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Qiao N, Villemure I, Wang Z, Petit Y, Aubin CE. Optimization of S2-alar-iliac screw (S2AI) fixation in adult spine deformity using a comprehensive genetic algorithm and finite element model personalized to patient geometry and bone mechanical properties. Spine Deform 2024; 12:595-602. [PMID: 38451404 DOI: 10.1007/s43390-024-00833-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/20/2024] [Indexed: 03/08/2024]
Abstract
PURPOSE To optimize the biomechanical performance of S2AI screw fixation using a genetic algorithm (GA) and patient-specific finite element analysis integrating bone mechanical properties. METHODS Patient-specific pelvic finite element models (FEM), including one normal and one osteoporotic model, were created from bi-planar multi-energy X-rays (BMEXs). The genetic algorithm (GA) optimized screw parameters based on bone mass quality (BM method) while a comparative optimization method maximized the screw corridor radius (GEO method). Biomechanical performance was evaluated through simulations, comparing both methods using pullout and toggle tests. RESULTS The optimal screw trajectory using the BM method was more lateral and caudal with insertion angles ranging from 49° to 66° (sagittal plane) and 29° to 35° (transverse plane). In comparison, the GEO method had ranges of 44° to 54° and 24° to 30° respectively. Pullout forces (PF) using the BM method ranged from 5 to 18.4 kN, which were 2.4 times higher than the GEO method (2.1-7.7 kN). Toggle loading generated failure forces between 0.8 and 10.1 kN (BM method) and 0.9-2.9 kN (GEO method). The bone mass surrounding the screw representing the fitness score and PF of the osteoporotic case were correlated (R2 > 0.8). CONCLUSION Our study proposed a patient-specific FEM to optimize the S2AI screw size and trajectory using a robust BM approach with GA. This approach considers surgical constraints and consistently improves fixation performance.
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Affiliation(s)
- Ningxin Qiao
- Institute of Biomedical Engineering, Polytechnique Montréal, PO Box 6079, Downtown station, Montreal, QC H3C 3A7, Canada
- Sainte-Justine University Hospital Center, Montreal, Canada
| | - Isabelle Villemure
- Institute of Biomedical Engineering, Polytechnique Montréal, PO Box 6079, Downtown station, Montreal, QC H3C 3A7, Canada
- Sainte-Justine University Hospital Center, Montreal, Canada
| | - Zhi Wang
- Centre Hospitalier de l'Université de Montréal, Montreal, Canada
- Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montreal, Canada
| | - Carl-Eric Aubin
- Institute of Biomedical Engineering, Polytechnique Montréal, PO Box 6079, Downtown station, Montreal, QC H3C 3A7, Canada.
- Sainte-Justine University Hospital Center, Montreal, Canada.
- Department of Surgery, Faculty of Medicine, Université de Montréal, Montreal, Canada.
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Chapleau J, Joly-Chevrier M, Tohmé P, El-Kayem E, Petit Y, Rouleau DM. A novel fragment specific classification of complex olecranon fractures: 3-dimensional model design, radiological validation, and proposed surgical algorithm. J Shoulder Elbow Surg 2024; 33:1084-1091. [PMID: 38365170 DOI: 10.1016/j.jse.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/04/2023] [Accepted: 12/25/2023] [Indexed: 02/18/2024]
Abstract
BACKGROUND Current classifications for proximal ulna fracture patterns rely on qualitative data and cannot inform surgical planning. We propose a new classification system based on a biological and anatomical stress analysis. Our hypothesis is that fragment types in complex fractures can be predicted by the tendon and ligament attachments on the proximal ulna. METHODS First, we completed a literature review to identify quantitative data on proximal ulna soft tissue attachments. On this basis, we created a 3-dimensional model of ulnar anatomy with SliceOMatic and Catia V5R20 software and determined likely locations for fragments and fracture lines. The second part of the study was a retrospective radiological study. A level-1 trauma radiological database was used to identify computed tomography scans of multifragmentary olecranon fractures from 2009 to 2021. These were reviewed and classified according to the "fragment specific" classification and compared to the Mayo and the Schatzker classifications. RESULTS Twelve articles (134 elbows) met the inclusion criteria and 7 potential fracture fragments were identified. The radiological study included 67 preoperative computed tomography scans (mean 55 years). The fragments identified were the following: posterior (40%), intermediate (42%), tricipital (100%), supinator crest (25%), coronoid (18%), sublime tubercle (12%), and anteromedial facet (18%). Eighteen cases (27%) were classified as Schatzker D (comminutive) and 21 (31%) Mayo 2B (stable comminutive). Inter-rater correlation coefficient was 0.71 among 3 observers. CONCLUSION This proposed classification system is anatomically based and considers the deforming forces from ligaments and tendons. Having a more comprehensive understanding of complex proximal ulna fractures would lead to more accurate fracture evaluation and surgical planning.
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Affiliation(s)
- Julien Chapleau
- Department of Orthopedic Surgery, CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | | | - Patrick Tohmé
- Department of Orthopedic Surgery, CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Elie El-Kayem
- Department of Orthopedic Surgery, CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada
| | - Yvan Petit
- Research Center, CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Dominique M Rouleau
- Department of Orthopedic Surgery, CIUSSS du Nord-de-l'île-de-Montréal, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada; Faculty of Medicine, Université de Montréal, Montreal, QC, Canada.
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Dahmani J, Petit Y, Laporte C. Quantitative validation of two model-based methods for the correction of probe pressure deformation in ultrasound. Int J Comput Assist Radiol Surg 2024; 19:309-320. [PMID: 37596378 DOI: 10.1007/s11548-023-03006-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/17/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE The acquisition of good quality ultrasound (US) images requires good acoustic coupling between the ultrasound probe and the patient's skin. In practice, this good coupling is achieved by the operator applying a force to the skin through the probe. This force induces a deformation of the tissues underlying the probe. The distorted images deteriorate the quality of the reconstructed 3D US image. METHODS In this work, we propose two methods to correct these deformations. These methods are based on the construction of a biomechanical model to predict the mechanical behavior of the imaged soft tissues. The originality of the methods is that they do not use external information (force or position value from sensors, or elasticity value from the literature). The model is parameterized thanks to the information contained in the image. This is allowed thanks to the optimization of two key parameters for the model which are the indentation d and the elasticity ratio α. RESULTS The validation is performed on real images acquired on a gelatin-based phantom using an ultrasound probe inducing an increasing vertical indentation using a step motor. The results showed a good correction of the two methods for indentations less than 4 mm. For larger indentations, one of the two methods (guided by the similarity score) provides a better quality of correction, presenting a Euclidean distance between the contours of the reference image and the corrected image of 0.71 mm. CONCLUSION The proposed methods ensured the correction of the deformed images induced by a linear probe pressure without using any information coming from sensors (force or position), or generic information about the mechanical parameters. The corrected images can be used to obtain a corrected 3D US image.
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Affiliation(s)
- Jawad Dahmani
- École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC, Canada.
| | - Yvan Petit
- École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC, Canada
| | - Catherine Laporte
- École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC, Canada
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Dionne A, Cavayas YA, Magnuson D, Richard-Denis A, Petit Y, Barthélémy D, Bernard F, Mac-Thiong JM. Is it safe to initiate activity-based therapy within days following traumatic spinal cord injury? Preliminary results from the PROMPT-SCI trial. J Spinal Cord Med 2023; 46:980-985. [PMID: 37531608 PMCID: PMC10653737 DOI: 10.1080/10790268.2023.2212329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/04/2023] Open
Abstract
CONTEXT Activity-based therapy initiated within days of the accident could prevent complications and improve neurofunctional outcomes in patients with traumatic spinal cord injury (TSCI). However, it has never been attempted in humans with TSCI because of practical obstacles and potential safety concerns. The PROMPT-SCI trial is the first attempt at implementing ABT within the first days following a TSCI (i.e. very early ABT; VE-ABT). The objective is to determine if VE-ABT can be initiated safely in the intensive care unit (ICU) within 48 h of early decompressive surgery. DESIGN As part of the PROMPT-SCI trial, 15 adult patients with severe TSCI were enrolled between April and November of 2021. The intervention consisted of 30-minute sessions of motor-assisted in-bed leg cycling starting within 48 h of early spinal surgery. Safety was assessed through continuous monitoring of vital signs and recording of adverse events during and after sessions. The main outcome measure was the achievement (yes or no) of a full and safe session within 48 h of early surgery. FINDINGS Out of the 15 participants, 10 (66.6%) achieved this outcome. Out of the remaining 5, 2 were not cleared to engage in cycling within 48 h of surgery and 3 initiated cycling within 48 h but stopped prematurely. All 5 eventually completed a full and safe session within the next 1-2 days. In all 15 participants, there were no neurological deteriorations after the first completed session. CONCLUSION Our results suggest that it is safe and feasible to perform a first session of VE-ABT within days of a severe TSCI with no serious adverse events and excellent completion rates.
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Affiliation(s)
- Antoine Dionne
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Yiorgos Alexandros Cavayas
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - David Magnuson
- Department of Neurological Surgery, University of Louisville, Louisville, KY, USA
| | - Andréane Richard-Denis
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Yvan Petit
- Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
- Department of Mechanical Engineering, École de technologie supérieure, Montreal, Quebec, Canada
| | - Dorothy Barthélémy
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, CRIR, Montreal, Quebec, Canada
- School of Rehabilitation, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Francis Bernard
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
| | - Jean-Marc Mac-Thiong
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada
- Sainte-Justine University Hospital Research Center, Montreal, Quebec, Canada
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Fournier M, Bailly N, Schäuble A, Petit Y. Head impact kinematics and injury risks during E-scooter collisions against a curb. Heliyon 2023; 9:e19254. [PMID: 37662814 PMCID: PMC10474420 DOI: 10.1016/j.heliyon.2023.e19254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 04/02/2023] [Accepted: 08/16/2023] [Indexed: 09/05/2023] Open
Abstract
E-scooters as a mode of transportation is rapidly growing in popularity. This study evaluates head impact conditions and injury risk associated with E-scooter crashes. A multibody model of E-scooter falls induced by wheel-curb collision was built and compared with an experimental E-scooter crash test. A total of 162 crash scenarios were simulated to assess the effect of fall conditions (E-scooter initial speed and inclination, obstacle orientation, and user size) on the head impact kinematics. The forehead hit the ground first in 44% of simulations. The average tangential and normal impact speeds were 3.5 m/s and 4.8 m/s respectively. Nearly 100% of simulations identified a risk of concussion (linear acceleration peak >82 g and rotational acceleration peak >6383 rad/s2) and 90% of simulations suggested a risk of severe head injuries (HIC>700). This work provides preliminary data useful for the assessment and design of protective gears.
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Affiliation(s)
- Marion Fournier
- École de technologie supérieure, 1100 Rue Notre Dame O, Montréal, QC, H3C 1K3, Canada
- Research Center, CIUSSS Nord de L’île de Montréal, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- ILab-Spine: International Laboratory on Spine Imaging and Biomechanics, France
| | - Nicolas Bailly
- Univ Gustave Eiffel, LBA, France, Bd Pierre Dramard, 13015, Marseille, France
- ILab-Spine: International Laboratory on Spine Imaging and Biomechanics, France
| | - Andreas Schäuble
- DEKRA Automobil GmbH, AG5 Unfallforschung Accident Research, HQ Stuttgart, Handwerkstraße 15, 70565, Stuttgart, Germany
| | - Yvan Petit
- École de technologie supérieure, 1100 Rue Notre Dame O, Montréal, QC, H3C 1K3, Canada
- Research Center, CIUSSS Nord de L’île de Montréal, 5400 Boul Gouin O, Montréal, QC, H4J 1C5, Canada
- Univ Gustave Eiffel, LBA, France, Bd Pierre Dramard, 13015, Marseille, France
- ILab-Spine: International Laboratory on Spine Imaging and Biomechanics, France
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Diotalevi L, Mac-Thiong JM, Wagnac E, Petit Y. Contribution of impactor misalignment to the neurofunctional variability in porcine spinal cord contusion models. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38082881 DOI: 10.1109/embc40787.2023.10340195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Traumatic spinal cord lesions studies are often carried out with animal models or numerical simulations. Unfortunately, animal models usually present a high variability in severity and type of neurofunctional impairments following impact surgery. We postulate that the variability of outcomes is strongly dependent on the positioning and alignment of the impactor during the contusion. A finite elements model of the spinal cord, predicting the action potential (AP) conduction alteration, was proposed and used to perform nine numerical simulations of a 50 g weight dropped from 200 mm on the exposed spinal cord in its spinal canal. Simulations followed a 32 factorial design with impactor eccentricity and spinal cord tilt angle as factors on two outcomes: injured spinal cord area (AP < 10 % of its baseline, 1h post-injury), and asymmetry of injury (ratio of right/left injured area of both half spinal cord). Eccentricity contributed highly and significantly on both outcomes, but not tilt angle. Damaged axons were found in conscious motor, sensory, and unconscious proprioception tracts. Variability in impactor alignment beyond ±6.2 % of the spinal canal width affects neurofunctional outcomes, and careful assessment of the impactor course is therefore key when producing spinal cord injury by contusion.Clinical Relevance- A precision value is proposed to mitigate the contribution of impactor misalignment to neurofunctional variability in animal models, allowing the reduction of animal used in research. The proposed method of action potential conduction assessment could easily be implanted in human numerical models for the cross-study of patient's cases.
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Kanmangne N, Laporte C, Diotalevi L, Petit Y. Automatic detection of spinal injuries under dynamic compressive loading using high-speed cine-radiography. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38082790 DOI: 10.1109/embc40787.2023.10339973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Every year, new cases of individuals suffering from traumatic spinal injuries are detected. Advances in numerical models have allowed for the understanding of the damage caused by trauma and its impact on the patient's life. However, the kinematics and dynamics of vertebral fracture formation from its point of origin to the speed of propulsion of the fragments remain unknown. This is mainly due to the lack of data that essentially includes high-speed videos, load and displacement measurements during experimental tests reproducing spinal traumatic loading conditions. This lack of data can be addressed by the analysis of X-Ray images of animal specimens acquired during the traumatic spinal injury formation process. Thus, the purpose of this study was to develop an approach to automatically detect and track in vitro vertebral fractures using high-speed cine-radiography imaging. Four segments of porcine thoracolumbar vertebrae were dynamically compressed using a servo-hydraulic test bench. The compression process was filmed with a custom high-speed cine-radiography device, and the imaging parameters were optimized based on the physical properties of vertebrae. This paper demonstrates the feasibility of using high-speed cine-radiography imaging in this way, combined with an image processing pipeline to allow automatic documentation of the fracture's appearance and its evolution in the vertebra over time.Clinical Relevance- The proposed method will provide helpful information for proper handling of traumatic spinal injuries.
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Llido M, Le Bras LA, Brailovski V, Séguin B, Masseau I, Petit Y, Lussier B. Muscular morphometric study of the canine shoulder for the design of 3D-printed endoprostheses in dogs with osteosarcoma of the proximal humerus: a pilot cadaveric study by MRI. Am J Vet Res 2023:1-8. [PMID: 37044376 DOI: 10.2460/ajvr.22.12.0220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/15/2023] [Indexed: 04/14/2023]
Abstract
OBJECTIVE Osteosarcoma frequently affects the proximal humerus in dogs. In veterinary medicine, no therapeutic option for the treatment of osteosarcoma satisfactorily preserves limb function. 3D-printed personalized endoprosthesis offers a promising treatment option. Morphometric data, necessary for the design of the endoprosthesis, are currently lacking in canine patients. Our objective was to acquire the morphometric data necessary to refine the design of the endoprosthesis. ANIMAL A single canine cadaveric thoracic limb. PROCEDURES Sagittal proton-density, and sagittal, dorsal, and transverse T1-weighted sequences of the thoracic limb were acquired with a 1.5 Tesla Magnetic Resonance Imaging (MRI) unit. Nineteen muscles of interest were subsequently identified using medical imaging software (Mimics©) and their volume was reconstructed in 3D using computer-aided design (CATIA©). Mormophetric data were recorded for each of the 19 muscles. The same canine cadaver was then dissected to measure the same parameters. RESULTS All muscles were successfully identified with data consistent with the dissected cadaveric data. Certain muscles were more challenging to isolate on MRI, namely the heads of the triceps brachii, superficial pectoral, and latissimus dorsi. The relative distribution of muscle volumes was similar to historical data. Muscle tissue density was not significantly affected by freezing (1.059 g/cm3). CLINICAL RELEVANCE MRI is a useful tool to collect morphometric data but imperfect if used alone. This approach was the first attempt to validate more general morphometric data that could be used to refine the design of custom 3D-printed prostheses for limb-sparing of the proximal humerus. Further imaging studies are warranted to refine our model.
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Affiliation(s)
- Marie Llido
- Department of Sciences Cliniques, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Quebec, Canada
| | | | | | - Bernard Séguin
- Central Victoria Veterinary Hospital, Victoria, British Columbia, Canada
| | - Isabelle Masseau
- Department of Sciences Cliniques, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Quebec, Canada
| | - Yvan Petit
- École de Technologie Supérieure, Montreal, Quebec, Canada
| | - Bertrand Lussier
- Department of Sciences Cliniques, Faculty of Veterinary Medicine, University of Montreal, St-Hyacinthe, Quebec, Canada
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Alonso Romero A, Amouzou KN, Sengupta D, Zimmermann CA, Richard-Denis A, Mac-Thiong JM, Petit Y, Lina JM, Ung B. Optoelectronic Pressure Sensor Based on the Bending Loss of Plastic Optical Fibers Embedded in Stretchable Polydimethylsiloxane. Sensors (Basel) 2023; 23:3322. [PMID: 36992033 PMCID: PMC10053520 DOI: 10.3390/s23063322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
We report the design and testing of a sensor pad based on optical and flexible materials for the development of pressure monitoring devices. This project aims to create a flexible and low-cost pressure sensor based on a two-dimensional grid of plastic optical fibers embedded in a pad of flexible and stretchable polydimethylsiloxane (PDMS). The opposite ends of each fiber are connected to an LED and a photodiode, respectively, to excite and measure light intensity changes due to the local bending of the pressure points on the PDMS pad. Tests were performed in order to study the sensitivity and repeatability of the designed flexible pressure sensor.
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Affiliation(s)
- Alberto Alonso Romero
- Electrical Engineering Department, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada
| | - Koffi Novignon Amouzou
- Electrical Engineering Department, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada
| | - Dipankar Sengupta
- Electrical Engineering Department, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada
| | - Camila Aparecida Zimmermann
- Electrical Engineering Department, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada
| | | | - Jean-Marc Mac-Thiong
- Hôpital du Sacré-Cœur de Montréal, 5400 Gouin Boul. West, Montreal, QC H4J 1C5, Canada
| | - Yvan Petit
- Mechanical Engineering Department, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada
| | - Jean-Marc Lina
- Electrical Engineering Department, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada
| | - Bora Ung
- Electrical Engineering Department, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada
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Wei W, Petit Y, Arnoux PJ, Bailly N. Head-ground impact conditions and helmet performance in E-scooter falls. Accid Anal Prev 2023; 181:106935. [PMID: 36571970 DOI: 10.1016/j.aap.2022.106935] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/28/2022] [Accepted: 12/19/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE Head injuries are common injuries in E-scooter accidents which have dramatically increased in recent years. The head impact conditions and helmet performance during E-scooter accidents are barely investigated. This study aims to characterize the head-ground impact biomechanics and evaluate bicycle helmet protection in typical E-scooter falls. METHOD The finite element (FE) model of a hybrid III dummy riding an E-scooter was developed and validated. The FE model with and without a bicycle helmet was used to reproduce twenty-seven E-scooter falls caused by the collision with a curb, in which different riding speeds (10, 20, and 30 km/h), curb orientations (30, 60, and 90°), and E-scooter orientations (-15, 0, and 15°) were simulated. Head-ground impact velocities and locations were evaluated for the unhelmeted configurations while the helmet performance was evaluated with the reduction of head injury metrics. RESULTS E-scooter falls always resulted in an oblique head-ground impact, with 78 % on the forehead. The mean vertical and tangential head-ground impact velocities were respectively 5.7 ± 1.5 m/s and 3.7 ± 2.0 m/s. The helmet significantly (p < 0.1) reduced the head linear acceleration, angular velocity, HIC_36, and BrIC, but not the angular acceleration. However, even with the helmet, the head injury metrics were mostly above the thresholds of severe head injuries. CONCLUSION Typical E-scooter falls might cause severe head injuries. The bicycle helmet was efficient to reduce head injury metrics but not to prevent severe head injuries. Future helmet standard evaluations should involve higher impact energy and the angular acceleration assessment in oblique impacts.
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Affiliation(s)
- Wei Wei
- LBA UMRT24, Aix Marseille Université/Université Gustave Eiffel, Marseille, France; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France.
| | - Yvan Petit
- LBA UMRT24, Aix Marseille Université/Université Gustave Eiffel, Marseille, France; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France; École de technologie supérieure, Canada
| | - Pierre-Jean Arnoux
- LBA UMRT24, Aix Marseille Université/Université Gustave Eiffel, Marseille, France; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France
| | - Nicolas Bailly
- LBA UMRT24, Aix Marseille Université/Université Gustave Eiffel, Marseille, France; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France
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Evin M, Sudres P, Weber P, Godio-Raboutet Y, Arnoux PJ, Wagnac E, Petit Y, Tillier Y. Experimental Bi-axial tensile tests of spinal meningeal tissues and constitutive models comparison. Acta Biomater 2022; 140:446-456. [PMID: 34838701 DOI: 10.1016/j.actbio.2021.11.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 11/18/2021] [Accepted: 11/18/2021] [Indexed: 11/01/2022]
Abstract
Introduction This study aims at identifying mechanical characteristics under bi-axial loading conditions of extracted swine pia mater (PM) and dura and arachnoid complex (DAC). Methods 59 porcine spinal samples have been tested on a bi-axial experimental device with a pre-load of 0.01 N and a displacement rate of 0.05 mm·s-1. Post-processing analysis included an elastic modulus, as well as constitutive model identification for Ogden model, reduced Gasser Ogden Holzapfel (GOH) model, anisotropic GOH model, transverse isotropic and anisotropic Gasser models as well as a Mooney-Rivlin model including fiber strengthening for PM. Additionally, micro-structure of the tissue was investigated using a bi-photon microscopy. Results Linear elastic moduli of 108 ± 40 MPa were found for DAC longitudinal direction, 53 ± 32 MPa for DAC circumferential direction, with a significant difference between directions (p < 0.001). PM presented significantly higher longitudinal than circumferential elastic moduli (26 ± 13 MPa vs 13 ± 9 MPa, p < 0.001). Transversely isotropic and anisotropic Gasser models were the most suited models for DAC (r2 = 0.99 and RMSE:0.4 and 0.3 MPa) and PM (r2 = 1 and RMSE:0.06 and 0.07 MPa) modelling. Conclusion This work provides reference values for further quasi-static bi-axial studies, and is the first for PM. Collagen structures observed by two photon microscopy confirmed the use of anisotropic Gasser model for PM and the existence of fenestration. The results from anisotropic Gasser model analysis depicted the best fit to experimental data as per this protocol. Further investigations are required to allow the use of meningeal tissue mechanical behaviour in finite element modelling with respect to physiological applications. STATEMENT OF SIGNIFICANCE: This study is the first to present biaxial tensile test of pia mater as well as constitutive model comparisons for dura and arachnoid complex tissue based on such tests. Collagen structures observed by semi-quantitative analysis of two photon microscopy confirmed the use of anisotropic Gasser model for pia mater and existence of fenestration. While clear identification of fibre population was not possible in DAC, results from anisotropic Gasser model depicted better fitting on experimental data as per this protocol. Bi-axial mechanical testing allows quasi-static characterization under conditions closer to the physiological context and the results presented could be used for further simulations of physiology. Indeed, the inclusion of meningeal tissue in finite element models will allow more accurate and reliable numerical simulations.
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Beauséjour MH, Petit Y, Wagnac É, Melot A, Troude L, Arnoux PJ. Cervical spine injury response to direct rear head impact. Clin Biomech (Bristol, Avon) 2022; 92:105552. [PMID: 34999391 DOI: 10.1016/j.clinbiomech.2021.105552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 09/29/2021] [Accepted: 12/14/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Direct rear head impact can occur during falls, road accidents, or sports accidents. They induce anterior shear, flexion and compression loads suspected to cause flexion-distraction injuries at the cervical spine. However, post-mortem human subject experiments mostly focus on sled impacts and not direct head impacts. METHODS Six male cadavers were subjected to a direct rear head impact of 3.5 to 5.5 m/s with a 40 kg impactor. The subjects were equipped with accelerometers at the forehead, mouth and sternum. High-speed cameras and stereography were used to track head displacements. Head range of motion in flexion-extension was measured before and after impact for four cadavers. The injuries were assessed from CT scan images and dissection. FINDINGS Maximum head rotation was between 43 degrees and 78 degrees, maximum cranial-caudal displacement between -12 mm and - 196 mm, and antero-posterior displacement between 90 mm and 139 mm during the impact. Four subjects had flexion-distraction injuries. Anterior vertebral osteophyte identification showed that fractures occurred at adjacent levels of osteophytic bridges. The other two subjects had no anterior osteophytes and suffered from C2 fracture, and one subject also had a C1-C2 subluxation. C6-C7 was the most frequently injured spinal level. INTERPRETATION Anterior vertebral osteophytes appear to influence the type and position of injuries. Osteophytes would seem to provide stability in flexion for the osteoarthritic cervical spine, but to also lead to stress concentration in levels adjacent to the osteophytes. Clinical management of patients presenting with osteophytes fracture should include neck immobilization and careful follow-up to ensure bone healing.
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Affiliation(s)
- Marie-Hélène Beauséjour
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, H3C 1K3, Montreal, Quebec, Canada; Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin, H4J 1C5, Montreal, Quebec, Canada; International Laboratory on Spine Imaging and Biomechanics, France and Canada; Laboratoire de Biomécanique Appliquée-Université Gustave-Eiffel, Aix-Marseille Université, UMR T24, 51 boulevard Pierre Dramard, 13015 Marseille, France
| | - Yvan Petit
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, H3C 1K3, Montreal, Quebec, Canada; Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin, H4J 1C5, Montreal, Quebec, Canada; International Laboratory on Spine Imaging and Biomechanics, France and Canada.
| | - Éric Wagnac
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, H3C 1K3, Montreal, Quebec, Canada; Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Boulevard Gouin, H4J 1C5, Montreal, Quebec, Canada; International Laboratory on Spine Imaging and Biomechanics, France and Canada
| | - Anthony Melot
- International Laboratory on Spine Imaging and Biomechanics, France and Canada; Laboratoire de Biomécanique Appliquée-Université Gustave-Eiffel, Aix-Marseille Université, UMR T24, 51 boulevard Pierre Dramard, 13015 Marseille, France; Hôpital privé Clairval, 317 boulevard du Redon, 13009 Marseille, France
| | - Lucas Troude
- Neurosurgery, CHU Nord Marseille, Chemin des Bourrely, cedex 20, 13015 Marseille, France
| | - Pierre-Jean Arnoux
- International Laboratory on Spine Imaging and Biomechanics, France and Canada; Laboratoire de Biomécanique Appliquée-Université Gustave-Eiffel, Aix-Marseille Université, UMR T24, 51 boulevard Pierre Dramard, 13015 Marseille, France
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Le Bras LA, Timercan A, Llido M, Petit Y, Seguin B, Lussier B, Brailovski V. Personalized endoprostheses for the proximal humerus and scapulohumeral joint in dogs: Biomechanical study of the muscles’ contributions during locomotion. PLoS One 2022; 17:e0262863. [PMID: 35073361 PMCID: PMC8786195 DOI: 10.1371/journal.pone.0262863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/06/2022] [Indexed: 11/21/2022] Open
Abstract
Osteosarcoma represents one of the most common bone tumours in dogs. It commonly occurs in the proximal humerus, the most affected anatomic site. Until recently, amputation or limb-sparing surgery leading to an arthrodesis coupled with chemotherapy were the only available treatments, but they often lead to complications, reduced mobility and highly impact dog’s quality of life. Prototypes of both articulated and monobloc (no mobility) patient-specific endoprostheses have been designed to spare the limb afflicted with osteosarcoma of the proximal humerus. This study focuses on the biomechanical effects of endoprostheses and shoulder muscle kinematics. For each of the endoprosthesis designs, a minimal number of muscles needed to ensure stability and a certain degree of joint movement during walking is sought. A quasi-static study based on an optimization method, the minimization of the sum of maximal muscle stresses, was carried out to assess the contribution of each muscle to the shoulder function. The identification of the most important muscles and their impact on the kinematics of the prosthetic joint lead to an improvement of the endoprosthesis design relevance and implantation feasibility.
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Affiliation(s)
- Linh-Aurore Le Bras
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montréal, Québec, Canada
| | - Anatolie Timercan
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montréal, Québec, Canada
| | - Marie Llido
- Faculté de Médecine Vétérinaire, Département de Sciences Cliniques, Université de Montréal, Montréal, Québec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montréal, Québec, Canada
| | - Bernard Seguin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado, United States of America
| | - Bertrand Lussier
- Faculté de Médecine Vétérinaire, Département de Sciences Cliniques, Université de Montréal, Montréal, Québec, Canada
| | - Vladimir Brailovski
- Department of Mechanical Engineering, Ecole de Technologie Supérieure, Montréal, Québec, Canada
- * E-mail:
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Del Carpio LI, Petit Y, Diotalevi L, Laroche E, Levasseur A, Lussier B. Three-dimensional kinematic evaluation of lateral suture stabilization in an in vitro canine cranial cruciate deficient stifle model. PLoS One 2021; 16:e0261187. [PMID: 34928969 PMCID: PMC8687534 DOI: 10.1371/journal.pone.0261187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/24/2021] [Indexed: 11/19/2022] Open
Abstract
The impact of surgical correction of cranial cruciate ligament rupture (CCLR) on 3D kinematics has not been thoroughly evaluated in dogs. The success of current techniques remains limited, as illustrated by suboptimal weightbearing and progression of osteoarthritis. The inability to restore the stifle's 3D kinematics might be a key element in understanding these suboptimal outcomes. The objective of this study was to evaluate the impact of lateral suture stabilization (LSS) on the 3D kinematics of the canine stifle joint. We hypothesized that LSS would not restore 3D kinematics in our model. Ten cadaveric pelvic limbs collected from large dogs (25-40 kg) were tested using a previously validated apparatus that simulates gait. Three experimental conditions were compared: (a) intact stifle; (b) unstable stifle following cranial cruciate ligament transection (CCLt) and (c) CCLt stabilized by LSS. Three-dimensional kinematics were collected through 5 loading cycles simulating the stance phase of gait and curves were analyzed using a Wilcoxon signed-rank test. LSS restored baseline kinematics for the entire stance phase for cranial and lateromedial translation, flexion, and abduction. It restored distraction over 90% of the stance phase. Internal rotation was limited, but not restored. This in vitro study had limitations, as it used a simplified model of stifle motion and weight-bearing. The results of this study report that LSS can restore physiologic 3D kinematics largely comparable to those of healthy stifles. Suboptimal outcome in patients following CCLR stabilization by LSS may therefore result from causes other than immediate postoperative abnormal 3D kinematics.
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Affiliation(s)
- Laura-Isabela Del Carpio
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Lucien Diotalevi
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Elisabeth Laroche
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Annie Levasseur
- Department of Mechanical Engineering, École de Technologie Supérieure, Montreal, Quebec, Canada
- CIUSSS-NÎM Research Center, Sacré-Cœur Hospital of Montreal, Montreal, Quebec, Canada
| | - Bertrand Lussier
- Department of Clinical Sciences, Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
- GREPAQ (Research Group in Animal Pharmacology of Quebec), Faculty of Veterinary Medicine, University of Montreal, Saint-Hyacinthe, Quebec, Canada
- Osteoarthritis Research Unit, Hospital Research Centre (CRCHUM), Université de Montréal, Montreal, Quebec, Canada
- * E-mail:
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Mac-Thiong JM, Richard-Denis A, Petit Y, Bernard F, Barthélemy D, Dionne A, Magnuson DSK. Protocol for rapid onset of mobilisation in patients with traumatic spinal cord injury (PROMPT-SCI) study: a single-arm proof-of-concept trial of early in-bed leg cycling following acute traumatic spinal cord injury. BMJ Open 2021; 11:e049884. [PMID: 34725077 PMCID: PMC8562499 DOI: 10.1136/bmjopen-2021-049884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 09/09/2021] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Activity-based therapy (ABT) is an important aspect of rehabilitation following traumatic spinal cord injury (SCI). Unfortunately, it has never been adapted to acute care despite compelling preclinical evidence showing that it is safe and effective for promoting neurological recovery when started within days after SCI. This article provides the protocol for a study that will determine the feasibility and explore potential benefits of early ABT in the form of in-bed leg cycling initiated within 48 hours after the end of spinal surgery for SCI. METHODS AND ANALYSIS PROMPT-SCI (protocol for rapid onset of mobilisation in patients with traumatic SCI) is a single-site single-arm proof-of-concept trial. Forty-five patients aged 18 years or older with a severe traumatic SCI (American Spinal Injury Association Impairment Scale grade A, B or C) from C0 to L2 undergoing spinal surgery within 48 hours of the injury will be included. Participants will receive daily 30 min continuous sessions of in-bed leg cycling for 14 consecutive days, initiated within 48 hours of the end of spinal surgery. The feasibility outcomes are: (1) absence of serious adverse events associated with cycling, (2) completion of 1 full session within 48 hours of spinal surgery for 90% of participants and (3) completion of 11 sessions for 80% of participants. Patient outcomes 6 weeks and 6 months after the injury will be measured using neurofunctional assessments, quality of life questionnaires and inpatient length of stay. Feasibility and patient outcomes will be analysed with descriptive statistics. Patient outcomes will also be compared with a matched historical cohort that has not undergone in-bed cycling using McNemar and Student's t-tests for binary and continuous outcomes, respectively. ETHICS AND DISSEMINATION PROMPT-SCI is approved by the Research Ethics Board of the CIUSSS NIM. Recruitment began in April 2021. Dissemination strategies include publications in scientific journals and presentations at conferences. TRIAL REGISTRATION NUMBER NCT04699474.
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Affiliation(s)
- Jean-Marc Mac-Thiong
- Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Department of Surgery, Université de Montréal, Montréal, Québec, Canada
| | - Andreane Richard-Denis
- Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Yvan Petit
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Department of Mechanical Engineering, École de technologie supérieure, Montréal, Québec, Canada
| | - Francis Bernard
- Department of Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Dorothy Barthélemy
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
- School of Rehabilitation, Université de Montréal, Montréal, Québec, Canada
| | - Antoine Dionne
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
- Research Centre, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - David S K Magnuson
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USA
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Constant C, Braïlovski V, Wagnac É, Petit Y, Desrochers A, Nichols S. Biomechanical evaluation of bovine stifles stabilized with an innovative braided superelastic nitinol prosthesis after transection of the cranial cruciate ligament. Vet Surg 2021; 50:1398-1408. [PMID: 34435675 DOI: 10.1111/vsu.13715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 07/31/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the stability bovine stifles stabilized with nylon or nitinol superelastic prostheses after transection of the cranial cruciate ligament (CCL). STUDY DESIGN Ex vivo study. SAMPLE POPULATION Stifles (n = 15) harvested from adult bovine cadavers. METHODS The stifles were randomly assigned pairwise to a ligament reconstruction technique (n = 5): (1) and (2) Hamilton's technique using a prosthesis made of 24 nitinol strands (0.39 mm) braided at 40°or single 600-lb test nylon implant, and (3) nitinol prosthesis placed in femoral and tibial bone tunnels (bone-to-bone). Craniocaudal tibial translation at ±2000 N was applied to the tibia, and mediolateral angular displacement via measured under torsional tibial loading at ±60 Nm on three occasions: intact CCL, transected, and stabilized. Outcomes were evaluated with a mixed effect linear model for repeated measures. RESULTS Bone-to-bone using nitinol was the only repair that decreased tibial translation after CCL transection (p = .001) with a 23% change magnitude compared with intact CCL. Hamilton was the only stabilization reestablishing angular displacement, similar to intact CCL (p = .109 and .134 for nitinol and nylon). Bone-to-bone nitinol stabilization decreased angular displacement after CCL-transection with an 8% change magnitude (p = .040) without returning to normal values. CONCLUSION CCL replacement with nylon did restore joint stability. Nitinol prostheses passed through single femoral and tibial bone tunnels (bone-to-bone) were the only techniques reducing tibial translation. CLINICAL SIGNIFICANCE/IMPACT Bone-to-bone stabilization with a nitinol prosthesis may be considered as an alternative to nylon for CCL replacement in cattle. These results provide evidence to justify clinical evaluation in cattle undergoing CCL replacement.
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Affiliation(s)
- Caroline Constant
- Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
| | | | - Éric Wagnac
- École de Technologie Supérieure and Hôpital du Sacré-Cœur, Montréal, Canada
| | - Yvan Petit
- École de Technologie Supérieure and Hôpital du Sacré-Cœur, Montréal, Canada
| | - André Desrochers
- Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
| | - Sylvain Nichols
- Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Canada
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Beausejour MH, Wagnac E, Arnoux PJ, Mac-Thiong JM, Petit Y. Numerical Investigation of Spinal Cord Injury After Flexion-Distraction Injuries At the Cervical Spine. J Biomech Eng 2021; 144:1115612. [PMID: 34369552 DOI: 10.1115/1.4052003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Indexed: 11/08/2022]
Abstract
Flexion-distraction injuries frequently cause traumatic cervical spinal cord injury (SCI). Post-traumatic instability can cause aggravation of the secondary SCI during patient's care. However, there is little information on how the pattern of disco-ligamentous injury affects the SCI severity and mechanism. This study objective was to analyze how different flexion-distraction disco-ligamentous injuries affect the SCI mechanisms during post-traumatic flexion and extension. A cervical spine finite element model including the spinal cord was used and different combinations of partial or complete intervertebral disc (IVD) rupture and disruption of various posterior ligaments were modeled at C4-C5, C5-C6 or C6-C7. In flexion, complete IVD rupture combined with posterior ligamentous complex rupture was the most severe injury leading to the most extreme von Mises stress (47 to 66 kPa), principal strains p1 (0.32 to 0.41 in white matter) and p3 (-0.78 to -0.96 in white matter) in the spinal cord and to the most important spinal cord compression (35 to 48 %). The main post-trauma SCI mechanism was identified as compression of the anterior white matter at the injured level combined with distraction of the posterior spinal cord during flexion. There was also a concentration of the maximum stresses in the gray matter after injury. Finally, in extension, the injuries tested had little impact on the spinal cord. The capsular ligament was the most important structure in protecting the spinal cord. Its status should be carefully examined during patient's management.
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Affiliation(s)
- Marie-Helene Beausejour
- Department of Mechanical Engineering,École de technologie supérieure; Research Center, Hôpital du Sacré-Coeur de Montréal; International Laboratory on Spine Imaging and Biomechanics; Laboratoire de Biomécanique Appliquée-Université Gustave-Eiffel; Aix-Marseille Université, 1100, rue Notre-Dame Ouest, H3C 1K3, Montreal, Quebec, Canada
| | - Eric Wagnac
- Department of Mechanical Engineering,École de technologie supérieure; Research Center, Hôpital du Sacré-Coeur de Montréal; International Laboratory on Spine Imaging and Biomechanics, 1100, rue Notre-Dame Ouest, H3C 1K3, Montreal, Quebec, Canada
| | - Pierre-Jean Arnoux
- International Laboratory on Spine Imaging and Biomechanics; Laboratoire de Biomécanique Appliquée-Université Gustave-Eiffel; Aix-Marseille Université, Faculté de Médecine Secteur Nord, Boulevard P. Dramard, 13916, Marseille, France
| | - Jean-Marc Mac-Thiong
- Department of Surgery, Medicine Faculty, Université de Montréal; Research Center, Hôpital du Sacré-Coeur de Montréal, 5400, boulevard Gouin Ouest, H4J 1C5, Montreal, Quebec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering,École de technologie supérieure; Research Center, Hôpital du Sacré-Coeur de Montréal; International Laboratory on Spine Imaging and Biomechanics, 1100, rue Notre-Dame Ouest, H3C 1K3, Montreal, Quebec, Canada
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Guillaume F, Le Cann S, Tengattini A, Törnquist E, Falentin-Daudre C, Albini Lomami H, Petit Y, Isaksson H, Haïat G. Neutron microtomography to investigate the bone-implant interface-comparison with histological analysis. Phys Med Biol 2021; 66. [PMID: 33831846 DOI: 10.1088/1361-6560/abf603] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/08/2021] [Indexed: 12/20/2022]
Abstract
Bone properties and especially its microstructure around implants are crucial to evaluate the osseointegration of prostheses in orthopaedic, maxillofacial and dental surgeries. Given the intrinsic heterogeneous nature of the bone microstructure, an ideal probing tool to understand and quantify bone formation must be spatially resolved. X-ray imaging has often been employed, but is limited in the presence of metallic implants, where severe artifacts generally arise from the high attenuation of metals to x-rays. Neutron tomography has recently been proposed as a promising technique to study bone-implant interfaces, thanks to its lower interaction with metals. The aim of this study is to assess the potential of neutron tomography for the characterisation of bone tissue in the vicinity of a metallic implant. A standardised implant with a bone chamber was implanted in rabbit bone. Four specimens were imaged with neutron tomography and subsequently compared to non-decalcified histology to stain soft and mineralised bone tissues, used here as a ground-truth reference. An intensity-based image registration procedure was performed to place the 12 histological slices within the corresponding 3D neutron volume. Significant correlations (p < 0.01) were obtained between the two modalities for the bone-implant contact (BIC) ratio (R = 0.77) and the bone content inside the chamber (R = 0.89). The results indicate that mineralised bone tissue can be reliably detected by neutron tomography. However, theBICratio and bone content were found to be overestimated with neutron imaging, which may be explained by its sensitivity to non-mineralised soft tissues, as revealed by histological staining. This study highlights the suitability of neutron tomography for the analysis of the bone-implant interface. Future work will focus on further distinguishing soft tissues from bone tissue, which could be aided by the adoption of contrast agents.
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Affiliation(s)
- Florian Guillaume
- Département de génie mécanique, École de technologie supérieure, Montréal, Canada.,MSME, CNRS UMR 8208, Univ Paris Est Creteil, Univ Gustave Eiffel, F-94010 Creteil, France
| | - Sophie Le Cann
- MSME, CNRS UMR 8208, Univ Paris Est Creteil, Univ Gustave Eiffel, F-94010 Creteil, France
| | - Alessandro Tengattini
- Institut Laue Langevin, Grenoble, France.,Laboratoire 3SR, Université Grenoble Alpes, Gières, France
| | - Elin Törnquist
- Department of Biomedical Engineering, Lund University, SE-221 00 Lund, Sweden
| | - Céline Falentin-Daudre
- LBPS/CSPBAT, UMR CNRS 7244, Institut Galilée, Université Sorbonne Paris Nord, 99 avenue JB Clément 93430- Villetaneuse, France
| | - Hugues Albini Lomami
- MSME, CNRS UMR 8208, Univ Paris Est Creteil, Univ Gustave Eiffel, F-94010 Creteil, France
| | - Yvan Petit
- Département de génie mécanique, École de technologie supérieure, Montréal, Canada
| | - Hanna Isaksson
- Department of Biomedical Engineering, Lund University, SE-221 00 Lund, Sweden
| | - Guillaume Haïat
- MSME, CNRS UMR 8208, Univ Paris Est Creteil, Univ Gustave Eiffel, F-94010 Creteil, France
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Mishra SK, Mac-Thiong JM, Wagnac É, Petit Y, Ung B. A Sensitive and Fast Fiber Bragg Grating-Based Investigation of the Biomechanical Dynamics of In Vitro Spinal Cord Injuries. Sensors (Basel) 2021; 21:s21051671. [PMID: 33804327 PMCID: PMC7957506 DOI: 10.3390/s21051671] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 02/23/2021] [Accepted: 02/23/2021] [Indexed: 01/30/2023]
Abstract
To better understand the real-time biomechanics of soft tissues under sudden mechanical loads such as traumatic spinal cord injury (SCI), it is important to improve in vitro models. During a traumatic SCI, the spinal cord suffers high-velocity compression. The evaluation of spinal canal occlusion with a sensor is required in order to investigate the degree of spinal compression and the fast biomechanical processes involved. Unfortunately, available techniques suffer with drawbacks such as the inability to measure transverse compression and impractically large response times. In this work, an optical pressure sensing scheme based on a fiber Bragg grating and a narrow-band filter was designed to detect and demonstrate the transverse compression inside a spinal cord surrogate in real-time. The response time of the proposed scheme was 20 microseconds; a five orders of magnitude enhancement over comparable schemes that depend on costly and slower optical spectral analyzers. We further showed that this improvement in speed comes with a negligible loss in sensitivity. This study is another step towards better understanding the complex biomechanics involved during a traumatic SCI, using a method capable of probing the related internal strains with high-spatiotemporal resolution.
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Affiliation(s)
- Satyendra Kumar Mishra
- École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada; (S.K.M.); (É.W.); (Y.P.)
- Hôpital du Sacré-Cœur de Montréal, 5400 Gouin Boul. West, Montreal, QC H4J 1C5, Canada;
| | - Jean-Marc Mac-Thiong
- Hôpital du Sacré-Cœur de Montréal, 5400 Gouin Boul. West, Montreal, QC H4J 1C5, Canada;
| | - Éric Wagnac
- École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada; (S.K.M.); (É.W.); (Y.P.)
- Hôpital du Sacré-Cœur de Montréal, 5400 Gouin Boul. West, Montreal, QC H4J 1C5, Canada;
| | - Yvan Petit
- École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada; (S.K.M.); (É.W.); (Y.P.)
- Hôpital du Sacré-Cœur de Montréal, 5400 Gouin Boul. West, Montreal, QC H4J 1C5, Canada;
| | - Bora Ung
- École de Technologie Supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada; (S.K.M.); (É.W.); (Y.P.)
- Correspondence:
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Sudres P, Evin M, Wagnac E, Bailly N, Diotalevi L, Melot A, Arnoux PJ, Petit Y. Tensile mechanical properties of the cervical, thoracic and lumbar porcine spinal meninges. J Mech Behav Biomed Mater 2021; 115:104280. [PMID: 33395616 DOI: 10.1016/j.jmbbm.2020.104280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/03/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND The spinal meninges play a mechanical protective role for the spinal cord. Better knowledge of the mechanical behavior of these tissues wrapping the cord is required to accurately model the stress and strain fields of the spinal cord during physiological or traumatic motions. Then, the mechanical properties of meninges along the spinal canal are not well documented. The aim of this study was to quantify the elastic meningeal mechanical properties along the porcine spinal cord in both the longitudinal direction and in the circumferential directions for the dura-arachnoid maters complex (DAC) and solely in the longitudinal direction for the pia mater. This analysis was completed in providing a range of isotropic hyperelastic coefficients to take into account the toe region. METHODS Six complete spines (C0 - L5) were harvested from pigs (2-3 months) weighing 43±13 kg. The mechanical tests were performed within 12 h post mortem. A preload of 0.5 N was applied to the pia mater and of 2 N to the DAC samples, followed by 30 preconditioning cycles. Specimens were then loaded to failure at the same strain rate 0.2 mm/s (approximately 0.02/s, traction velocity/length of the sample) up to 12 mm of displacement. RESULTS The following mean values were proposed for the elastic moduli of the spinal meninges. Longitudinal DAC elastic moduli: 22.4 MPa in cervical, 38.1 MPa in thoracic and 36.6 MPa in lumbar spinal levels; circumferential DAC elastic moduli: 20.6 MPa in cervical, 21.2 MPa in thoracic and 12.2 MPa in lumbar spinal levels; and longitudinal pia mater elastic moduli: 18.4 MPa in cervical, 17.2 MPa in thoracic and 19.6 MPa in lumbar spinal levels. DISCUSSION The variety of mechanical properties of the spinal meninges suggests that it cannot be regarded as a homogenous structure along the whole length of the spinal cord.
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Affiliation(s)
- Patrice Sudres
- Laboratoire de Biomécanique Appliquée, UMRT24 AMU/IFSTTAR, Marseille, France; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France & Montréal, Canada
| | - Morgane Evin
- Laboratoire de Biomécanique Appliquée, UMRT24 AMU/IFSTTAR, Marseille, France; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France & Montréal, Canada.
| | - Eric Wagnac
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin blvd, Montréal Québec, H4J 1C5, Canada; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France & Montréal, Canada
| | - Nicolas Bailly
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin blvd, Montréal Québec, H4J 1C5, Canada; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France & Montréal, Canada
| | - Lucien Diotalevi
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin blvd, Montréal Québec, H4J 1C5, Canada; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France & Montréal, Canada
| | - Anthony Melot
- Laboratoire de Biomécanique Appliquée, UMRT24 AMU/IFSTTAR, Marseille, France; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France & Montréal, Canada; Hôpital privé Clairval, Marseille, France
| | - Pierre-Jean Arnoux
- Laboratoire de Biomécanique Appliquée, UMRT24 AMU/IFSTTAR, Marseille, France; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France & Montréal, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Coeur de Montréal, 5400 Gouin blvd, Montréal Québec, H4J 1C5, Canada; iLab-Spine - Laboratoire International en Imagerie et Biomécanique du Rachis, Marseille, France & Montréal, Canada
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Diotalevi L, Wagnac E, Laurent H, Petit Y. In vitro assessment of the role of the nucleus pulposus in the mechanism of vertebral body fracture under dynamic compressive loading using high-speed cineradiography. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:4717-4720. [PMID: 33019045 DOI: 10.1109/embc44109.2020.9176150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Traumatic Spinal Cord Injuries (TSCI) have a disastrous effect on the physical and mental health of both the patients and their relatives. Around 15 % of these injuries are caused by burst fractures, a sub-type of compressive fractures of the vertebral body. The transient dynamics of these fracture have been studied through in vitro experiments coupled with numerical simulations, but no direct observation have ever been made of their genesis and evolution and the behaviour of the nucleus pulposus under compressive loading has only been hypothesized. The purpose of this study was to evaluate the interactions between the vertebral body and the nucleus pulposus under dynamic compressive loading using high-speed cineradiography. A radiopaque agent was injected into the nuclei pulposi of 4 young porcine thoraco-lumbar and lumbar cadaveric segments, and a dynamic compressive load was applied to them using a servo-hydraulic bench-test. The compression process was filmed with a custom high-speed fluoroscope. The nucleus pulposus loaded the vertebral endplate up to 14,142 ± 486 N, before fracturing it and diffusing into the vertebral body. Then, internal pressure seemingly built up until an outward projection of the nucleus pulposus, at an antero-posterior velocity up to 2.9 m.s-1, or until retroprojection of bony fragments into the spinal canal. These results directly corroborate the hypotheses previously made by other studies and stress the unprecedented advantages of using high-speed cineradiography for the study of complex fractures genesis and evolution.Clinical Relevance- Methodology and results from this study would provide an unprecedented insight on the genesis and transient evolution of complex spinal fractures.
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Benasson I, Wagnac E, Diotalevi L, Moore D, Mac-Thiong JM, Petit Y. Gait analysis of a post induced traumatic spinal cord injury porcine model. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2020:3803-3806. [PMID: 33018829 DOI: 10.1109/embc44109.2020.9175280] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Porcine model constitutes a potential translational model to study traumatic spinal cord injuries (TSCI) considering its recent use in numerous studies. Recovery of the animal is currently monitored through a qualitative evaluation of the gait. Adding a quantitative evaluation might help to better assess the functional recovery of the animal. In this study, a new controlled method involving the use of an electro-magnetic actuator was used on a pig to induce a TSCI. Chronic monitoring was done using a quantitative analysis of the gait. Results show both, the injury of the pig and its functional recovery. This large animal model will help to provide a better understanding of injury and recovery mechanisms and thus could constitute a strong preclinical model for future therapeutic studies.Clinical Relevance- Methodology and results from this study would provide a better insight on the functional recovery after traumatic spinal cord injuries.
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Missiuna P, Shen J, Nahle I, Shen J, Alanazi M, Rutges J, Rocos B, Miyanji F, Lohkamp L, Grootjen L, Hachem L, Aldebeyan S, Machida M, Padhye K, Rushton P, Jentzsch T, Jentzsch T, Lewis S, Passias P, Pierce K, Lewis S, Passias P, Nielsen C, Glennie A, Crawford E, Schneider N, Ayling O, Christie S, Greene R, Singh S, Beauchamp-Chalifour P, Balasuberamaniam P, Singh S, Mercure-Cyr R, Wilson J, Evaniew N, Martin A, Rienmueller A, Martin A, Karim M, Martin A, Cheung A, Badhiwala J, Diotalevi L, Jaja B, Fallah N, Badhiwala J, Wasim A, Manson N, Lasry O, Crawford E, Brown A, MacLean MA, Khan O, Badhiwala J, Odai KG, Bailly N, Khan O, Evaniew N, Yamamoto S, Singh M, Kashigar A, Persad A, Fernandes RJR, Malakoutian M, Ahuja C, Morris S, Stukas S, Chen T, Babadagli E, Xu M, Nater A, Oitment C, Karim M, Aziz M, Pahuta M, Versteeg A, Sundararajan K, Tanguay R, Stratton A, Cushnie D, Correale M, Sadiq I, Badhiwala J, Passias P, Badhiwala J, McGregor S, Passias P, Badhiwala J, Chen T, Singh S, Ayling O, Bond M, Rienmueller A, Chen T, Lasry O, Lyons F, Ahmed U, Inglis T, Waheed Z, Wilson J, Nater A, Pahuta M, Klein G, McKibben N, Kassam F, Clement A, Kanawati A, Shaikh N, Kanawati A, Alshammari A, Kanawati A, Yamamoto S, Hamilton K, Huschi Z, Peng YN, Huschi Z, Filgueira É, Goulet J, Kashigar A, Chen T, Hadgaonkar S, MacLean M, Chen T, Kerr HL, Meagher J, Wilson J, Stevens M, Rocos B, Pai A, Kingwell S, Thibault J, Touchette C, Moskven E, Greene R, DeVries Z, Sarraj M, Bosakhar B, Thornley P, Donnellan J, Kishta W, Darby P, Nahle I, Alzakri A, Roy-Beaudry M, Joncas J, Turgeon I, Parent S, Shen J, Alzakri A, Roy-Beaudry M, Joncas J, Turgeon I, Parent S, Samson N, Lamontagne-Proulx J, Soulet D, Tremblay Y, Praud JP, Parent S, Parent S, Gross D, Renkens J, Schlösser T, Stadhouder A, Kruyt M, Mostert A, Tee J, de Klerk L, De Kleuver M, Castelein R, Zeller R, Lewis S, Tan T, Lebel D, Rushton P, Petcharaporn M, Samdani A, Newton P, Marks M, Drake J, Dirks P, Rutka J, Kulkarni A, Ibrahim G, Taylor M, Dewan M, Zeller R, Donze S, Damen L, Rutges J, Hokken-Koelega A, Mathieu F, Lamberti-Pasculi M, Hanak B, Zeller R, Kulkarni A, Drake J, Ibrahim G, Rushton P, Ghag R, Miyanji F, Zeller R, Lewis S, Lebel D, Peiro-Garcia A, Benavides B, Parsons D, Ferri-de-Barros F, Aldebeyan S, Ghag R, Miyanji F, Kutschke L, Laux C, Kabelitz M, Schüpbach R, Böni T, Farshad M, Nielsen C, Lewis S, Lenke L, Shaffrey C, Cheung K, Berven S, Qiu Y, Matsuyama Y, Pellisé-Urquiza F, Polly D, Sembrano J, Dahl B, Kelly M, de Kleuver M, Spruit M, Alanay A, Alas H, Kim HJ, Lafage R, Soroceanu A, Hockley A, Ames C, Klineberg E, Burton D, Diebo B, Bess S, Line B, Shaffrey C, Smith J, Schwab F, Lafage V, Passias P, Lafage R, Soroceanu A, Hockley A, Line B, Klineberg E, Bess S, Protopsaltis T, Shaffrey C, Schwab F, Scheer J, Smith J, Lafage V, Ames C, Lenke L, Shaffrey C, Cheung K, Berven S, Qiu Y, Matsuyama Y, Pellisé-Urquiza F, Polly D, Sembrano J, Dahl B, Kelly M, de Kleuver M, Spruit M, Alanay A, Bortz C, Pierce K, Alas H, Brown A, Soroceanu A, Hockley A, Vira S, Ahmad W, Naessig S, Diebo B, Raman T, Protopsaltis T, Buckland A, Gerling M, Lafage R, Lafage V, Lewis S, Lenke L, Shaffrey C, Cheung K, Berven S, Qiu Y, Matsuyama Y, Pellisé-Urquiza F, Polly D, Sembrano J, Dahl B, Kelly M, de Kleuver M, Spruit M, Alanay A, Bailey C, Rampersaud R, Fisher C, Chen T, McIntosh G, Rampersaud R, Karim M, Urquhart J, Fisher C, Street J, Dvorak M, Paquette S, Charest-Morin R, Ailon T, Glennie A, Manson N, Rampersaud R, Thomas K, Rasoulinejad P, Bailey C, Ailon T, Fisher C, Greene R, Glennie A, Duquette D, LeBlanc D, Martell B, Schmidt M, Christie S, Wong DBT, Di Paola C, Ailon T, Charest-Morin R, Dea N, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, Street J, Flexman A, Charest-Morin R, Wasim A, Schwartz C, Stark R, Shrikumar M, Finkelstein J, Gara A, Banaszek D, Wong T, Ailon T, Bryce E, Charest-Morin R, Dea N, Dvorak M, Fisher C, Kwon B, Paquette S, Street J, Persad A, Spiess M, Wu A, Woo A, Hnenny L, Fourney D, Joshi H, Khan O, Badhiwala J, Rampersaud R, Lewis S, Massicotte E, Fehlings M, Cadotte D, Bailey C, Christie S, Dea N, Fisher C, Paquet J, Soroceanu A, Thomas KC, Rampersaud YR, Wilson J, Manson N, Johnson M, Hall H, McIntosh G, Jacobs B, Kalsi-Ryan S, Akbar MA, Badhiwala J, Wilson J, Tetreault L, Nouri A, Rienmuller A, Massicotte E, Fehlings M, Kalsi-Ryan S, Riehm L, Martin A, Badhiwala J, Akbar M, Massicotte E, Fehlings M, Kalsi-Ryan S, Akbar MA, Badhiwala J, Wilson J, Tetreault L, Nouri A, Rienmuller A, Massicotte E, Fehlings M, Jacobs B, Johnson M, Bailey C, Christie S, Paquet J, Nataraj A, Cadotte D, Wilson J, Manson N, Hall H, Thomas K, Rampersaud R, McIntosh G, Fisher C, Dea N, Wilson J, Jentzsch T, Jiang F, Badhiwala J, Moghaddamjou A, Akbar MA, Nater A, Rienmuller A, Ganau M, Massicotte E, Fehlings M, Tu L, Manouchehri N, Kim KT, So K, Webster M, Fisk S, Tigchelaar S, Dalkilic S, Sayre E, Streijger F, Macnab A, Kwon B, Shadgan B, Wilson J, Fehlings M, Bailly N, Wagnac E, Mac-Thiong JM, Goulet J, Petit Y, Badhiwala J, Grossman R, Geisler F, Fehlings M, Wilson J, Rivers C, Kwon B, Waheed Z, Buenaventura J, Humphreys S, Noonan V, Evaniew N, Dvorak M, Wilson J, Fehlings M, Shrikumar M, Balasuberamaniam P, Rapkin B, Schwartz C, Stark R, Finkelstein J, Bigney E, Darling M, Richardson E, El-Mughayyar D, Abraham E, Street J, Radomski L, Rampersaud R, Pierce K, Bortz C, Alas H, Naessig S, Ahmad W, Vira S, Diebo B, Sciubba D, Hassanzadeh H, Hockley A, Soroceanu A, Protopsaltis T, Buckland A, Passias P, Greene R, Christie SD, Badhiwala J, Fehlings M, Witiw C, Wilson J, Fehlings M, Nessek H, Wai E, Phan P, Diotalevi L, Beauséjour MH, Wagnac E, Mac-Thiong JM, Petit Y, Badhiwala J, Fehlings M, Mazlouman S, Belley-Côté E, Jacobs B, Kwon B, Malakoutian M, Theret M, Street J, Brown S, Rossi F, Oxland T, Singh P, Chandra S, Laratta J, Carreon L, Bisson E, Ghogawala Z, Yew A, Mkorombindo T, Mummaneni P, Glassman S, Kindrachuk M, Hnenny L, Wu A, Norton J, Fourney D, Gee A, Kerr HL, Kanawati A, Zdero R, Gurr K, Bailey C, Rasoulinejad P, Yamamoto S, Sadaram S, Speidel J, Liu J, Street J, Brown S, Oxland T, Khazaei M, Walji I, Dadabhoy M, Gulati N, Aiyar N, Ostmeier S, Hasan A, Senthilnathan V, Punjani N, Yao Y, Yue S, Ozdemir G, Lou Z, Luong W, Post A, Tootsi A, Chan P, Fehlings M, Yung A, George S, Prevost V, Bauman A, Kozlowski P, Samadi F, Fournier C, Parker L, Dong K, Streijger F, Moore W, Laule C, Kwon B, Gill J, Cooper J, Dong K, Streijger F, Street J, Paquette S, Ailon T, Charest-Morin R, Fisher C, Dvorak M, Dhall S, Mac-Thiong JM, Parent S, Bailey C, Christie S, Wellington C, Kwon B, Crawford E, Zhang Y, Hardisty M, Finkelstein J, Kureshi N, Julien L, Abidi R, Christie S, Parashin S, Gascoyne T, Goytan M, Chuang J, Liu K, Quraishi N, Pasku D, Wilson J, Fehlings M, Bozzo A, Reinmuller A, Martin A, Hananel SY, Thornley P, Gazendam A, Aoude A, Nielsen C, Rampersaud R, Dea N, Versteeg A, Sahgal A, Verlaan JJ, Morin RC, Rhines L, Sciubba D, Schuster J, Weber M, Lazary A, Fehlings M, Clarke M, Arnold P, Boriani S, Laufer I, Gokaslan Z, Fisher C, Rosenzweig D, Weber M, Fisk F, Versteeg A, Fisher C, Sahgal A, Gokaslan Z, Rhines L, Boriani S, Bettegowda C, Dea N, Gal R, Charest-Morin R, Verlaan JJ, Verkooijen L, Fisher C, Perruccio A, Rampersaud R, Eckenswiller D, Yu A, Klassen K, Lewkonia P, Thomas K, Jacobs B, Miller N, Swamy G, Yang M, Soroceanu A, Phan P, Wai E, Kingwell S, Moravek D, Tierney S, Street J, Sundararajan K, Bosma R, Faclier G, Di Renna T, Rampersaud R, Frederick A, Kassam F, Nicholls F, Swamy G, Lewkonia P, Thomas K, Jacobs B, Miller N, Tanguay R, Soroceanu A, Platt A, Traynelis V, Witiw C, Horn S, Weiser-Horwitz S, Bortz C, Segreto F, Pierce K, Lafage R, Hockley A, Vira S, Lafage V, Witiw C, Wilson J, Nassiri F, da Costa L, Nathens A, Fehlings M, Jacobs B, Alas H, Pierce K, Brown A, Bortz C, Hockley A, Soroceanu A, Vira S, Naessig S, Ahmad W, Lafage R, Lafage V, Witiw C, Wilson J, da Costa L, Nathens A, Fehlings M, Crawford E, McIntosh G, Rampersaud R, Fisher C, Manson N, Thomas K, Hall H, Rampersaud R, Dea N, McIntosh G, Charest-Morin R, Investigators CSORN, Ailon T, Fisher C, Evaniew N, Aldebeyan S, Thomas K, Sundararajan K, Oitment C, Lewis S, Perruccio A, Rampersaud R, Christie S, Yee A, Fisher C, Jarzem P, Roy JF, Bouchard J, Evans D, Kwon B, Splawinski J, Warren D, Street J, Morris S, Costello J, Farrell M, Humphreys S, Kurban D, Rivers C, Jeffrey M, Juutilainen S, Casha S, Christie S, Clarke T, Drew B, Ethans K, Fehlings M, Fox R, Linassi G, Marion T, O’Connell C, Paquet J, Reid J, Scott L, Fourney D, Schouten R, Rivers C, Chen M, Nunnerley J, Croot T, Young L, Patel A, Dvorak M, Kwon B, Rivers C, Buenaventura J, Humphreys S, Noonan V, Fallah N, Evaniew N, Dvorak M, Cronin S, Badhiwala J, Ginsberg H, Fehlings M, Kwon B, Jaglal S, Wilson J, Fehlings M, Fisk F, Versteeg A, Fisher C, Sahgal A, Gokaslan Z, Rhines L, Boriani S, Bettegowda C, Dea N, Martel A, Sahgal A, Finkelstein J, Whyne C, Hardisty M, Baksh N, Nguyen T, Brown S, Jaboin J, Lin C, Yach J, Hardisty M, Whyne C, Fernandez R, Gee A, Urquhart J, Bailey C, Rasoulinejad P, Zhang H, Shewchuk J, Street J, Wilson D, Oxland T, Fernandez R, Gee A, Urquhart J, Bailey C, Rasoulinejad P, Algarni N, Aljarboa N, Jarzem P, Fernandez R, Gee A, Urquhart J, Bailey C, Rasoulinejad P, Whyte T, Van Toen C, Melnyk A, Shewchuk J, Street J, Cripton P, Oxland T, Avila M, Hurlbert RJ, Neuburger L, Ahmed SU, Cheng Y, Fourney D, Hsu HC, Kao CH, Neuburger L, Ahmed SU, Cheng Y, Fourney D, Meves R, de Oliveira AI, da Silva HC, Richard-Denis A, Petit Y, Diotalevi L, Mac-Thiong JM, Laratta J, Bisson E, Carreon L, Yew A, Mkorombindo T, Glassman S, Christie S, Bouchard J, Fisher C, Roy JF, Yee A, Jarzem P, Khurjekar K, Kothari A, Zawar A, Sanchetui P, Shyam A, Touchette C, Han JH, Christie S, Pickett G, Yee A, Bouchard J, Christie S, Fisher C, Jarzem P, Roy JF, Hashem L, Urquhart J, Rasoulinejad P, Gurr K, Siddiqi F, Bailey C, Attabib N, Bigney E, Richardson E, El-Mughayyar D, Darling M, Manson N, Abraham E, Badhiwala J, Jiang F, Wilson J, Fehlings M, Dunning C, Oxner W, Stewart S, Glennie A, Hutchinson J, Oxland T, Zhang H, Shewchuk J, Wilson D, Street J, Wilk S, Wai E, Phan P, Stratton A, Mohammed S, Tsai E, Alkerayf F, Michalowski W, Phan P, Wai E, Hoda M, MacLean M, Brunette-Clément T, Abduljabba F, Weber M, Fourney D, Charest-Morin R, Flexman A, Street J, Frey M, Mackey S, De Carvalho D, Barrowman N, Smit K, Tice A, Mervitz D, Jarvis J, Kingwell S. Canadian Spine SocietyPresentation CPSS1: Spinal insufficiency fracture in the geriatric pediatric spinePresentation CPSS2: The clinical significance of tether breakages in anterior vertebral body growth modulation: a 2-year postoperative analysisPresentation CPSS3: Anterior vertebral body growth modulation for idiopathic scoliosis: early, mid-term and late complicationsPresentation CPSS4: Ovine model of congenital chest wall and spine deformity with alterations of respiratory mechanics: follow-up from birth to 3 monthsPresentation CPSS5: Test–retest reliability and minimum detectable change of the English translation of the Italian Spine Youth Quality of Life questionnaire in adolescents with idiopathic scoliosisPresentation B1. Abstract 31: Incidence of delayed spinal cord injury in pediatric spine deformity surgery seems to be higher than previously assumedPresentation B2. Abstract 155: What is the optimal surgical method for achieving successful symptom relief in pediatric high-grade spondylolisthesis?Presentation B3. Abstract 47: Vertebral body tethering: Truly motion preserving or rather limiting?Presentation B4. Abstract 180: Fusion rates in pediatric patients after posterior cervical spine instrumentationPresentation B5. Abstract 102: Effects of 8 years of growth hormone treatment on the onset and progression of scoliosis in children with Prader–Willi syndromePresentation B6. Abstract 144: Klippel–Feil syndrome: clinical phenotypes associated with surgical treatmentPresentation B7. Abstract 123: Anterior release for idiopathic scoliosis: Is it necessary for curve correction?Presentation B8. Abstract 62: Severe scoliosis: Do we know a better way? A retrospective comparative studyPresentation B9. Abstract 21: Intraoperative skull femoral traction in adolescent idiopathic scoliosis: the correlation of traction with side-bending radiographsPresentation B10. Abstract 147: What is the effect of intraoperative halo-femoral traction on correction of adolescent idiopathic scoliosis?Presentation B11. Abstract 174: Extreme long-term outcome of surgically versus non-surgically treated patients with adolescent idiopathic scoliosisPresentation B12. Abstract 172: The influence of multilevel spinal deformity surgery on the clinical outcome in the elderly: a prospective, observational, multicentre studyPresentation B13. Abstract 49: Demographics of a prospective evaluation of elderly deformity surgery: a prospective international observational multicentre studyPresentation B14. Abstract 119: Timing of conversion to cervical malalignment and proximal junctional kyphosis following surgical correction of adult spinal deformityPresentation B15. Abstract 44: Prioritization of realignment associated with superior clinical outcomes for surgical cervical deformity patientsPresentation B16. Abstract 50: Outcome of multilevel spinal deformity surgery in patients over 60 years of age: a multicentre international prospective studyPresentation B17. Abstract 122: A simpler, modified frailty index weighted by complication occurrence correlates to pain and disability for adult spinal deformity patientsPresentation B18. Abstract 75: Change in Oswestry Disability Index at 24 months following multilevel spinal deformity surgery in patients over 60 years of age: a multicentre international prospective studyPresentation C19. Abstract 19: A prospective cohort study evaluating trends in the surgical treatment of degenerative spondylolisthesis in Canada and the utility of a novel surgical decision aidPresentation C20. Abstract 154: Decompression compared with decompression and fusion for degenerative lumbar spondylolisthesis: a Canadian Spine Outcomes and Research Network (CSORN) studyPresentation C21. Abstract ID 77: Lumbar degenerative spondylolisthesis: factors impacting decision to fusePresentation C22. Abstract 27: Patient-reported outcomes following surgery for lumbar disc herniation: comparison of a universal and multitier health care systemPresentation C23. Abstract 151: Do patients with recurrent lumbar disc herniations fair worse with discectomy than primary operations? A retrospective analysis from the Canadian Spine Outcomes and Research NetworkPresentation C24. Abstract 136: A province-wide assessment of the appropriateness of lumbar spine MRIPresentation D25. Abstract 32: Surgical site infection reduction — a 10-year quality improvement journeyPresentation D26. Abstract 34: The impact of frailty on patient-reported outcome measures following elective thoraco-lumbar spine surgeryPresentation D27. Abstract 8: Moving toward better health: exercise practice is associated with improved outcomes after spine surgeryPresentation D28. Abstract 33: Preoperative decolonization does not adversely affect the microbiologic spectrum of spine surgical site infectionPresentation D29. Abstract 61: Feedback: reducing after-hours spine cases using an encrypted messaging systemPresentation D30. Abstract 177: Complex spine surgery is safe and effective in the extremely elderly age group: results from an ambispective study of 722 patients over 75 years old from a single institutionPresentation E31. Abstract 38: Clinical predictors of achieving minimal clinically important difference after surgery for cervical spondylotic myelopathy: an external validation study from the Canadian Spine Outcomes and Research NetworkPresentation E32. Abstract 66: The natural history of degenerative cervical myelopathy: an ambispective longitudinal cohort studyPresentation E33. Abstract 159: Quantitative assessment of gait characteristics in degenerative cervical myelopathy (DCM): a prospective studyPresentation E34. Abstract 130: Prognostic factors in degenerative cervical myelopathy (DCM) for patients managed operatively and nonoperativelyPresentation E35. Abstract 175: Efficacy of surgical decompression in patients with cervical spondylotic myelopathy: results of a Canadian prospective multicentre studyPresentation E36. Abstract 67: Interobserver reliability of the modified Japanese Orthopedic Association (mJOA) score in degenerative cervical myelopathyPresentation F37. Abstract 128: Continuous optical monitoring of spinal cord hemodynamics during the first 7 days after injury in a porcine model of acute spinal cord injuryPresentation F38. Abstract 106: Development of a prediction model for central cord syndrome: an evaluation of motor recovery and the effectiveness of early surgery in a prospective, multicentre cohortPresentation F39. Abstract 135: Spinal cord dynamics under different clinical configurations of thoracolumbar burst fractures through numerical simulationsPresentation F40. Abstract 60: Predicting the heterogeneity of outcome following sensorimotor complete cervical spinal cord injury: trajectory-based analysis of 655 prospectively enrolled patientsPresentation F41. Abstract 167: Mortality in the year following discharge to the community from inpatient care for acute traumatic spinal cord injury: When and why?Presentation F42. Abstract 104: A novel method to classify patients with cervical incomplete spinal cord injury based on potential for recovery: a group-based trajectory analysis using prospective, multicentre data from over 800 patientsPresentation G43. Abstract 7: Responsiveness of standard spine outcome tools: Do they measure up?Presentation G44. Abstract 142: Patient outcomes: important psychological measuresPresentation G45. Abstract 84: Accuracy of surveillance for surgical site infections after spine surgery: a Bayesian latent class analysis using 4 independent data sourcesPresentation G46. Abstract 169: Econometric modelling: development of a surgical cost calculator for degenerative conditions of the lumbar spinePresentation G47. Abstract 124: The economic impact of nonreimbursable events in open, minimally invasive and robot-assisted lumbar fusion surgeryPresentation G48. Abstract 164: Are there sex differences in preoperative health status and health care delivery for patients undergoing scheduled lumbar surgery? An analysis from the Canadian Spine Outcomes and Research NetworkPresentation H49. Abstract 41: Patient phenotypes associated with functional outcomes after spinal cord injury: a principal component analysis in 1119 patientsPresentation H50. Abstract 103: Early versus late surgical decompression for acute traumatic spinal cord injury: a pooled analysis of prospective, multicentre data in 1548 patientsPresentation H51. Abstract 79: Clinical outcome correlation of diffusion tensor imaging and magnetic resonance imaging values: a systematic reviewPresentation H52. Abstract 137: A numerical study on the pathogenesis of central cord syndromePresentation H53. Abstract 42: Feasibility and utility of machine learning in prediction of bladder outcomes after spinal cord injury: analysis of 1250 patients from the European Multicenter Study about Spinal Cord Injury (EMSCI) registryPresentation H54. Abstract 18: Interventions to optimize spinal cord perfusion in patients with acute traumatic spinal cord injuries: a systematic reviewPresentation i55. Abstract 55: The effect of posterior lumbar spinal surgery on passive stiffness of rat paraspinal muscles 13 weeks post-surgeryPresentation i56. Abstract 43: A computed tomographic based morphometric analysis of the axis in adult populationPresentation i57. Abstract 92: Is there value to flexion–extension x-rays for degenerative spondylolisthesis? A multicentre retrospective studyPresentation i58. Abstract 98: The novel “7/20 EMG protocol” in combination with O-arm image-guided navigation for accurate lumbar pedicle placement while minimizing diagnostic radiation exposurePresentation i59. Abstract 148: Comparative biomechanical study of 2 types of transdiscal fixation implants for high-grade L5/S1 spine spondylolisthesis in a porcine modelPresentation i60. Abstract 85: The effects of fibre bundle size and vertebral level on passive stiffness of the lumbar paraspinal muscles in a rat modelPresentation J61. Abstract 157: A self-assembling peptide biomaterial to enhance human neural stem cell-based regeneration of the injured spinal cordPresentation J62. Abstract 162: Measuring demyelination, axonal loss and inflammation after human spinal cord injury with quantitative magnetic resonance imaging and histopathologyPresentation J63. Abstract 179: Characterization of ubiquitin C-terminal hydrolase L1 (UCH-L1) as a fluid biomarker of human traumatic spinal cord injuryPresentation J64. Abstract 13: Utility and role of virtual reality based simulation models in spinal decompression trainingPresentation J65. Abstract 160: Investigating the determinants for predicting surgical patient outcomes through the application of machine learning methodsPresentation J66. Abstract 143: Comparison of screw design and technique on cervical lateral mass screw fixationPresentation K67. Abstract 57: Development of clinical prognostic models for postoperative survival and quality of life in patients with surgically treated metastatic epidural spinal cord compressionPresentation K68. Abstract 170: Sarcomas of the spine: a 20-year survey of disease and treatment strategy in Ontario, CanadaPresentation K69. Abstract 15: Metastatic spine disease: Should patients with short life expectancy be denied surgical care? An international retrospective cohort studyPresentation K70. Abstract 29: Nanoparticle-functionalized polymethyl methacrylate bone cement for sustained chemotherapeutic drug deliveryPresentation K71. Abstract 90: Development of the Spine Oncology Study Group Outcomes Questionnaire – 8 Domain (SOSGOQ-8D)Presentation K72. Abstract 6: Treatment expectations of patients with spinal metastases: What do we tell our patients?Presentation L73. Abstract 48: Factors related to risk of opioid abuse in primary care patients with low back painPresentation L74. Abstract 65: QI/QA of a transitional outpatient pain program for spinePresentation L75. Abstract 168: The effect of preoperative opioid use on hospital length of stay in patients undergoing elective spine surgeryPresentation L76. Abstract 163: Disability or pain: Which best predicts patient satisfaction with surgical outcome? A Canadian Spine Outcomes and Research Network (CSORN) studyPresentation L77. Abstract 58: Rapid access to interventional pain management for lumbar nerve root pain through collaborative interprofessional provider networksPresentation L78. Abstract 63: Chronic preoperative opioid use associated with higher perioperative resource utilization and complications in adult spinal deformity patientsPresentation M79. Abstract 108: Cervical disc arthroplasty versus anterior cervical discectomy and fusion: a longitudinal analysis of reoperationsPresentation M80. Abstract 46: Preliminary results of randomized controlled trial investigating the role of psychological distress on cervical spine surgery outcomes: a baseline analysisPresentation M81. Abstract 110: Operative versus nonoperative treatment of geriatric odontoid fractures: a study of North American trauma centresPresentation M82. Abstract 74: Clinical outcome of posterior cervical foraminotomy versus anterior cervical discectomy and fusionPresentation M83. Abstract 45: “Reverse Roussouly”: ratios of cervical to thoracic shape curvature in an adult cervical deformity populationPresentation M84. Abstract 109: Treatment of acute traumatic central cord syndrome: a study of North American trauma centresPresentation N85. Abstract 118: Comparing minimally invasive versus traditional open lumbar decompression and fusion surgery: a Canadian Spine Outcomes and Research Network (CSORN) studyPresentation N86. Abstract 54: Time to return to work after lumbar spine surgeryPresentation N87. Abstract 28: Patient-reported outcomes following surgery for lumbar spinal stenosis: comparison of a universal and multitier health care systemPresentation N88. Abstract 93: Outcomes of surgery in older adults with lumbar spinal stenosisPresentation N89. Abstract 162: Functional objective assessment using the TUG test is a useful tool to evaluate outcome in lumbar spinal stenosisPresentation N90. Abstract 36: A Canadian Spine Outcomes and Research Network (CSORN) matched-cohort study comparing lumbar fusion and disk arthroplastyPresentation o91. Abstract 171: Development of clinical practice guidelines for the management of traumatic spinal column and cord injuries in British Columbia: an approach to standardizing care of spine trauma patientsPresentation o92. Abstract 22: Notes from a small island: stemming the tide of a spinal deluge. The use of encrypted software applications to ensure accountability, quality control and surgical consensus in a national acute adult spinal surgery centrePresentation o93. Abstract 129: Traumatic spinal cord injuries among Aboriginal and non-Aboriginal populations in Canada: an ambispective outcomes studyPresentation o94. Abstract 132: Traumatic spinal cord injury in New Zealand and Canada: a comparative analysisPresentation o95. Abstract 150: Exploring the reasons for readmission following traumatic spinal cord injuryPresentation o96. Abstract 59: Exploring the epidemiology and impact of spinal cord injury in the elderly: a 15-year Canadian population-based cohort studyPresentation P1. Abstract 139: Incidence and management of spinal metastasis in Ontario: a population-based studyPresentation P2. Abstract 91: A general population utility valuation study for the Spine Oncology Study Group Outcomes Questionnaire – 8DPresentation P3. Abstract 158: Metastatic vertebrae segmentation by augmented 3D convolutional neural networkPresentation P4. Abstract 73: Risk factors for failure of radiation therapy for spinal metastasesPresentation P5. Abstract 68: Significance of extracanalicular cement extravasation in thoracolumbar kyphoplastyPresentation P6. Abstract 120: Modelling fracture in osteoblastic vertebraePresentation P7. Abstract 97: The development of novel 2-in-1 patient-specific, 3D-printed laminar osteotomy guides with integrated pedicle screw guidesPresentation P8. Abstract 56: Effect of pelvic retroversion on pelvic geometry and muscle morphometry from upright magnetic resonance imagingPresentation P9. Abstract 161: Anatomic relationship between the accessory process of the lumbar spine and the pedicle screw entry pointPresentation P10. Abstract 20: Novel chair to measure lumbar spine extensors strength in adultsPresentation P11. Abstract 95: Error measurement between human spine, 3D scans, CT-based models, and 3D-printed modelsPresentation P12. Abstract 52: The diagnostic precision of computed tomography for traumatic cervical spine injury: an in vitro investigationPresentation P13. Abstract 94: Epidural abscess causing spinal cord infarctionPresentation P14. Abstract 83: The nerve root sedimentation sign on magnetic resonance imaging is not only correlated with neurogenic claudication: association with all types of leg-dominant mechanical painPresentation P15. Abstract 3: Accuracy of robot-assisted compared with freehand pedicle screw placement in spine surgery: a meta-analysis of randomized controlled trialsPresentation P16. Abstract 82: A positive nerve root sedimentation sign on magnetic resonance imaging is associated with improved surgical outcomes in patients with back dominant painPresentation P17. Abstract 16: Thoracolumbar burst fracture: McCormack load-sharing classification —systematic review and single-arm meta-analysisPresentation P18. Abstract 86: Morphological features of thoracolumbar burst fractures associated with neurologic recovery after thoracolumbar traumatic spinal cord injuryPresentation P19. Abstract 89: Radiographic parameters of listhesis and instability are not associated with health status or clinical outcomes in grade 1 degenerative spondylolisthesisPresentation P20. Abstract 37: Predictive socioeconomic factors following lumbar disk arthroplasty: a Canadian Spine Outcomes and Research Network (CSORN) studyPresentation P21. Abstract 25: Effect of in situ fusion in lumbar spondylolisthesis on clinical outcomes and spino-pelvic sagittal balancingPresentation P22. Abstract 10: Sex differences in the surgical management of lumbar degenerative disease: a systematic reviewPresentation P23. Abstract 35: Two-year results of lumbar disk arthroplasty: a Canadian Spine Outcomes and Research Network (CSORN) studyPresentation P24. Abstract 78: Does disc morphology affect the success of nonoperative treatment of chronic sciatica from a lumbar disc herniation?Presentation P25. Abstract 141: Opioid prescribing patterns: preliminary investigationPresentation P26. Abstract 133: Frailty is a better predictor of complications than age alone after surgical treatment of degenerative cervical myelopathy: an ambispective study of 5107 elderly patients from the National Surgical Quality Improvement Program databasePresentation P27. Abstract 26: Pathway analysis in spine surgery: a model for evaluating length of stayPresentation P29. Abstract 156: Patients with adolescent idiopathic scoliosis (AIS) have different cervical lordosis than the normal populationPresentation P31. Abstract 64: Investigation of thoracic spinal muscle morphology with upright magnetic resonance imagingPresentation P32. Abstract 80: Postoperative complication prediction between spinal surgeons and a machine learning model: a comparative studyPresentation P33. Abstract 81: Is using a simplified procedural classification as accurate as using current procedural terminology codes to predict future complications in spinal surgery?Presentation P34. Abstract 88: Preoperative patient performance status and frailty phenotype as predictive factors of outcome in surgically treated patients with metastatic spinal disease: a systematic literature reviewPresentation P35. Abstract 101: The measurements of frailty and their application to spine surgeryPresentation P36. Abstract 131: The effect of prolonged sitting on muscle reflexes of the low backPresentation P37. Abstract 87: Implementing a rapid discharge pathway for adolescent idiopathic scoliosis in Canada. Can J Surg 2020. [DOI: 10.1503/cjs.014720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Beauséjour MH, Petit Y, Hagen J, Arnoux PJ, Thiong JMM, Wagnac E. Contribution of injured posterior ligamentous complex and intervertebral disc on post-traumatic instability at the cervical spine. Comput Methods Biomech Biomed Engin 2020; 23:832-843. [PMID: 32463324 DOI: 10.1080/10255842.2020.1767776] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Posterior ligamentous complex (PLC) and intervertebral disc (IVD) injuries are common cervical spine flexion-distraction injuries, but the residual stability following their disruption is misknown. The objective of this study was to evaluate the effect of PLC and IVD disruption on post-traumatic cervical spine stability under low flexion moment (2 Nm) using a finite element (FE) model of C2-T1. The PLC was removed first and a progressive disc rupture (one third, two thirds and complete rupture) was modeled to simulate IVD disruption at C2-C3, C4-C5 and C6-C7. At each step, a non-traumatic flexion moment was applied and the change in stability was evaluated. PLC removal had little impact at C2-C3 but increased local range of motion (ROM) at the injured level by 77.2% and 190.7% at C4-C5 and C6-C7, respectively. Complete IVD rupture had the largest impact on C2-C3, increasing C2-C3 ROM by 181% and creating a large antero-posterior displacement of the C2-C3 segment. The FE analysis showed PLC and disc injuries create spinal instability. However, the PLC played a bigger role in the stability of the middle and lower cervical spine while the IVD was more important at the upper cervical spine. Stabilization appears important when managing patients with soft tissue injuries.
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Affiliation(s)
- Marie-Hélène Beauséjour
- Department of Mechanical Engineering, Ecole de technologie superieure, Montreal, Canada.,Department of traumatology and acute care, Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Canada.,Department TS2, Laboratoire de biomecanique appliquee, IFSTTAR, LBA UMR T24, Aix-Marseille Universite, Marseille, France
| | - Yvan Petit
- Department of Mechanical Engineering, Ecole de technologie superieure, Montreal, Canada.,Department of traumatology and acute care, Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Canada
| | - Jeremy Hagen
- Department of Mechanical Engineering, Ecole de technologie superieure, Montreal, Canada.,Department of traumatology and acute care, Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Canada
| | - Pierre-Jean Arnoux
- Department TS2, Laboratoire de biomecanique appliquee, IFSTTAR, LBA UMR T24, Aix-Marseille Universite, Marseille, France
| | - Jean-Marc Mac Thiong
- Department of traumatology and acute care, Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Canada
| | - Eric Wagnac
- Department of Mechanical Engineering, Ecole de technologie superieure, Montreal, Canada.,Department of traumatology and acute care, Research Center, Hopital du Sacre-Coeur de Montreal, Montreal, Canada
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Fournely M, Petit Y, Wagnac E, Evin M, Arnoux PJ. Effect of experimental, morphological and mechanical factors on the murine spinal cord subjected to transverse contusion: A finite element study. PLoS One 2020; 15:e0232975. [PMID: 32392241 PMCID: PMC7213721 DOI: 10.1371/journal.pone.0232975] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/24/2020] [Indexed: 12/22/2022] Open
Abstract
Finite element models combined with animal experimental models of spinal cord injury provides the opportunity for investigating the effects of the injury mechanism on the neural tissue deformation and the resulting tissue damage. Thus, we developed a finite element model of the mouse cervical spinal cord in order to investigate the effect of morphological, experimental and mechanical factors on the spinal cord mechanical behavior subjected to transverse contusion. The overall mechanical behavior of the model was validated with experimental data of unilateral cervical contusion in mice. The effects of the spinal cord material properties, diameter and curvature, and of the impactor position and inclination on the strain distribution were investigated in 8 spinal cord anatomical regions of interest for 98 configurations of the model. Pareto analysis revealed that the material properties had a significant effect (p<0.01) for all regions of interest of the spinal cord and was the most influential factor for 7 out of 8 regions. This highlighted the need for comprehensive mechanical characterization of the gray and white matter in order to develop effective models capable of predicting tissue deformation during spinal cord injuries.
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Affiliation(s)
- Marion Fournely
- Laboratoire de Biomécanique Appliquée (LBA), UMR T24, Aix-Marseille Université, IFSTTAR, Marseille, France
- International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Marseille, France
| | - Yvan Petit
- International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Marseille, France
- Mechanical Engineering Department, École de technologie supérieure, Montréal, Canada
- Research Center, Hôpital du Sacré-Cœur, Montréal, Canada
| | - Eric Wagnac
- International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Marseille, France
- Mechanical Engineering Department, École de technologie supérieure, Montréal, Canada
- Research Center, Hôpital du Sacré-Cœur, Montréal, Canada
| | - Morgane Evin
- Laboratoire de Biomécanique Appliquée (LBA), UMR T24, Aix-Marseille Université, IFSTTAR, Marseille, France
- International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Marseille, France
| | - Pierre-Jean Arnoux
- Laboratoire de Biomécanique Appliquée (LBA), UMR T24, Aix-Marseille Université, IFSTTAR, Marseille, France
- International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Marseille, France
- * E-mail:
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Dahmani J, Laporte C, Pereira D, Belanger P, Petit Y. Predictive Model for Designing Soft-Tissue Mimicking Ultrasound Phantoms With Adjustable Elasticity. IEEE Trans Ultrason Ferroelectr Freq Control 2020; 67:715-726. [PMID: 31725375 DOI: 10.1109/tuffc.2019.2953190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The use of mechanically representative phantoms is important for experimental validation in ultrasound (US) imaging, elastography, and image registration. This article proposes a model to predict the elastic modulus of a soft tissue-mimicking phantom based on two very easily controllable parameters: gelatin concentration and refrigeration duration. The model has been validated on small- and large-scale phantoms; it provides a good prediction of the elastic modulus in both cases (error < 16.2%). The tissue-mimicking phantom is made following a low-cost and simple fabrication procedure using commercial household gelatin with psyllium hydrophilic mucilloid fiber to obtain echogenicity. A large range of elastic properties was obtained (15-100kPa) by adjusting the gelatin concentration between 5% and 20% (g/mL) and the refrigeration time of the sample between 2 and 168 h, allowing to mimic normal and pathological human soft tissues. The phantom's acoustic properties (velocity, attenuation, and acoustic impedance) are also assessed using the American Institute of Ultrasound in Medicine (AIUM) standard.
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Bailly N, Diotalevi L, Beauséjour MH, Wagnac É, Mac-Thiong JM, Petit Y. Numerical investigation of the relative effect of disc bulging and ligamentum flavum hypertrophy on the mechanism of central cord syndrome. Clin Biomech (Bristol, Avon) 2020; 74:58-65. [PMID: 32145670 DOI: 10.1016/j.clinbiomech.2020.02.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 02/07/2020] [Accepted: 02/13/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The pathogenesis of the central cord syndrome is still unclear. While there is a consensus on hyperextension as the main traumatic mechanism leading to this condition, there is yet to be consensus in studies regarding the pathological features of the spine (intervertebral disc bulging or ligamentum flavum hypertrophy) that could contribute to clinical manifestations. METHODS A comprehensive finite element model of the cervical spine segment and spinal cord was used to simulate high-speed hyperextension. Four stenotic cases were modelled to study the effect of ligamentum flavum hypertrophy and intervertebral disc bulging on the von Mises stress and strain. FINDINGS During hyperextension, the downward displacement of the ligamentum flavum and a reduction of the spinal canal diameter (up to 17%) led to a dynamic compression of the cord. Ligamentum flavum hypertrophy was associated with stress and strain (peak of 0.011 Mpa and 0.24, respectively) in the lateral corticospinal tracts, which is consistent with the histologic pattern of the central cord syndrome. Linear intervertebral disc bulging alone led to a higher stress in the anterior and posterior funiculi (peak 0.029 Mpa). Combined with hypertrophic ligamentum flavum, it further increased the stress and strain in the corticospinal tracts and in the posterior horn (peak of 0.023 Mpa and 0.35, respectively). INTERPRETATION The stenotic typology and geometry greatly influence stress and strain distribution resulting from hyperextension. Ligamentum flavum hypertrophy is a main feature leading to central cord syndrome.
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Affiliation(s)
- Nicolas Bailly
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), France
| | - Lucien Diotalevi
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), France
| | - Marie-Hélène Beauséjour
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), France; Laboratoire de Biomécanique Appliquée, UMRT24 IFSTTAR- Université de la Méditerranée, F-13916 Marseille cedex 20, France
| | - Éric Wagnac
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), France
| | - Jean-Marc Mac-Thiong
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; Department of Orthopaedic Surgery, Université de Montréal, P.O. box 6128, Station Centre-Ville, Montréal, Québec H3C 3J7, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), France.
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Rouleau DM, Bedard R, Canet F, Petit Y. Teaching simulated arthroscopic Bankart repair: residents’ assessment at the Annual Shoulder Course. Can J Surg 2020; 62:227-234. [PMID: 31348628 DOI: 10.1503/cjs.004618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Background This study’s aim was to evaluate the performance of senior orthopedic residents during simulated arthroscopic anterior stabilization (Bankart repair) before and after a national shoulder review course. Methods Participants were assessed before and after the Annual Shoulder Review Course over a 3-day period, using a multiple-choice examination and surgery performance assessment. The surgical evaluation was completed by fellowship-trained surgeons using a standardized procedure checklist and a global rating scale. All Canadian senior orthopedic residents were invited to participate in the course. Results The 57 participants showed improvement following the course. The written knowledge evaluation mean score increased, and all 3 surgical performance measurements improved: surgical task time improved from 4:40 min to 2:53 min (p < 0.001), surgical technique evaluation increased from 56% to 67% after the procedure checklist (p < 0.001), and anchor placement improved for all 3 aspects. Anchor entry point was the sole measure not to improve enough to reach statistical significance (p = 0.37). Conclusion Our data support the inclusion of dry model surgical simulation as part of a surgical skills course for both training and assessment of orthopedic surgery residents.
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Affiliation(s)
- Dominique M. Rouleau
- From the Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Montreal, Que. (Rouleau, Canet, Petit); and the Department of Surgery, Université de Montréal, Montréal, Que. (Bédard)
| | - Rosalie Bedard
- From the Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Montreal, Que. (Rouleau, Canet, Petit); and the Department of Surgery, Université de Montréal, Montréal, Que. (Bédard)
| | - Fanny Canet
- From the Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Montreal, Que. (Rouleau, Canet, Petit); and the Department of Surgery, Université de Montréal, Montréal, Que. (Bédard)
| | - Yvan Petit
- From the Department of Surgery, Hôpital du Sacré-Coeur de Montréal, Montreal, Que. (Rouleau, Canet, Petit); and the Department of Surgery, Université de Montréal, Montréal, Que. (Bédard)
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Diotalevi L, Bailly N, Wagnac É, Mac-Thiong JM, Goulet J, Petit Y. Dynamics of spinal cord compression with different patterns of thoracolumbar burst fractures: Numerical simulations using finite element modelling. Clin Biomech (Bristol, Avon) 2020; 72:186-194. [PMID: 31901589 DOI: 10.1016/j.clinbiomech.2019.12.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 12/15/2019] [Accepted: 12/23/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND In thoracolumbar burst fractures, spinal cord primary injury involves a direct impact and energy transfer from bone fragments to the spinal cord. Unfortunately, imaging studies performed after the injury only depict the residual bone fragments position and pattern of spinal cord compression, with little insight on the dynamics involved during traumas. Knowledge of underlying mechanisms could be helpful in determining the severity of the primary injury, hence the extent of spinal cord damage and associated potential for recovery. Finite element models are often used to study dynamic processes, but have never been used specifically to simulate different severities of thoracolumbar burst fractures. METHODS Previously developed thoracolumbar spine and spinal cord finite element models were used and further validated, and representative vertebral fragments were modelled. A full factorial design was used to investigate the effects of comminution of the superior fragment, presence of an inferior fragment, fragments rotation and velocity, on maximum Von Mises stress and strain, maximum major strain, and pressure in the spinal cord. FINDINGS Fragment velocity clearly was the most influential factor. Fragments rotation and presence of an inferior fragment increased pressure, but rotation decreased both strains outputs. Although significant for both strains outputs, comminution of the superior fragment isn't estimated to influence outputs. INTERPRETATION This study is the first, to the authors' knowledge, to examine a detailed spinal cord model impacted in situ by fragments from burst fractures. This numeric model could be used in the future to comprehensively link traumatic events or imaging study characteristics to known spinal cord injuries severity and potential for recovery.
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Affiliation(s)
- Lucien Diotalevi
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Canada
| | - Nicolas Bailly
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Canada
| | - Éric Wagnac
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Canada.
| | - Jean-Marc Mac-Thiong
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; Department of Orthopaedic Surgery, Université de Montréal, P.O. box 6128, Station Centre-Ville, Montréal, Québec H3C 3J7, Canada
| | - Julien Goulet
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; Department of Orthopaedic Surgery, Université de Montréal, P.O. box 6128, Station Centre-Ville, Montréal, Québec H3C 3J7, Canada.
| | - Yvan Petit
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 Notre-Dame Street West, Montréal, Québec H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 Gouin blvd, Montréal H4J 1C5, Québec, Canada; International Laboratory on Spine Imaging and Biomechanics (iLab-Spine), Canada.
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Diotalevi L, Petit Y, Peyrache LM, Facchinello Y, Mac-Thiong JM, Wagnac E. A novel spinal cord surrogate for the study of compressive traumatic spinal cord injuries .. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:5678-5680. [PMID: 31947141 DOI: 10.1109/embc.2019.8857641] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Although in vitro studies are frequent for the study of traumatic spine and spinal cord injuries, few include the spinal cord due to its prompt post-mortem decay. Several materials have been proposed to mimic the spinal cord behaviour, but none matched its mechanical properties under transverse compression, which is vital for the study of burst fractures and other injury mechanisms leading to spinal cord compression. In this study, a new material named Soma Foama 15 (Reynolds Advanced Material, USA) was used to manufacture three spinal cord surrogates at 3 mixing ratios of elastomer to catalyst (1:1, 2:1 and 3:1) and tested at three different strain rates (0.5, 5 and 50 .s-1). The mixing ratio 3:1 presents a mechanical behaviour comparable to that of the porcine spinal cord at each of these strain rates, making the surrogate a valid substitute up to 75 % of transverse compression.
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Beausejour MH, Petit Y, Arnoux PJ, Wagnac E. Comparison of Two Intervertebral Disc Failure Models in a Numerical C4-C5 Trauma Model .. Annu Int Conf IEEE Eng Med Biol Soc 2020; 2019:5415-5418. [PMID: 31947080 DOI: 10.1109/embc.2019.8857095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The intervertebral disc (IVD) is essential for the mobility and stability of the spine. During flexion-distraction injuries, which are frequent at the cervical spine level, the IVD is often disrupted. Finite element studies have been done to investigate injury mechanisms and patterns at the cervical spine. However, they rarely include IVD failure model. The aim of this paper was to implement and compare two types of IVD failure models and their impact on hyperflexion and hyperflexion-compression injuries simulations. The failure models were tested on a detailed C4-C5 finite elements model. The first failure model consisted in a maximal strain model applied to the elements of the annulus and nucleus. The second failure model consisted in the implementation of a rupture plane in the middle of the IVD with a tied interface created between the two sections. This interface is defined by threshold stress values of detachment in traction and shearing. The two failure models were tested in flexion only and in flexion-compression. The model without inclusion of an IVD failure model was also tested. Loads at failure and injury patterns were reported. Both failure models produce failure loads that were consistent with experimental data. Injury patterns observed were in agreement with experimental and numerical studies. However, in flexion-compression, the rupture plane model simulation reached important energy error due to high deformations in the IVD elements. Also, without inclusion of an IVD failure model, energy error forced the end of the simulation in flexion-compression. Therefore, inclusion of IVD failure model is important since it leads to realistic results, but the maximal strain failure model is recommended.
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Sergent A, Rouleau DM, Beauvais É, Ménard J, Petit Y, Leduc S, Laflamme GY. Quantitative localization of the entry point of the lateral ascending branch of the anterior circumflex humeral artery: a high definition CT-scan radiological study. Surg Radiol Anat 2019; 42:233-237. [DOI: 10.1007/s00276-019-02356-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/29/2019] [Indexed: 10/25/2022]
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Laugier M, Tremblay J, Petit Y, Grignon-Lemieux A, Levasseur A, Lussier B. Three-dimensional kinematic evaluation of Tightrope CCL in a canine in vitro cranial cruciate deficient stifle model. Can J Vet Res 2019; 83:317-321. [PMID: 31571733 PMCID: PMC6753885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 12/12/2018] [Indexed: 06/10/2023]
Abstract
The impact of surgical correction of cranial cruciate ligament-deficient stifles (CCDS) on the 3-dimensional (3D) kinematics of the canine stifle has been sparsely evaluated. Tightrope (TR) cranial cruciate ligament (CCL) has been proposed to restore baseline 3D kinematics in CCDS by using isometric points. We hypothesized that TR would restore baseline 3D kinematics of the stifle in our model. Ten pelvic limbs were used with a previously validated apparatus. Three experimental conditions were evaluated: i) intact stifle, ii) cranial cruciate ligament transection (CCLt), and iii) CCLt stabilized with TR; kinematic data was recorded. Tightrope CCL in CCDS did not limit sagittal flexion. Tightrope CCL neutralized internal rotation without restoring baseline curves, but it did not restore abduction, nor did it neutralize or restore cranial translation, but it did restore latero-medial and proximo-distal translations. In our model, TR without pre-conditioning of the FiberTape strands did not restore baseline stifle 3D kinematics and residual cranial translation could result in frequent meniscal tears.
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Affiliation(s)
- Mathieu Laugier
- Faculté de médecine vétérinaire, Département de sciences cliniques, (Laugier); Départment de sciences cliniques, GREPAQ, Faculté de médecine vétérinaire, OA research unit CRCHUM (Lussier), Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2; Research Center (Tremblay), École de technologie supérieure, Department of mechanical engineering, Research Center (Petit, Levasseur), Sacré-Coeur Hospital, Montréal; École de technologie supérieure, Montréal (Grignon-Lemieux)
| | - Jaëlle Tremblay
- Faculté de médecine vétérinaire, Département de sciences cliniques, (Laugier); Départment de sciences cliniques, GREPAQ, Faculté de médecine vétérinaire, OA research unit CRCHUM (Lussier), Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2; Research Center (Tremblay), École de technologie supérieure, Department of mechanical engineering, Research Center (Petit, Levasseur), Sacré-Coeur Hospital, Montréal; École de technologie supérieure, Montréal (Grignon-Lemieux)
| | - Yvan Petit
- Faculté de médecine vétérinaire, Département de sciences cliniques, (Laugier); Départment de sciences cliniques, GREPAQ, Faculté de médecine vétérinaire, OA research unit CRCHUM (Lussier), Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2; Research Center (Tremblay), École de technologie supérieure, Department of mechanical engineering, Research Center (Petit, Levasseur), Sacré-Coeur Hospital, Montréal; École de technologie supérieure, Montréal (Grignon-Lemieux)
| | - Alexandre Grignon-Lemieux
- Faculté de médecine vétérinaire, Département de sciences cliniques, (Laugier); Départment de sciences cliniques, GREPAQ, Faculté de médecine vétérinaire, OA research unit CRCHUM (Lussier), Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2; Research Center (Tremblay), École de technologie supérieure, Department of mechanical engineering, Research Center (Petit, Levasseur), Sacré-Coeur Hospital, Montréal; École de technologie supérieure, Montréal (Grignon-Lemieux)
| | - Annie Levasseur
- Faculté de médecine vétérinaire, Département de sciences cliniques, (Laugier); Départment de sciences cliniques, GREPAQ, Faculté de médecine vétérinaire, OA research unit CRCHUM (Lussier), Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2; Research Center (Tremblay), École de technologie supérieure, Department of mechanical engineering, Research Center (Petit, Levasseur), Sacré-Coeur Hospital, Montréal; École de technologie supérieure, Montréal (Grignon-Lemieux)
| | - Bertrand Lussier
- Faculté de médecine vétérinaire, Département de sciences cliniques, (Laugier); Départment de sciences cliniques, GREPAQ, Faculté de médecine vétérinaire, OA research unit CRCHUM (Lussier), Université de Montréal, 3200 rue Sicotte, Saint-Hyacinthe, Quebec J2S 2M2; Research Center (Tremblay), École de technologie supérieure, Department of mechanical engineering, Research Center (Petit, Levasseur), Sacré-Coeur Hospital, Montréal; École de technologie supérieure, Montréal (Grignon-Lemieux)
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Timercan A, Brailovski V, Petit Y, Lussier B, Séguin B. Personalized 3D-printed endoprostheses for limb sparing in dogs: Modeling and in vitro testing. Med Eng Phys 2019; 71:17-29. [PMID: 31327657 DOI: 10.1016/j.medengphy.2019.07.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 06/21/2019] [Accepted: 07/04/2019] [Indexed: 01/01/2023]
Abstract
Osteosarcoma is the most common type of bone cancer in dogs, treatable by amputation or limb-sparing surgery. For the latter, commercially available plate - endoprosthesis assemblies require contouring, to be adapted to the patient's bone geometry, and lead to sub-optimal results. The use of additively-manufactured personalized endoprostheses and cutting guides for distal radius limb-sparing surgery in dogs presents a promising alternative. Specialized software is used for the bone structure reconstruction from the patient's CT scans and for the design of endoprostheses and cutting guides. The prostheses are manufactured from a titanium alloy using a laser powder bed fusion system, while the cutting guides are manufactured from an ABS plastic using a fused deposition modeling system. A finite element model of an instrumented limb was developed and validated using experimental testing of a cadaveric limb implanted with a personalized endoprosthesis. Personalized endoprostheses and cutting guides can reduce limb sparing surgery time by 25-50% and may reduce the risk of implant failure. The numerical model was validated using the kinematics and force-displacement diagrams of the implant-limb construct. The model indicated that a modulus of elasticity of an implant material ranging from 25 to 50 GPa would improve the stress distribution within the implant. The results of the current study will allow optimization of the design of the personal implants in both veterinary and human patients.
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Affiliation(s)
- Anatolie Timercan
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame West, Montreal, Quebec H3C1K3, Canada.
| | - Vladimir Brailovski
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame West, Montreal, Quebec H3C1K3, Canada.
| | - Yvan Petit
- Department of Mechanical Engineering, École de technologie supérieure, 1100 Notre-Dame West, Montreal, Quebec H3C1K3, Canada.
| | - Bertrand Lussier
- Faculty of Veterinary Medicine, Université de Montréal, 3200 Sicotte, Saint-Hyacinthe, Quebec J2S2M2, Canada.
| | - Bernard Séguin
- Colorado State University Flint Animal Cancer Center, 300 W Drake, Fort Collins, Colorado 80525, USA.
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Séguin B, Pinard C, Lussier B, Williams D, Griffin L, Podell B, Mejia S, Timercan A, Petit Y, Brailovski V. Limb-sparing in dogs using patient-specific, three-dimensional-printed endoprosthesis for distal radial osteosarcoma: A pilot study. Vet Comp Oncol 2019; 18:92-104. [PMID: 31209977 DOI: 10.1111/vco.12515] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 05/26/2019] [Accepted: 05/31/2019] [Indexed: 12/22/2022]
Abstract
Limb-sparing for distal radial osteosarcoma has a high rate of complications. Using personalized three-dimensional (3D)-printed implants might improve outcome. The goals of this study were to optimize use of patient-specific, 3D-printed endoprostheses for limb-sparing in dogs in the clinical environment and to report the outcome. This was a pilot study where five client-owned dogs were enrolled. Computed tomography (CT) of the thoracic limbs was performed, which was used to create patient-specific endoprostheses and cutting guides, and repeated on the day of surgery. Intra-arterial (IA) carboplatin was introduced in the clinical management. Limb-sparing was performed. Outcome measures were time required to produce the endoprosthesis and cutting guide, fit between cutting guide and endoprosthesis with host bones, gait analysis, size of the tumour, percent tumour necrosis, complications, disease-free interval (DFI) and survival time (ST). Four dogs received IA carboplatin. Excessive tumour growth between planning CT and surgery did not occur in any dog. The interval between the CT and surgery ranged from 14 to 70 days. Fit between the cutting-guide and endoprosthesis with the host bones was good to excellent. At least one complication occurred in all dogs. Two dogs were euthanized with STs of 192 and 531 days. The other dogs were alive with a follow up of 534 to 575 days. IA chemotherapy is a promising strategy to minimize the risk of excessive tumour growth while waiting for the endoprosthesis and cutting-guide to be made. The design of the cutting-guide was critical for best fit of the endoprosthesis with host bones.
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Affiliation(s)
- Bernard Séguin
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Chris Pinard
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Bertrand Lussier
- Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, Montréal, Québec, Canada
| | - Deanna Williams
- Veterinary Teaching Hospital, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Lynn Griffin
- Department of Environmental and Radiological Health Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Brendan Podell
- Department of Microbiology, Immunology, and Pathology, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Sebastian Mejia
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Fort Collins, Colorado
| | - Anatolie Timercan
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
| | - Vladimir Brailovski
- Department of Mechanical Engineering, Ecole de Technolgie Supérieure, Montréal, Québec, Canada
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Lecours C, Petit Y, Wagnac É. Biomechanical Analysis of Head Impacts during Real Time Soccer Play: a Preliminary Study. Med Sci Sports Exerc 2019. [DOI: 10.1249/01.mss.0000561921.20872.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Petit Y, Park CH, Mok JM, Smetanina E, Chimier B, Duchateau G, Cardinal T, Canioni L, Park SH. Ultrashort laser induced spatial redistribution of silver species and nano-patterning of etching selectivity in silver-containing glasses. Opt Express 2019; 27:13675-13680. [PMID: 31163827 DOI: 10.1364/oe.27.013675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/03/2019] [Indexed: 06/09/2023]
Abstract
Femtosecond laser-induced spatial redistribution of silver species (ions, clusters, and hole centers) in a silver-containing phosphate glass is investigated by correlative means of near-field scanning optical microscopy (NSOM) images, numerical simulations, chemical micro-probe analysis, and nanoscale spatial profiles after soft etching. In particular, we found that the chemical etching selectivity for nanoscale patterning is strongly dependent upon the irradiation of femtosecond laser due to the spatial redistribution of silver species within the affected area. These results strongly indicate that controlling the distribution of silver species by femtosecond laser irradiation may open new routes for surface nanoscale chemical and/or spatial patterning for the fabrication of 2D surface photonic crystals.
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Seguin B, Pinard C, Lussier B, Griffin L, Duerr F, Williams D, Timercan A, Petit Y, Brailovski V. Limb Sparing in Dogs using Individualized 3D-Printed Endoprostheses and Cutting Guides for Distal Radial Osteosarcoma: A Pilot Study. Vet Comp Orthop Traumatol 2019. [DOI: 10.1055/s-0039-1692225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- B. Seguin
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, United States
| | - C. Pinard
- Flint Animal Cancer Center, Colorado State University, Fort Collins, Colorado, United States
| | - B. Lussier
- Sciences Cliniques, Universite de Montreal, St-Hyacinthe, Quebec, Canada
| | - L. Griffin
- Clinical Sciences, Colorado State University, Ft. Collins, Colorado, United States
| | - F.M. Duerr
- Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, United States
| | - D. Williams
- Veterinary Teaching Hospital, Colorado State University, Fort Collins, Colorado, United States
| | - A. Timercan
- Ecole de technologie superieure, Montreal, Quebec, Canada
| | - Y. Petit
- Departement de genie mecanique, Ecole de technologie superieure, Montreal, Quebec, Canada
| | - V. Brailovski
- Departement de genie mecanique, Ecole de technolgie superieure, Montreal, Quebec, Canada
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Niederman F, Lechler T, Petit Y. A Research Agenda for Extending Agile Practices In Software Development and Additional Task Domains. Project Management Journal 2018. [DOI: 10.1177/8756972818802713] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This article is intended to serve as an introduction to this special issue on agile practices. In doing so, we briefly survey a number of key issues that are emerging in the application of agile practices to software development (SWD) and, similarly, examine recent work on extending knowledge about these practices to other task domains. We note that the extant literature on agile practices has been criticized for lacking a theoretical basis and comment on various ways that a theory orientation can enhance the accumulation of knowledge in this area. We also address issues that expand our current understanding of agile practices as they apply to non-SWD tasks. We present a framework for surfacing and discussing some of these emergent issues. We comment on the articles in this special issue and situate them within the research framework. We discuss some of the topics we think are likely to become influential as agile practices move outside the SWD domain and, finally, we present some summarizing observations.
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Affiliation(s)
- Fred Niederman
- Chaifetz School of Business Saint Louis University, St. Louis, MO, USA
| | | | - Yvan Petit
- Business School of University of Quebec at Montreal, QC, Canada
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Diotalevi L, Petit Y, Brailovski V, Nichols S, Marchionatti E, Wagnac É. Quasi-static tensile properties of the Cranial Cruciate Ligament (CrCL) in adult cattle: towards the design of a prosthetic CrCL. J Mech Behav Biomed Mater 2017; 79:239-245. [PMID: 29331937 DOI: 10.1016/j.jmbbm.2017.12.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/10/2017] [Accepted: 12/22/2017] [Indexed: 11/18/2022]
Abstract
Mechanical properties of the Cranial Cruciate Ligament (CrCL) in adult cattle are not well documented and protocols used in the literature focus on testing a full femur-CrCL-tibia complex rather than an isolated CrCL. The aim of this study was to assess a wider range of tensile properties of the CrCL along its anatomic axis with experimental measurements of the global elongation, displacement and strain fields, in order to provide guidelines for the design of CrCL prosthetic surrogates. Fourteen bovine CrCL were harvested from seven mature cows (5.1 ± 1.3 years) weighing 631 ± 90kg. The mean CrCL length was 41.4 ± 1.5mm and its mean cross-section was 103.9 ± 23.8mm2. Pre-conditioning was achieved with 30 cycles of loading from 30 to 200N at a strain rate of 0.02s-1. Specimens were then loaded to failure at the same strain rate. The following results were obtained: the mean ultimate tensile load (UTL) 4372 ± 1485N and the median [quartiles] maximal global elongation 19.3 [17.8; 21.4] %. At first physical signs of tearing, the mean load was 3315 ± 1336N and mean elongation 13.5 ± 4.9%. The mean absorbed energy at failure was 5.23 ± 2.08 MJ.mm-3 and the mean stiffness at various levels of elongation was: 220 ± 195N.%-1 (5%), 285 ± 162N.%-1 (10%), 239 ± 200N.%-1 (15%), 146 ± 59N.%-1 (20%), 153 ± 136N.%-1 (25%). None of these properties were related to the bovine weight, age and side of the body (p > 0.05). An ideal prosthetic surrogate should then follow these sets of properties and the experimental data suggest that the in-vivo maximal elongation is below 13.5%.
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Affiliation(s)
- Lucien Diotalevi
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, Québec, Canada H3C 1K3; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 boulevard Gouin, Montréal, Québec, Canada H4J 1C5.
| | - Yvan Petit
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, Québec, Canada H3C 1K3; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 boulevard Gouin, Montréal, Québec, Canada H4J 1C5.
| | - Vladimir Brailovski
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, Québec, Canada H3C 1K3; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 boulevard Gouin, Montréal, Québec, Canada H4J 1C5.
| | - Sylvain Nichols
- Université de Montréal, Faculty of Veterinary Medicine, 3200 rue Sciotte, Saint-Hyacinthe, Québec, Canada J2S 2M2.
| | - Emma Marchionatti
- Université de Montréal, Faculty of Veterinary Medicine, 3200 rue Sciotte, Saint-Hyacinthe, Québec, Canada J2S 2M2.
| | - Éric Wagnac
- Department of Mechanical Engineering, École de Technologie Supérieure, 1100 rue Notre-Dame Ouest, Montréal, Québec, Canada H3C 1K3; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400 boulevard Gouin, Montréal, Québec, Canada H4J 1C5.
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Wagnac E, Aubin CÉ, Chaumoître K, Mac-Thiong JM, Ménard AL, Petit Y, Garo A, Arnoux PJ. Substantial vertebral body osteophytes protect against severe vertebral fractures in compression. PLoS One 2017; 12:e0186779. [PMID: 29065144 PMCID: PMC5655488 DOI: 10.1371/journal.pone.0186779] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Accepted: 10/06/2017] [Indexed: 11/19/2022] Open
Abstract
Recent findings suggest that vertebral osteophytes increase the resistance of the spine to compression. However, the role of vertebral osteophytes on the biomechanical response of the spine under fast dynamic compression, up to failure, is unclear. Seventeen human spine specimens composed of three vertebrae (from T5-T7 to T11-L1) and their surrounding soft tissues were harvested from nine cadavers, aged 77 to 92 years. Specimens were imaged using quantitative computer tomography (QCT) for medical observation, classification of the intervertebral disc degeneration (Thomson grade) and measurement of the vertebral trabecular density (VTD), height and cross-sectional area. Specimens were divided into two groups (with (n = 9) or without (n = 8) substantial vertebral body osteophytes) and compressed axially at a dynamic displacement rate of 1 m/s, up to failure. Normalized force-displacement curves, videos and QCT images allowed characterizing failure parameters (force, displacement and energy at failure) and fracture patterns. Results were analyzed using chi-squared tests for sampling distributions and linear regression for correlations between VTD and failure parameters. Specimens with substantial vertebral body osteophytes present higher stiffness (2.7 times on average) and force at failure (1.8 times on average) than other segments. The presence of osteophytes significantly influences the location, pattern and type of fracture. VTD was a good predictor of the dynamic force and energy at failure for specimens without substantial osteophytes. This study also showed that vertebral body osteophytes provide a protective mechanism to the underlying vertebra against severe compression fractures.
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Affiliation(s)
- Eric Wagnac
- Department of Mechanical Engineering, École de technologie supérieure, Montréal, Québec, Canada
- Research Center, Sacré-Cœur Hospital, Montreal, Quebec, Canada
- iLAB-Spine, Associated International Laboratory on Spine Biomechanics and Imagery, Montreal, Canada
- * E-mail:
| | - Carl-Éric Aubin
- iLAB-Spine, Associated International Laboratory on Spine Biomechanics and Imagery, Montreal, Canada
- Department of Mechanical Engineering, École Polytechnique de Montréal, Montreal, Canada
- Research Center, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
| | - Kathia Chaumoître
- Department of medical imaging, North Hospital, Aix Marseille Université, Marseille, France
- Laboratoire d’Anthropologie Biologique, Aix Marseille Université, Marseille, France
| | - Jean-Marc Mac-Thiong
- Research Center, Sacré-Cœur Hospital, Montreal, Quebec, Canada
- Research Center, Sainte-Justine University Hospital Center, Montreal, Quebec, Canada
- Department of Surgery, Faculty of medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Anne-Laure Ménard
- Department of Mechanical Engineering, École de technologie supérieure, Montréal, Québec, Canada
| | - Yvan Petit
- Department of Mechanical Engineering, École de technologie supérieure, Montréal, Québec, Canada
- Research Center, Sacré-Cœur Hospital, Montreal, Quebec, Canada
- iLAB-Spine, Associated International Laboratory on Spine Biomechanics and Imagery, Montreal, Canada
| | - Anaïs Garo
- Department of Mechanical Engineering, École Polytechnique de Montréal, Montreal, Canada
- Laboratoire de Biomécanique Appliquée, IFSTTAR Aix Marseille Université, Marseille, France
| | - Pierre-Jean Arnoux
- Laboratoire de Biomécanique Appliquée, IFSTTAR Aix Marseille Université, Marseille, France
- iLAB-Spine, Associated International Laboratory on Spine Biomechanics and Imagery, Marseille, France
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Brummund M, Brailovski V, Petit Y, Facchinello Y, Mac-Thiong JM. Impact of spinal rod stiffness on porcine lumbar biomechanics: Finite element model validation and parametric study. Proc Inst Mech Eng H 2017; 231:1071-1080. [PMID: 28927347 DOI: 10.1177/0954411917732596] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A three-dimensional finite element model of the porcine lumbar spine (L1-L6) was used to assess the effect of spinal rod stiffness on lumbar biomechanics. The model was validated through a comparison with in vitro measurements performed on six porcine spine specimens. The validation metrics employed included intervertebral rotations and the nucleus pressure in the first instrumented intervertebral disc. The numerical results obtained suggest that rod stiffness values as low as 0.1 GPa are required to reduce the mobility gradient between the adjacent and instrumented segments and the nucleus pressures across the porcine lumbar spine significantly. Stiffness variations above this threshold value have no significant effect on spine biomechanics. For such low-stiffness rods, intervertebral rotations in the instrumented zone must be monitored closely in order to guarantee solid fusion. Looking ahead, the proposed model will serve to examine the transverse process hooks and variable stiffness rods in order to further smooth the transition between the adjacent and instrumented segments, while preserving the stability of the instrumented zone, which is needed for fusion.
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Affiliation(s)
- Martin Brummund
- 1 Department of Mechanical Engineering, École de technologie supérieure, Montreal, QC, Canada.,2 Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Vladimir Brailovski
- 1 Department of Mechanical Engineering, École de technologie supérieure, Montreal, QC, Canada.,2 Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Yvan Petit
- 1 Department of Mechanical Engineering, École de technologie supérieure, Montreal, QC, Canada.,2 Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Yann Facchinello
- 1 Department of Mechanical Engineering, École de technologie supérieure, Montreal, QC, Canada.,2 Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada
| | - Jean-Marc Mac-Thiong
- 2 Research Center, Hôpital du Sacré-Cœur de Montréal, Montreal, QC, Canada.,3 Department of Surgery, Faculty of Medicine, University of Montreal, Montreal, QC, Canada
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Facchinello Y, Wagnac É, Ung B, Petit Y, Pradhan P, Peyrache LM, Mac-Thiong JM. Development of an instrumented spinal cord surrogate using optical fibers: A feasibility study. Med Eng Phys 2017; 48:212-216. [PMID: 28687472 DOI: 10.1016/j.medengphy.2017.06.033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 06/15/2017] [Accepted: 06/17/2017] [Indexed: 11/17/2022]
Abstract
In vitro replication of traumatic spinal cord injury is necessary to understand its biomechanics and to improve animal models. During a traumatic spinal cord injury, the spinal cord withstands an impaction at high velocity. In order to fully assess the impaction, the use of spinal canal occlusion sensor is necessary. A physical spinal cord surrogate is also often used to simulate the presence of the spinal cord and its surrounding structures. In this study, an instrumented physical spinal cord surrogate is presented and validated. The sensing is based on light transmission loss observed in embedded bare optical fibers subjected to bending. The instrumented surrogate exhibits similar mechanical properties under static compression compared to fresh porcine spinal cords. The instrumented surrogate has a compression sensing threshold of 40% that matches the smallest compression values leading to neurological injuries. The signal obtained from the sensor allows calculating the compression of the spinal cord surrogate with a maximum of 5% deviation. Excellent repeatability was also observed under repetitive loading. The proposed instrumented spinal cord surrogate is promising with satisfying mechanical properties and good sensing capability. It is the first attempt at proposing a method to assess the internal loads sustained by the spinal cord during a traumatic injury.
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Affiliation(s)
- Yann Facchinello
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, Quebec H4J 1C5, Canada ; Department of Surgery, Faculty of Medicine, University of Montreal, Pavillon Roger-Gaudry, S-749, C.P. 6128, succ. Centre-ville, Montreal, Quebec H3C 3J7, Canada
| | - Éric Wagnac
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, Quebec H4J 1C5, Canada ; École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, Quebec H3C 1K3, Canada.
| | - Bora Ung
- École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, Quebec H3C 1K3, Canada
| | - Yvan Petit
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, Quebec H4J 1C5, Canada ; École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, Quebec H3C 1K3, Canada
| | - Prabin Pradhan
- École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, Quebec H3C 1K3, Canada
| | - Louis-Marie Peyrache
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, Quebec H4J 1C5, Canada ; École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, Quebec H3C 1K3, Canada
| | - Jean-Marc Mac-Thiong
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, Quebec H4J 1C5, Canada ; Department of Surgery, Faculty of Medicine, University of Montreal, Pavillon Roger-Gaudry, S-749, C.P. 6128, succ. Centre-ville, Montreal, Quebec H3C 3J7, Canada
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Abstract
Agile methods have taken software development by storm but have been primarily applied to projects in what is referred to as the “agile sweet spot,” which consists of small collocated teams working on small, non-critical, green field, in-house software projects with stable architectures and simple governance rules. These methods are being used more and more on large projects, but little documentation is available in the academic literature. This article investigates the adoption and adaptation of agile methods for use on large projects in large organizations. The empirical study is based first on case studies, followed by a survey to validate and enrich the case study results. The results are somewhat paradoxical in that some features are common to almost all observations, whereas others show extreme variability. The common features include use of Scrum methodology and agile coaches, as well as the non-respect of the agile principle of emergent architecture.
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Affiliation(s)
- Brian Hobbs
- School of Management, University of Quebec at Montreal, Canada
| | - Yvan Petit
- School of Management, University of Quebec at Montreal, Canada
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Smetanina EO, Chimier B, Petit Y, Royon A, Cardinal T, Canioni L, Duchateau G. Laser writing of nonlinear optical properties in silver-doped phosphate glass. Opt Lett 2017; 42:1688-1691. [PMID: 28454136 DOI: 10.1364/ol.42.001688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The formation of both local second- and third-harmonic generations (SHG and THG) induced by a train of femtosecond laser pulses in silver-doped phosphate glasses is addressed. Based on modeling calculations, including various diffusion and kinetic processes, THG is shown to result from the formation of silver clusters. The latter organize into a ring-shape structure, leading to the emergence of a static electric field. By breaking the glass centro-symmetry, this field gives rise to a local effective second-order susceptibility, inducing SHG. Both theoretically predicted SHG and THG evolutions with respect to the number of pulses in the train are in good agreement with experimental observations. In particular, the observed reaching of a maximum in the nonlinear optical responses after a few thousands of pulses is explained by the competition of various physical processes. A cooling of the glass is shown to improve the process efficiency of the laser writing of second-order nonlinearity.
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Fradet L, Cliche F, Petit Y, Mac-Thiong JM, Arnoux PJ. Strain rate dependent behavior of the porcine spinal cord under transverse dynamic compression. Proc Inst Mech Eng H 2016; 230:858-866. [DOI: 10.1177/0954411916655373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The accurate description of the mechanical properties of spinal cord tissue benefits to clinical evaluation of spinal cord injuries and is a required input for analysis tools such as finite element models. Unfortunately, available data in the literature generally relate mechanical properties of the spinal cord under quasi-static loading conditions, which is not adapted to the study of traumatic behavior, as neurological tissue adopts a viscoelastic behavior. Thus, the objective of this study is to describe mechanical properties of the spinal cord up to mechanical damage, under dynamic loading conditions. A total of 192 porcine cervical to lumbar spinal cord samples were compressed in a transverse direction. Loading conditions included ramp tests at 0.5, 5 or 50 s−1 and cyclic loading at 1, 10 or 20 Hz. Results showed that spinal cord behavior was significantly influenced by strain rate. Mechanical damage occurred at 0.64, 0.68 and 0.73 strains for 0.5, 5 or 50 s−1 loadings, respectively. Variations of behavior between the tested strain rates were explained by cyclic loading results, which revealed behavior more or less viscous depending on strain rate. Also, a parameter (stress multiplication factor) was introduced to allow transcription of a stress–strain behavior curve to different strain rates. This factor was described and was significantly different for cervical, thoracic and lumbar vertebral heights, and for the strain rates evaluated in this study.
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Affiliation(s)
- Léo Fradet
- Département de Génie Mécanique, École Polytechnique de Montréal, Montréal, QC, Canada
- iLab-Spine (International Laboratory - Spine Imaging and Biomechanics), Montreal, Canada and Marseille, France
| | - Francis Cliche
- iLab-Spine (International Laboratory - Spine Imaging and Biomechanics), Montreal, Canada and Marseille, France
- Département de Génie Mécanique, École de technologie supérieure, Montréal, QC, Canada
- Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - Yvan Petit
- iLab-Spine (International Laboratory - Spine Imaging and Biomechanics), Montreal, Canada and Marseille, France
- Département de Génie Mécanique, École de technologie supérieure, Montréal, QC, Canada
- Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
- Laboratoire de Biomécanique Appliquée, UMRT24 IFSTTAR, Université de la Méditerranée Aix-Marseille II, Marseille, France
| | - Jean-Marc Mac-Thiong
- iLab-Spine (International Laboratory - Spine Imaging and Biomechanics), Montreal, Canada and Marseille, France
- Research Center, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
- Department of Surgery, Université de Montréal, Montréal, QC, Canada
| | - Pierre-Jean Arnoux
- iLab-Spine (International Laboratory - Spine Imaging and Biomechanics), Montreal, Canada and Marseille, France
- Laboratoire de Biomécanique Appliquée, UMRT24 IFSTTAR, Université de la Méditerranée Aix-Marseille II, Marseille, France
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Sandman E, Canet F, Petit Y, Laflamme GY, Athwal GS, Rouleau DM. Effect of elbow position on radiographic measurements of radio-capitellar alignment. World J Orthop 2016; 7:117-122. [PMID: 26925383 PMCID: PMC4757656 DOI: 10.5312/wjo.v7.i2.117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 10/22/2015] [Accepted: 12/04/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To evaluate the effect of different elbow and forearm positions on radiocapitellar alignment.
METHODS: Fifty-one healthy volunteers were recruited and bilateral elbow radiographs were taken to form a radiologic database. Lateral elbow radiographs were taken with the elbow in five different positions: Maximal extension and forearm in neutral, maximal flexion and forearm in neutral, elbow at 90° and forearm in neutral, elbow at 90° and forearm in supination and elbow at 90° and forearm in pronation. A goniometer was used to verify the accuracy of the elbow’s position for the radiographs at a 90° angle. The radiocapitellar ratio (RCR) measurements were then taken on the collected radiographs using the SliceOmatic software. An orthopedic resident performed the radiographic measurements on the 102 elbows, for a total of 510 lateral elbow radiographic measures. ANOVA paired t-tests and Pearson coefficients were used to assess the differences and correlations between the RCR in each position.
RESULTS: Mean RCR values were -2% ± 7% (maximal extension), -5% ± 9% (maximal flexion), and for elbow at 90° and forearm in neutral -2% ± 5%, supination 1% ± 6% and pronation 1% ± 5%. ANOVA analyses demonstrated significant differences between the RCR in different elbow and forearm positions. Paired t-tests confirmed significant differences between the RCR at maximal flexion and flexion at 90°, and maximal extension and flexion. The Pearson coefficient showed significant correlations between the RCR with the elbow at 90° - maximal flexion; the forearm in neutral-supination; the forearm in neutral-pronation.
CONCLUSION: Overall, 95% of the RCR values are included in the normal range (obtained at 90° of flexion) and a value outside this range, in any position, should raise suspicion for instability.
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Petit Y, Boisclair D, Parent S, Mac-Thiong JM. Simulation of high energy vertebral fractures on complete porcine specimens. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:3901-4. [PMID: 26737146 DOI: 10.1109/embc.2015.7319246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
This work presents a novel method creating high energy vertebral fractures on complete swine specimens to investigate realistic vertebral fracture mechanisms. An apparatus was developed to maintain a porcine specimen in an upright position and apply a caudal impact simulating a fall. Five mature minipigs were impacted with varying impact magnitude. Computed tomography scans were used to assess the resulting fracture type, fracture level, spinal canal encroachment and fractures of adjacent bony structures. Lumbar fractures were produced on four specimens: three inferior endplate burst fractures (L2) and one superior endplate burst fracture (L5). One trial resulted in a hyperextension fracture between L2 and L3 vertebrae. Spinal canal encroachment was important for three specimens. No fracture was created on the pelvis or hind limbs. The proposed method developed and the resulting swine model of high energy vertebral fractures could be used to instigate novel biomechanical studies, to validate finite element models or to investigate surgical strategies.
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Brummund M, Brailovski V, Facchinello Y, Petit Y, Mac-Thiong JM. Implementation of a 3D porcine lumbar finite element model for the simulation of monolithic spinal rods with variable flexural stiffness. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:917-20. [PMID: 26736412 DOI: 10.1109/embc.2015.7318512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Monolithic superelastic-elastoplastic spinal rods (MSER) are promising candidates to provide (i) dynamic stabilisation in spinal segments prone to mechanical stress concentration and adjacent segment disease and (ii) to provide fusion-ready stabilization in spinal segments at risk of implant failure. However, the stiffness distributions along the rod's longitudinal axis that best meet clinical requirements remain unknown. The present study is part of a mixed numerical experimental research project and aims at the implementation of a 3D finite element model of the porcine lumbar spine to study the role of MSER material properties and stiffness distributions on the intradiscal pressure distribution in the adjacent segment. In this paper, preliminary intradiscal pressure predictions obtained at one functional spinal unit are presented. Due to a lack of porcine material property data, these predictions were obtained on the basis of uncalibrated human vertebral disc data which were taken from the literature. The results indicate that human annulus and nucleus data predict experimental porcine in vivo and in vitro data reasonably well for the compressive forces of varying magnitudes.
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Facchinello Y, Brailovski V, Petit Y, Brummund M, Tremblay J, Mac-Thiong JM. Biomechanical assessment of the stabilization capacity of monolithic spinal rods with different flexural stiffness and anchoring arrangement. Clin Biomech (Bristol, Avon) 2015; 30:1026-35. [PMID: 26421654 DOI: 10.1016/j.clinbiomech.2015.09.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/12/2015] [Accepted: 09/15/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND Spinal disorders can be treated by several means including fusion surgery. Rigid posterior instrumentations are used to obtain the stability needed for fusion. However, the abrupt stiffness variation between the stabilized and intact segments leads to proximal junctional kyphosis. The concept of spinal rods with variable flexural stiffness is proposed to create a more gradual transition at the end of the instrumentation. METHOD Biomechanical tests were conducted on porcine spine segments (L1-L6) to assess the stabilization capacity of spinal rods with different flexural stiffness. Dual-rod fusion constructs containing three kinds of rods (Ti, Ti-Ni superelastic, and Ti-Ni half stiff-half superelastic) were implanted using two anchor arrangements: pedicle screws at all levels or pedicle screws at all levels except for upper instrumented vertebra in which case pedicle screws were replaced with transverse process hooks. Specimens were loaded in forward flexion, extension, and lateral bending before and after implantation of the fusion constructs. The effects of different rods on specimen stiffness, vertebra mobility, intradiscal pressures, and anchor forces were evaluated. FINDING The differences in rod properties had a moderate impact on the biomechanics of the instrumented spine when only pedicle screws were used. However, this effect was amplified when transverse process hooks were used as proximal anchors. INTERPRETATION Combining transverse hooks and softer (Ti-Ni superelastic and Ti-Ni half stiff-half superelastic) rods provided more motion at the upper instrumented level and applied less force on the anchors, potentially improving the load sharing capacity of the instrumentation.
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Affiliation(s)
- Yann Facchinello
- École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, QC H4J 1C5, Canada
| | - Vladimir Brailovski
- École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, QC H4J 1C5, Canada.
| | - Yvan Petit
- École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, QC H4J 1C5, Canada
| | - Martin Brummund
- École de technologie supérieure, 1100 Notre-Dame Street West, Montreal, QC H3C 1K3, Canada; Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, QC H4J 1C5, Canada
| | - Jaëlle Tremblay
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, QC H4J 1C5, Canada
| | - Jean-Marc Mac-Thiong
- Research Center, Hôpital du Sacré-Cœur de Montréal, 5400, Gouin Boul. West, Montreal, QC H4J 1C5, Canada; Department of Surgery, Faculty of Medicine, University of Montreal, Pavillon Roger-Gaudry, S-749, C.P. 6128, succ. Centre-ville, Montreal, QC H3C 3J7, Canada
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