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Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth
PURPOSE: This study describes the creation of patient-specific (PS) osteo-ligamentous finite element (FE) models of the spine, ribcage, and pelvis, simulation of up to three years of region-specific, stress-modulated growth, and validation of simulated curve progression with patient clinical angle m...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147794/ https://www.ncbi.nlm.nih.gov/pubmed/36593421 http://dx.doi.org/10.1007/s43390-022-00636-z |
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author | D’Andrea, Christian R. Samdani, Amer F. Balasubramanian, Sriram |
author_facet | D’Andrea, Christian R. Samdani, Amer F. Balasubramanian, Sriram |
author_sort | D’Andrea, Christian R. |
collection | PubMed |
description | PURPOSE: This study describes the creation of patient-specific (PS) osteo-ligamentous finite element (FE) models of the spine, ribcage, and pelvis, simulation of up to three years of region-specific, stress-modulated growth, and validation of simulated curve progression with patient clinical angle measurements. Research Question: Does the inclusion of region-specific, stress-modulated vertebral growth, in addition to scaling based on age, weight, skeletal maturity, and spine flexibility allow for clinically accurate scoliotic curve progression prediction in patient-specific FE models of the spine, ribcage, and pelvis? METHODS: Frontal, lateral, and lateral bending X-Rays of five AIS patients were obtained for approximately three-year timespans. PS-FE models were generated by morphing a normative template FE model with landmark points obtained from patient X-rays at the initial X-ray timepoint. Vertebral growth behavior and response to stress, as well as model material properties were made patient-specific based on several prognostic factors. Spine curvature angles from the PS–FE models were compared to the corresponding X-ray measurements. RESULTS: Average FE model errors were 6.3 ± 4.6°, 12.2 ± 6.6°, 8.9 ± 7.7°, and 5.3 ± 3.4° for thoracic Cobb, lumbar Cobb, kyphosis, and lordosis angles, respectively. Average error in prediction of vertebral wedging at the apex and adjacent levels was 3.2 ± 2.2°. Vertebral column stress ranged from 0.11 MPa in tension to 0.79 MPa in compression. CONCLUSION: Integration of region-specific stress-modulated growth, as well as adjustment of growth and material properties based on patient-specific data yielded clinically useful prediction accuracy while maintaining physiological stress magnitudes. This framework can be further developed for PS surgical simulation. |
format | Online Article Text |
id | pubmed-10147794 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-101477942023-04-30 Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth D’Andrea, Christian R. Samdani, Amer F. Balasubramanian, Sriram Spine Deform Biomechanics PURPOSE: This study describes the creation of patient-specific (PS) osteo-ligamentous finite element (FE) models of the spine, ribcage, and pelvis, simulation of up to three years of region-specific, stress-modulated growth, and validation of simulated curve progression with patient clinical angle measurements. Research Question: Does the inclusion of region-specific, stress-modulated vertebral growth, in addition to scaling based on age, weight, skeletal maturity, and spine flexibility allow for clinically accurate scoliotic curve progression prediction in patient-specific FE models of the spine, ribcage, and pelvis? METHODS: Frontal, lateral, and lateral bending X-Rays of five AIS patients were obtained for approximately three-year timespans. PS-FE models were generated by morphing a normative template FE model with landmark points obtained from patient X-rays at the initial X-ray timepoint. Vertebral growth behavior and response to stress, as well as model material properties were made patient-specific based on several prognostic factors. Spine curvature angles from the PS–FE models were compared to the corresponding X-ray measurements. RESULTS: Average FE model errors were 6.3 ± 4.6°, 12.2 ± 6.6°, 8.9 ± 7.7°, and 5.3 ± 3.4° for thoracic Cobb, lumbar Cobb, kyphosis, and lordosis angles, respectively. Average error in prediction of vertebral wedging at the apex and adjacent levels was 3.2 ± 2.2°. Vertebral column stress ranged from 0.11 MPa in tension to 0.79 MPa in compression. CONCLUSION: Integration of region-specific stress-modulated growth, as well as adjustment of growth and material properties based on patient-specific data yielded clinically useful prediction accuracy while maintaining physiological stress magnitudes. This framework can be further developed for PS surgical simulation. Springer International Publishing 2023-01-03 2023 /pmc/articles/PMC10147794/ /pubmed/36593421 http://dx.doi.org/10.1007/s43390-022-00636-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Biomechanics D’Andrea, Christian R. Samdani, Amer F. Balasubramanian, Sriram Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth |
title | Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth |
title_full | Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth |
title_fullStr | Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth |
title_full_unstemmed | Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth |
title_short | Patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth |
title_sort | patient-specific finite element modeling of scoliotic curve progression using region-specific stress-modulated vertebral growth |
topic | Biomechanics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10147794/ https://www.ncbi.nlm.nih.gov/pubmed/36593421 http://dx.doi.org/10.1007/s43390-022-00636-z |
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