Sharif Digital Repository

Purpose: This study exploits a novel musculoskeletal finite element (MS-FE) spine model to evaluate the post-fusion (L4–L5) alterations in adjacent segment kinetics. Methods: Unlike the existing MS models with idealized representation of spinal joints, this model predicts stress/strain distributions in all passive tissues while organically coupled to a MS model. This generic (in terms of musculature and material properties) model uses population-based in vivo vertebral sagittal rotations, gravity loads, and an optimization algorithm to calculate muscle forces. Simulations represent individuals with an intact L4–L5, a preoperative severely degenerated L4–L5 (by reducing the disc height by ~... 

Passive finite element (FE) models of the spine are commonly used to simulate intact and various pre- and postoperative pathological conditions. Being devoid of muscles, these traditional models are driven by simplistic loading scenarios, e.g., a constant moment and compressive follower load (FL) that do not properly mimic the complex in vivo loading condition under muscle exertions. We aim to develop novel passive FE models that are driven by more realistic yet simple loading scenarios, i.e., in vivo vertebral rotations and pathological-condition dependent FLs (estimated based on detailed musculoskeletal finite element (MS-FE) models). In these novel force–displacement control FE models,... 

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... 

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... 

As a primary load-resisting component, annulus fibrosus (AF) maintains structural integrity of the entire intervertebral disc. Experiments have demonstrated that permanent deformation and damage take place in the tissue under mechanical loads. Development of an accurate model to capture the complex behaviour of AF tissue is hence crucial in disc model studies. We, therefore, aimed to develop a non-homogenous model to capture elastic, inelastic and failure responses of the AF tissue and the entire disc model under axial load. Our model estimations satisfactorily agreed with results of existing uniaxial (along fiber, circumferential and axial directions) and biaxial tissue-level tests. The... 

Spinal posture including thorax/pelvis orientations as well as loads on the intervertebral discs are crucial parameters in biomechanical models and ergonomics to evaluate the risk of low back injury. In vivo measurement of spinal posture toward estimation of spine loads requires the common motion capture techniques and laboratory instruments that are costly and time-consuming. Hence, a closed loop algorithm including an artificial neural network (ANN) and fuzzy logic is proposed here to predict the L5–S1 segment loads and thorax/pelvis orientations in various 3D reaching activities. Two parts namely a fuzzy logic strategy and an ANN from this algorithm; the former, developed based on the... 

Spinal cord is a long, thin, tubular bundle of nervous tissue located in the vertebral column. Since the spinal cord is one of the most crucial pathways for information connecting of the central nervous system, it has to stay safe under any blunt impact loading, i.e., accident, punch, gunshot, burst, etc. Therefore, it is important to investigate the possible injuries that may occur in the vertebral column, especially the spinal cord, as a result of blunt loading. However, due to various experimental limitations, numerical modelling, specifically finite element (FE) models, has been beneficial in predicting the injury to the spinal cord. This study, thus, aimed at predicting the stresses and... 

Low back pain is the most prevalent orthopedic disorder and the first main cause of poor working functionality in developed as wells as many developing countries. In Absence of noninvasive in vivo measurement approaches, biomechanical models are used to estimate mechanical loads on human joints during physical activities. To estimate joint loads via musculoskeletal models, the calculation of muscle forces are of importance. It is however difficult to estimate muscle forces as the number of muscles, i.e. unknown parameters, is far more than the existing degrees of freedom; the system is highly redundant. Therefore, in this study, instead of muscle forces estimation, their effects (i.e.,... 

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... 

Degenerative disc disease, associated with discrete structural changes in the peripheral annulus and vertebral endplate, is one of the most common pathological triggers of acute and chronic low back pain, significantly depreciating an individual's quality of life and instigating huge socioeconomic costs. Novel emerging therapeutic techniques are hence of great interest to both research and clinical communities alike. Exogenous crosslinking, such as Genipin, and platelet-rich plasma therapies have been recently demonstrated encouraging results for the repair and regeneration of degenerated discs, but there remains a knowledge gap regarding the quantitative degree of effectiveness and... 

This study developed and validated a lumped parameter model for the FLEXI-BAR, a popular training instrument that provides vibration stimulation. The model which can be used in conjunction with musculoskeletal-modeling software for quantitative biomechanical analyses, consists of 3 rigid segments, 2 torsional springs, and 2 torsional dashpots. Two different sets of experiments were conducted to determine the model's key parameters including the stiffness of the springs and the damping ratio of the dashpots. In the first set of experiments, the free vibration of the FLEXI-BAR with an initial displacement at its end was considered, while in the second set, forced oscillations of the bar were... 

ABSTRACT Disc rheological parameters regulate the mechanical and biological function of intervertebral disc. The knowledge of effects of degeneration on disc rheology can be beneficial for the design of new disc implants or therapy. We developed two material property identification protocols, i.e., inverse poroelas-tic finite element analysis, and biphasic closed form solution. These protocols were used to find the material properties of intact, moderate and severe degenerated porcine discs. Comparing these two computational protocols for intact and artificial degenerated discs showed they are valid in defining bi-phasic/poroelastic properties. We found that enzymatic agent disrupts the... 

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... 

Two artificial neural networks (ANNs) are constructed, trained, and tested to map inputs of a complex trunk finite element (FE) model to its outputs for spinal loads and muscle forces. Five input variables (thorax flexion angle, load magnitude, its anterior and lateral positions, load handling technique, i.e., one- or two-handed static lifting) and four model outputs (L4-L5 and L5-S1 disc compression and anterior-posterior shear forces) for spinal loads and 76 model outputs (forces in individual trunk muscles) are considered. Moreover, full quadratic regression equations mapping input-outputs of the model developed here for muscle forces and previously for spine loads are used to compare the... 

This paper focuses on characterization of intervertebral disc behavior upon fatigue stress. It consists in in-vitro experiments to measure intervertebral disc deformation with regard to forces applied to produce fatigues test. In this paper, a system modeling based non-invasive method to assess back pain is proposed which may be used for designing of prediction model to predict the failure of intervertebral disc (IVD) experiencing fatigue loading. An artificial compression fracture was simulated in the lower level of vertebra followed by a poly(methyl methacrylate) (PMMA) bone cement injection. Fatigue loading was applied on the specimens and the load was incrementally increased form 650 N... 

This paper presents recent developments on effects of rest and fatigue loading on properties of healthy vertebra discs. A comparison of different approaches used in literature to study the properties of intervertebral disc is presented. The major achievements in this area so far are discussed in the context of their advantages and disadvantages. The past approaches are based on bio-mechanical models which mostly used statistical techniques for the analysis and estimation of fatigue loaded Intervertebral Disc (IVD). However, those modeling techniques were not flexible enough for analysis of customized tests. In this paper, we applied System Identification (SI) based NLARX modeling technique... 

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... 

This paper presents the background of low back problem caused by repetitive fatigue loading. We emphasize on mechanism of Intervertebral Disc (IVD) and conditions for which the disc does not recover its original status under repetitive work and cause low back pain. The objective of this study is to identify structural changes in system parameters for fatigue loaded intervertebral disc. Principal component analysis (PCA) is used for studying the behavioral change of spine against cyclic loading as a function of time. Percentage difference and similarity factor was calculated for the analysis. Specimens were applied with impulse testing to measure the stiffness and acceleration after fracture,... 

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... 

We proposed a model to investigate the transient diffusion of drug (sulphate) into the intervertebral disc. Using finite element method, drug diffusion was simulated and the concentration of diffused drug in each region of disc including Nucleus pulpous (NP), Inner annulus fibroses (IA), and Outer annulus fibroses (OA) was measured. In addition, to investigate the role of CEP permeability on the amount of diffused drug, model was simulated with different cartilage endplate (CEP) permeability. Having obtained concentration distribution for different cases, it was clearly shown that the amount of diffused drug is affected by the endplate permeability and the more permeable CEP, the more...