MRI between 2006 and 2012 were reviewed (n = 198). Disc height (DH) and endplate degeneration (ED) were evaluated between Th12/L1-L5/S1. Statistics consisted of Spearman correlation and univariate/multivariable regression (adjusting for age and gender). RESULTS The mean CT-DH increased kranio-caudally (8.04 millimeters (mm) at T12/L1, 9.17 mm at L1/2, 10.59 mm at L2/3, 11.34 mm at L3/4, 11.42 mm at L4/5 and 10.47 mm at L5/S1). MRI-ED was observed in 58 (29%) individuals. CT-DH and MRI-DH had strong to very strong correlations (rho 0.781-0.904, p < .001). MRI-DH showed higher absolute values than CT-DH (mean of 1.76 mm). There was a significant association between CT-DH and MRI-ED at L2/3 (p = .006), L3/4 (p = .002), L4/5 (p < .001) and L5/S1 (p < .001). A calculated cut-off point was set at 11 mm. CONCLUSIONS In the lumbar spine, there is a correlation between disc height on CT and MRI. This can be useful in trauma and emergency cases, where CT is readily available in the lack of an MRI. In addition, in the middle and lower part of the lumbar spine, loss of disc height on CT scans is associated with more pronounced endplate degeneration on MRIs. If the disc height on CT scans is lower than 11 mm, endplate degeneration on MRIs is likely more pronounced. LEVEL AND DESIGN Level III, a retrospective study.
Collapse
Affiliation(s)
- Thorsten Jentzsch
- Department of Traumatology, University Hospital Zürich, University of Zurich, Zurich, Switzerland.
- Department of Orthopaedics, Balgrist University Hospital, Zurich, Switzerland.
| | - Karin E Mantel
- Department of Traumatology, University Hospital Zürich, University of Zurich, Zurich, Switzerland
| | - Ksenija Slankamenac
- Department of Traumatology, University Hospital Zürich, University of Zurich, Zurich, Switzerland
| | - Georg Osterhoff
- Department of Traumatology, University Hospital Zürich, University of Zurich, Zurich, Switzerland
| | - Clément M L Werner
- Department of Traumatology, University Hospital Zürich, University of Zurich, Zurich, Switzerland
| |
Collapse
|
2
|
Lerchl T, Nispel K, Bodden J, Sekuboyina A, El Husseini M, Fritzsche C, Senner V, Kirschke JS. Musculoskeletal spine modeling in large patient cohorts: how morphological individualization affects lumbar load estimation. Front Bioeng Biotechnol 2024; 12:1363081. [PMID: 38933541 PMCID: PMC11199547 DOI: 10.3389/fbioe.2024.1363081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/22/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction: Achieving an adequate level of detail is a crucial part of any modeling process. Thus, oversimplification of complex systems can lead to overestimation, underestimation, and general bias of effects, while elaborate models run the risk of losing validity due to the uncontrolled interaction of multiple influencing factors and error propagation. Methods: We used a validated pipeline for the automated generation of multi-body models of the trunk to create 279 models based on CT data from 93 patients to investigate how different degrees of individualization affect the observed effects of different morphological characteristics on lumbar loads. Specifically, individual parameters related to spinal morphology (thoracic kyphosis (TK), lumbar lordosis (LL), and torso height (TH)), as well as torso weight (TW) and distribution, were fully or partly considered in the respective models according to their degree of individualization, and the effect strengths of these parameters on spinal loading were compared between semi- and highly individualized models. T-distributed stochastic neighbor embedding (T-SNE) analysis was performed for overarching pattern recognition and multiple regression analyses to evaluate changes in occurring effects and significance. Results: We were able to identify significant effects (p < 0.05) of various morphological parameters on lumbar loads in models with different degrees of individualization. Torso weight and lumbar lordosis showed the strongest effects on compression (β ≈ 0.9) and anterior-posterior shear forces (β ≈ 0.7), respectively. We could further show that the effect strength of individual parameters tended to decrease if more individual characteristics were included in the models. Discussion: The induced variability due to model individualization could only partly be explained by simple morphological parameters. Our study shows that model simplification can lead to an emphasis on individual effects, which needs to be critically assessed with regard to in vivo complexity. At the same time, we demonstrated that individualized models representing a population-based cohort are still able to identify relevant influences on spinal loading while considering a variety of influencing factors and their interactions.
Collapse
Affiliation(s)
- Tanja Lerchl
- Associate Professorship of Sports Equipment and Sports Materials, School of Engineering and Design, Technical University of Munich, Garching, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Kati Nispel
- Associate Professorship of Sports Equipment and Sports Materials, School of Engineering and Design, Technical University of Munich, Garching, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Anjany Sekuboyina
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Quantitative Biomedicine, University of Zurich, Zurich, Switzerland
| | - Malek El Husseini
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christian Fritzsche
- Associate Professorship of Sports Equipment and Sports Materials, School of Engineering and Design, Technical University of Munich, Garching, Germany
| | - Veit Senner
- Associate Professorship of Sports Equipment and Sports Materials, School of Engineering and Design, Technical University of Munich, Garching, Germany
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| |
Collapse
|
3
|
Daqiq O, Roossien CC, Wubs FW, van Minnen B. Biomechanical assessment of mandibular fracture fixation using finite element analysis validated by polymeric mandible mechanical testing. Sci Rep 2024; 14:11795. [PMID: 38782942 PMCID: PMC11116419 DOI: 10.1038/s41598-024-62011-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024] Open
Abstract
The clinical finite element analysis (FEA) application in maxillofacial surgery for mandibular fracture is limited due to the lack of a validated FEA model. Therefore, this study aims to develop a validated FEA model for mandibular fracture treatment, by assessing non-comminuted mandibular fracture fixation. FEA models were created for mandibles with single simple symphysis, parasymphysis, and angle fractures; fixated with 2.0 mm 4-hole titanium miniplates located at three different configurations with clinically known differences in stability, namely: superior border, inferior border, and two plate combinations. The FEA models were validated with series of Synbone polymeric mandible mechanical testing (PMMT) using a mechanical test bench with an identical test set-up. The first outcome was that the current understanding of stable simple mandibular fracture fixation was reproducible in both the FEA and PMMT. Optimal fracture stability was achieved with the two plate combination, followed by superior border, and then inferior border plating. Second, the FEA and the PMMT findings were consistent and comparable (a total displacement difference of 1.13 mm). In conclusion, the FEA and the PMMT outcomes were similar, and hence suitable for simple mandibular fracture treatment analyses. The FEA model can possibly be applied for non-routine complex mandibular fracture management.
Collapse
Affiliation(s)
- Omid Daqiq
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands.
| | - Charlotte Christina Roossien
- Engineering and Technology Institute Groningen, Department of Bio-Inspired MEMS and Biomedical Devices, University of Groningen, Nijenborgh 4, 9747 AG, Groningen, The Netherlands
| | - Frederik Wilhelm Wubs
- Bernoulli Institute for Mathematics, Computer Science and Artificial Intelligence, University of Groningen, Nijenborgh 9, 9747 AG, Groningen, The Netherlands
| | - Baucke van Minnen
- Department of Oral and Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, The Netherlands
| |
Collapse
|
4
|
Abraira VE, Barocas VH, Winkelstein BA, Cook CE. Uniting disciplines for a modern take: exploring the science behind manual therapies. J Man Manip Ther 2024; 32:4-9. [PMID: 38130107 PMCID: PMC10795604 DOI: 10.1080/10669817.2023.2291595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023] Open
Affiliation(s)
- Victoria E. Abraira
- Department of Cell Biology and Neuroscience, W.M. Keck Center for Collaborative Neuroscience, Rutgers, The State University of New Jersey
| | | | | | - Chad E. Cook
- Department of Orthopaedic Surgery, Duke University
| |
Collapse
|
5
|
Remus R, Selkmann S, Lipphaus A, Neumann M, Bender B. Muscle-driven forward dynamic active hybrid model of the lumbosacral spine: combined FEM and multibody simulation. Front Bioeng Biotechnol 2023; 11:1223007. [PMID: 37829567 PMCID: PMC10565495 DOI: 10.3389/fbioe.2023.1223007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 09/05/2023] [Indexed: 10/14/2023] Open
Abstract
Most spine models belong to either the musculoskeletal multibody (MB) or finite element (FE) method. Recently, coupling of MB and FE models has increasingly been used to combine advantages of both methods. Active hybrid FE-MB models, still rarely used in spine research, avoid the interface and convergence problems associated with model coupling. They provide the inherent ability to account for the full interplay of passive and active mechanisms for spinal stability. In this paper, we developed and validated a novel muscle-driven forward dynamic active hybrid FE-MB model of the lumbosacral spine (LSS) in ArtiSynth to simultaneously calculate muscle activation patterns, vertebral movements, and internal mechanical loads. The model consisted of the rigid vertebrae L1-S1 interconnected with hyperelastic fiber-reinforced FE intervertebral discs, ligaments, facet joints, and force actuators representing the muscles. Morphological muscle data were implemented via a semi-automated registration procedure. Four auxiliary bodies were utilized to describe non-linear muscle paths by wrapping and attaching the anterior abdominal muscles. This included an abdominal plate whose kinematics was optimized using motion capture data from upper body movements. Intra-abdominal pressure was calculated from the forces of the abdominal muscles compressing the abdominal cavity. For the muscle-driven approach, forward dynamics assisted data tracking was used to predict muscle activation patterns that generate spinal postures and balance the spine without prescribing accurate spinal kinematics. During calibration, the maximum specific muscle tension and spinal rhythms resulting from the model dynamics were evaluated. To validate the model, load cases were simulated from -10° extension to +30° flexion with weights up to 20 kg in both hands. The biomechanical model responses were compared with in vivo literature data of intradiscal pressures, intra-abdominal pressures, and muscle activities. The results demonstrated high agreement with this data and highlight the advantages of active hybrid modeling for the LSS. Overall, this new self-contained tool provides a robust and efficient estimation of LSS biomechanical responses under in vivo similar loads, for example, to improve pain treatment by spinal stabilization therapies.
Collapse
Affiliation(s)
- Robin Remus
- Chair of Product Development, Department of Mechanical Engineering, Ruhr-University Bochum, Bochum, Germany
| | - Sascha Selkmann
- Chair of Product Development, Department of Mechanical Engineering, Ruhr-University Bochum, Bochum, Germany
| | - Andreas Lipphaus
- Biomechanics Research Group, Chair of Product Development, Department of Mechanical Engineering, Ruhr-University Bochum, Bochum, Germany
| | - Marc Neumann
- Chair of Product Development, Department of Mechanical Engineering, Ruhr-University Bochum, Bochum, Germany
| | - Beate Bender
- Chair of Product Development, Department of Mechanical Engineering, Ruhr-University Bochum, Bochum, Germany
| |
Collapse
|
6
|
Ma CZH, Li Z, He C. Advances in Biomechanics-Based Motion Analysis. Bioengineering (Basel) 2023; 10:677. [PMID: 37370608 DOI: 10.3390/bioengineering10060677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 05/24/2023] [Accepted: 05/31/2023] [Indexed: 06/29/2023] Open
Abstract
Motion patterns in humans have been closely associated with neurological/musculoskeletal/behavioral/psychological health issues and competitive sports performance [...].
Collapse
Affiliation(s)
- Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
- Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong SAR 999077, China
| | - Zhengrong Li
- School of Mechanical Engineering, Tongji University, Shanghai 200082, China
| | - Chen He
- Institute of Rehabilitation Engineering and Technology, University of Shanghai for Science and Technology, Shanghai 200093, China
| |
Collapse
|