Sharif Digital Repository

Labeling vertebral discs from MRI scans is important for the proper diagnosis of spinal related diseases, including multiple sclerosis, amyotrophic lateral sclerosis, degenerative cervical myelopathy and cancer. Automatic labeling of the vertebral discs in MRI data is a difficult task because of the similarity between discs and bone area, the variability in the geometry of the spine and surrounding tissues across individuals, and the variability across scans (manufacturers, pulse sequence, image contrast, resolution and artefacts). In previous studies, vertebral disc labeling is often done after a disc detection step and mostly fails when the localization algorithm misses discs or has false... 

Adjacent segment disorders are prevalent in patients following a spinal fusion surgery. Postoperative alterations in the adjacent segment biomechanics play a role in the etiology of these conditions. While experimental approaches fail to directly quantify spinal loads, previous modeling studies have numerous shortcomings when simulating the complex structures of the spine and the pre/postoperative mechanobiology of the patient. The biomechanical effects of the L4–L5 fusion surgery on muscle forces and adjacent segment kinetics (compression, shear, and moment) were investigated using a validated musculoskeletal model. The model was driven by in vivo kinematics for both preoperative (intact or... 

Understanding the effect of impact loading on the mechanical response of the intervertebral disc (IVD) is valuable for investigating injury mechanisms and devising effective therapeutic modalities. This study used 24 porcine thoracic motion segments to characterize the mechanical response of intact (N = 8), degenerated (Trypsin-denatured, N = 8), and repaired (Genepin-treated, N = 8) IVDs subject to impact loading. A meta-model analysis of poroelastic finite element simulations was used in combination with ex-vivo creep and impact tests to extract the material properties. Forward analyses using updated specimen-specific FE models were performed to evaluate the effect of impact duration. The... 

An anatomically detailed eighteen-rotational-degrees-of-freedom model of the human spine using optimization constrained to equilibrium and stability requirements is developed and used to simulate several symmetric tasks in upright and flexed standing postures. Predictions of this stability and kinematics-driven (S. +. KD) model for trunk muscle forces and spine compressive/shear loads are compared to those of our existing kinematics-driven (KD) model where both translational and rotational degrees-of-freedom are included but redundancy is resolved using equilibrium conditions alone. Unlike the KD model, the S. +. KD model predicted abdominal co-contractions that, in agreement with... 

Development of a subject-specific computational musculoskeletal trunk model (accounting for age, sex, body weight and body height), estimation of muscle forces and internal loads as well as subsequent validation by comparison with measured intradiscal pressure in various lifting tasks are novel, important and challenging. The objective of the present study is twofold. First, it aims to update and personalize the passive and active structures in an existing musculoskeletal kinematics-driven finite element model. The scaling scheme used an existing imaging database and biomechanical principles to adjust muscle geometries/cross-sectional-areas and passive joint geometry/properties in accordance... 

Frontal vehicle crashes have been a leading cause of spinal injuries in recent years. Reconstruction of frontal crashes using computational models and spinal load analysis helps us understand the patterns of injury and load propagation during frontal crashes. By reconstructing a real crash test and using a viscoelastic crash dummy model, spinal injury patterns were analyzed. The results indicated that a moderate crash with an impact speed of 56 km/h leads to injuries in L1-L2 and L5-S1 levels (L for lumbar and S for sacral vertebrae). The largest spinal loads and injuries were mainly observed immediately after the airbag deployment when the peak of the crash acceleration transpires. Also,... 

Irrespective of the lifting technique (squat or stoop), the lumbar spine posture (more kyphotic versus more lordotic) adopted during lifting activities is an important parameter affecting the active-passive spinal load distribution. The advantages in either posture while lifting remains, however, a matter of debate. To comprehensively investigate the role on the trunk biomechanics of changes in the lumbar posture (lordotic, free or kyphotic) during forward trunk flexion, validated musculoskeletal and finite element models, driven by in vivo kinematics data, were used to estimate detailed internal tissue stresses-forces in and load-sharing among various joint active-passive tissues. Findings... 

This work aimed to evaluate trunk muscle forces, internal loads and stability margin under some simulated standing postures, with and without external loads, using a nonlinear finite element model of the T1-S1 spine with realistic nonlinear load-displacement properties. A novel kinematics-based algorithm was applied that exploited a set of spinal sagittal rotations, initially calculated to minimize balancing moments, to solve the redundant active-passive system. The loads consisted of upper body gravity distributed along the spine with or without 200 N held in the hands, either in the front of the body or on the sides. Nonlinear and linear stability/perturbation analyses at deformed,... 

Finite element analysis is an effective tool to evaluate the material properties of living tissue. For an interactive optimization procedure, the finite element analysis usually needs many simulations to reach a reasonable solution. The metamodel analysis of finite element simulation can be used to reduce the computation of a structure with complex geometry or a material with composite constitutive equations. The intervertebral disc is a complex, heterogeneous, and hydrated porous structure. A poroelastic finite element model can be used to observe the fluid transferring, pressure deviation, and other properties within the disc. Defining reasonable poroelastic material properties of the... 

Low back pain is a common reason for activity limitation in people younger than 45 years old, and was proved to be associated with heavy physical works, repetitive lifting, impact, stationary work postures and vibrations. The study of load transferring and the loading condition encountered in spinal column can be simulated by finite element models. The intervertebral disc is a structure composed of a porous material. Many physical models were developed to simulate this phenomenon. The confounding effects of poroelastic properties and loading conditions on disc mechanical responses are, nevertheless, not cleared yet. The objective of this study was to develop an axisymmetric poroelastic... 

A six-degree-of-freedom musculoskeletal model of the lumbar spine was developed to predict the activity of trunk muscles during light, moderate and heavy lifting tasks in standing posture. The model was formulated into a multi-objective optimization problem, minimizing the sum of the cubed muscle stresses and maximizing the spinal stability index. Two intelligent optimization algorithms, i.e., the vector evaluated particle swarm optimization (VEPSO) and nondominated sorting genetic algorithm (NSGA), were employed to solve the optimization problem. The optimal solution for each task was then found in the way that the corresponding in vivo intradiscal pressure could be reproduced. Results... 

An essential input to the musculoskeletal (MS) trunk models that estimate muscle and spine forces is kinematics of the thorax, pelvis, and lumbar vertebrae. While thorax and pelvis kinematics are usually measured via skin motion capture devices (with inherent errors on the proper identification of the underlying bony landmarks and the relative skin-sensor-bone movements), those of the intervening lumbar vertebrae are commonly approximated at fixed proportions based on the thorax-pelvis kinematics. This study proposes an image-based kinematics measurement approach to drive subject-specific (musculature, geometry, mass, and center of masses) MS models. Kinematics of the thorax, pelvis, and... 

The dummies currently used for predicting vehicle occupant response during frontal crashes or whole-body vibration provide insufficient information about spinal loads. Although they aptly approximate upper-body rotations in different loading scenarios, they overlook spinal loads, which are crucial to injury assessment. This paper aims to develop a modified dummy finite element (FE) model with a detailed viscoelastic lumbar spine. This model has been developed and validated against in-vitro and in-silico data under different loading conditions, and its predicted ranges of motion (RoM) and intradiscal pressure (IDP) maintain close correspondence with the in-vitro data. The dominant frequency... 

Whole-body vibration (WBV) has been identified as one of the serious risk factors leading to spinal disorders, particularly in professional drivers. Although the influential factors in this area have been investigated epidemiologically, finite element (FE) modeling can efficiently help us better understand the problem. In this study, a modified HYBRID III dummy FE model which was enhanced by detailed viscoelastic discs in the lumbar region was utilized to simulate the effect of WBV on lumbar spine loads. Spinal responses to the vertical sinusoidal vibrations of a generic seat were obtained and spinal injury risk factors were calculated. Effects of variation of excitation frequencies, three... 

Biomechanical modeling approaches require body posture to evaluate the risk of spine injury during manual material handling. The procedure to measure body posture via motion-analysis techniques as well as the subsequent calculations of lumbosacral moments and spine loads by, respectively, inverse-dynamic and musculoskeletal models are complex and time-consuming. We aim to develop easy-to-use yet accurate artificial neural networks (ANNs) that predict 3D whole-body posture (ANNposture), segmental orientations (ANNangle), and lumbosacral moments (ANNmoment) based on our measurements during load-handling activities. Fifteen individuals each performed 135 load-handling activities by reaching (0... 

Workplace safety assessment, personalized treatment design and back pain prevention programs require accurate subject-specific estimation of spinal loads. Since no noninvasive method can directly estimate spinal loads, easy-to-use regression equations that are constructed based on the results of complex musculoskeletal models appear as viable alternatives. Thus, we aim to develop subject-specific regression equations of L4-L5 and L5-S1 shear and compression forces during various symmetric/asymmetric tasks using a nonlinear personalized finite element musculoskeletal trunk model. Kinematics and electromyography (EMG) activities of 19 young healthy subjects were collected during 64 different... 

Purpose: This study aimed to investigate the biomechanical impact of laminectomy on cervical intersegmental motion and load sharing using a parametric patient-specific finite element (FE) model towards providing clinicians with a viable quantitative tool for informed decision-making and improved surgical planning. Methods: Ten subject-specific nonlinear osteo-ligamentous cervical spine (C3–C7) FE models were developed using X-ray image-based algorithms. The models were used to evaluate the effect of laminectomy on lower cervical spine biomechanics for two-level (C3–C4) and three-level (C3–C5) laminectomy procedures. Results: The average cervical spine ranges of motion (ROM) for the pre-op... 

Spine musculoskeletal (MS) models make simplifying assumptions on the intervertebral joint degrees-of-freedom (rotational and/or translational), representation (spherical or beam-like joints), and properties (linear or nonlinear). They also generally neglect the realistic structure of the joints with disc nuclei/annuli, facets, and ligaments. We aim to develop a novel MS model where trunk muscles are incorporated into a detailed finite element (FE) model of the ligamentous T12-S1 spine thus constructing a gold standard coupled MS-FE model. Model predictions are compared under some tasks with those of our earlier spherical joints, beam joints, and hybrid (uncoupled) MS-FE models. The coupled... 

Spinal fusion surgery is usually followed by accelerated degenerative changes in the unfused segments above and below the treated segment(s), i.e., adjacent segment disease (ASD). While a number of risk factors for ASD have been suggested, its exact pathogenesis remains to be identified. Finite element (FE) models are indispensable tools to investigate mechanical effects of fusion surgeries on post-fusion changes in the adjacent segment kinematics and kinetics. Existing modeling studies validate only their intact FE model against in vitro data and subsequently simulate post-fusion in vivo conditions. The present study provides a novel approach for the comprehensive validation of a lumbar... 

Background: Asymmetric lifting activities are associated with low back pain. Methods: A finite element biomechanical model is used to estimate spinal loads during one- and two-handed asymmetric static lifting activities. Model input variables are thorax flexion angle, load magnitude as well as load sagittal and lateral positions while response variables are L4-L5 and L5-S1 disc compression and shear forces. A number of levels are considered for each input variable and all their possible combinations are introduced into the model. Robust yet user-friendly predictive equations that relate model responses to its inputs are established. Findings: Predictive equations with adequate...