Finite element analysis of moment-rotation relationships for human cervical spine

A comprehensive, geometrically accurate, nonlinear C0-C7 FE model of head and cervical spine based on the actual geometry of a human cadaver specimen was developed. The motions of each cervical vertebral level under pure moment loading of 1.0 Nm applied incrementally on the skull to simulate the movements of the head and cervical spine under flexion, tension, axial rotation and lateral bending with the inferior surface of the C7 vertebral body fully constrained were analysed. The predicted range of motion (ROM) for each motion segment were computed and compared with published experimental data. The model predicted the nonlinear moment-rotation relationship of human cervical spine. Under the same loading magnitude, the model predicted the largest rotation in extension, followed by flexion and axial rotation, and least ROM in lateral bending. The upper cervical spines are more flexible than the lower cervical levels. The motions of the two uppermost motion segments account for half (or even higher) of the whole cervical spine motion under rotational loadings. The differences in the ROMs among the lower cervical spines (C3-C7) were relatively small. The FE predicted segmental motions effectively reflect the behavior of human cervical spine and were in agreement with the experimental data. The C0-C7 FE model offers potentials for biomedical and injury studies.     

A three-dimensional human head finite element model and power flow in a human head subject to impact loading

A three-dimensional finite element model of the human head is presented. The model has been validated against two sets of experimental results. To assess injury likelihood of the head subjected to impact loading, the structural intensity (SI) methodology is introduced in accordance with the prevailing practice in experimental biomechanics. SI is a vector quantity indicating the direction and magnitude of power flow inside a dynamically loaded structure. In this paper, the SI field inside the head model is computed for three cases, namely frontal, rear and side impacts. The results for the three cases have revealed that there exist power flow paths. The skull is, in general, a good energy flow channel. The study has also revealed the high possibility of spinal cord injury due to wave motion inside the head.     

The peculiar properties of the falx and tentorium in brain injury biomechanics

The influence of the falx and tentorium on brain injury biomechanics during impact was studied with finite element (FE) analysis. Three detailed 3D FE head models were created based on the images of a healthy, normal size head. Two of the models contained the addition of falx and tentorium with material properties from previously published experiments. Impact loadings from a reconstructed concussive case in a sport accident were applied to the two players involved. The results suggested that the falx and tentorium could induce large strains to the surrounding brain tissues, especially to the corpus callosum and brainstem. The tentorium seemed to constrain the motion of the cerebellum while inducing large strain in the brainstem in both players involved in the accident (one player had mainly coronal head rotation and the other had both coronal and transversal rotations). Since changed strain levels were observed in the brainstem and corpus callosum, which are classical sites for diffuse axonal injuries (DAI), we confirmed the importance of using accurate material properties for falx and tentorium in a FE head model when studying traumatic brain injuries.     

Simulation-based assessment for construction helmets

In recent years, there has been a concerted effort for greater job safety in all industries. Personnel protective equipment (PPE) has been developed to help mitigate the risk of injury to humans that might be exposed to hazardous situations. The human head is the most vulnerable to impact as a moderate magnitude can cause serious injury or death. That is why industries have required the use of an industrial hard hat or helmet. There have only been a few articles published to date that are focused on the risk of head injury when wearing an industrial helmet. A full understanding of the effectiveness of construction helmets on reducing injury is lacking. This paper presents a simulation-based method to determine the threshold at which a human will sustain injury when wearing a construction helmet and assesses the risk of injury for wearers of construction helmets or hard hats. Advanced finite element, or FE, models were developed to study the impact on construction helmets. The FE model consists of two parts: the helmet and the human models. The human model consists of a brain, enclosed by a skull and an outer layer of skin. The level and probability of injury to the head was determined using both the head injury criterion (HIC) and tolerance limits set by Deck and Willinger. The HIC has been widely used to assess the likelihood of head injury in vehicles. The tolerance levels proposed by Deck and Willinger are more suited for finite element models but lack wide-scale validation. Different cases of impact were studied using LSTC's LS-DYNA.     

Technique and preliminary findings for in vivo quantification of brain motion during injurious head impacts

Computational models of the human brain are widely used in the evaluation and development of helmets and other protective equipment. These models are often attempted to be validated using cadaver tissue displacements despite studies showing neural tissue degrades quickly after death. Addressing this limitation, this study aimed to develop a technique for quantifying living brain motion in vivo using a closed head impact animal model of traumatic brain injury (TBI) called CHIMERA. We implanted radiopaque markers within the brain of three adult ferrets and resealed the skull while the animals were anesthetized. We affixed additional markers to the skull to track skull kinematics. The CHIMERA device delivered controlled, repeatable head impacts to the head of the animals while the impacts were fluoroscopically stereo-visualized. We observed that 1.5 mm stainless steel fiducials (∼8 times the density of the brain) migrated from their implanted positions while neutral density targets remained in their implanted position post-impact. Brain motion relative to the skull was quantified in neutral density target tests and showed increasing relative motion at higher head impact severities. We observed the motion of the brain lagged behind that of the skull, similar to previous studies. This technique can be used to obtain a comprehensive dataset of in vivo brain motion to validate computational models reflecting the mechanical properties of the living brain. The technique would also allow the mechanical response of in vivo brain tissue to be compared to cadaveric preparations for investigating the fidelity of current human computational brain models.     

Geometrical and material parameters to assess the macroscopic mechanical behaviour of fresh cranial bone samples

The present study aims at providing quantitative data for the personalisation of geometrical and mechanical characteristics of the adult cranial bone to be applied to head FE models. A set of 351 cranial bone samples, harvested from 21 human skulls, were submitted to three-point bending tests at 10 mm/min. For each of them, an apparent elastic modulus was calculated using the beam's theory and a density-dependant beam inertia. Thicknesses, apparent densities and percentage of ash weight were also measured. Distributions of characteristics among the different skull bones show their symmetry and their significant differences between skull areas. A data analysis was performed to analyse potential relationship between thicknesses, densities and the apparent elastic modulus. A specific regression was pointed out to estimate apparent elastic modulus from the product of thickness by apparent density. These results offer quantitative tools in view of personalising head FE models and thus improve definition of local injury criteria for this body part.     

The importance of nonlinear tissue modelling in finite element simulations of infant head impacts

Despite recent efforts on the development of finite element (FE) head models of infants, a model capable of capturing head responses under various impact scenarios has not been reported. This is hypothesized partially attributed to the use of simplified linear elastic models for soft tissues of suture, scalp and dura. Orthotropic elastic constants are yet to be determined to incorporate the direction-specific material properties of infant cranial bone due to grain fibres radiating from the ossification centres. We report here on our efforts in advancing the above-mentioned aspects in material modelling in infant head and further incorporate them into subject-specific FE head models of a newborn, 5- and 9-month-old infant. Each model is subjected to five impact tests (forehead, occiput, vertex, right and left parietal impacts) and two compression tests. The predicted global head impact responses of the acceleration–time impact curves and the force–deflection compression curves for different age groups agree well with the experimental data reported in the literature. In particular, the newly developed Ogden hyperelastic model for suture, together with the nonlinear modelling of scalp and dura mater, enables the models to achieve more realistic impact performance compared with linear elastic models. The proposed approach for obtaining age-dependent skull bone orthotropic material constants counts both an increase in stiffness and decrease in anisotropy in the skull bone—two essential biological growth parameters during early infancy. The profound deformation of infant head causes a large stretch at the interfaces between the skull bones and the suture, suggesting that infant skull fractures are likely to initiate from the interfaces; the impact angle has a profound influence on global head impact responses and the skull injury metrics for certain impact locations, especially true for a parietal impact.     

Finite Element Study of the Mechanical Response in Spinal Cord during the Thoracolumbar Burst Fracture

Background

The mechanical response of the spinal cord during burst fracture was seldom quantitatively addressed and only few studies look into the internal strain of the white and grey matters within the spinal cord during thoracolumbar burst fracture (TLBF). The aim of the study is to investigate the mechanical response of the spinal cord during TLBF and correlate the percent canal compromise (PCC) with the strain in the spinal cord.

Methodology/Principal Findings

A three-dimensional (3D) finite element (FE) model of human T12-L1 spinal cord with visco-elastic property was generated based on the transverse sections images of spinal cord, and the model was validated against published literatures under static uniaxial tension and compression. With the validated model, a TLBF simulation was performed to compute the mechanical strain in the spinal cord with the PCC. Linear regressions between PCC and strain in the spinal cord show that at the initial stage, with the PCC at 20%, and 45%, the corresponding mechanical strains in ventral grey, dorsal grey, ventral white, dorsal white matters were 0.06, 0.04, 0.12, 0.06, and increased to 0.14, 0.12, 0.23, and 0.13, respectively. At the recoiled stage, when the PCC was decreased from 45% to 20%, the corresponding strains were reduced to 0.03, 0.02, 0.04 and 0.03. The strain was correlated well with PCC.

Conclusions/Significance

The simulation shows that the strain in the spinal cord correlated well with the PCC, and the mechanical strains in the ventral regions are higher than those in the dorsal regions of spinal cord tissue during burst fracture, suggesting that the ventral regions of the spinal cord may susceptible to injury than the dorsal regions.     

Utilizing multiple scale models to improve predictions of extra-axial hemorrhage in the immature piglet

Traumatic brain injury (TBI) is a leading cause of death and disability in the USA. To help understand and better predict TBI, researchers have developed complex finite element (FE) models of the head which incorporate many biological structures such as scalp, skull, meninges, brain (with gray/white matter differentiation), and vasculature. However, most models drastically simplify the membranes and substructures between the pia and arachnoid membranes. We hypothesize that substructures in the pia–arachnoid complex (PAC) contribute substantially to brain deformation following head rotation, and that when included in FE models accuracy of extra-axial hemorrhage prediction improves. To test these hypotheses, microscale FE models of the PAC were developed to span the variability of PAC substructure anatomy and regional density. The constitutive response of these models were then integrated into an existing macroscale FE model of the immature piglet brain to identify changes in cortical stress distribution and predictions of extra-axial hemorrhage (EAH). Incorporating regional variability of PAC substructures substantially altered the distribution of principal stress on the cortical surface of the brain compared to a uniform representation of the PAC. Simulations of 24 non-impact rapid head rotations in an immature piglet animal model resulted in improved accuracy of EAH prediction (to 94 % sensitivity, 100 % specificity), as well as a high accuracy in regional hemorrhage prediction (to 82–100 % sensitivity, 100 % specificity). We conclude that including a biofidelic PAC substructure variability in FE models of the head is essential for improved predictions of hemorrhage at the brain/skull interface.     

Effects of fluid structure interaction in a three dimensional model of the spinal subarachnoid space

It is unknown whether spinal cord motion has a significant effect on cerebrospinal fluid (CSF) pressure and therefore the importance of including fluid structure interaction (FSI) in computational fluid dynamics models (CFD) of the spinal subarachnoid space (SAS) is unclear. This study aims to determine the effects of FSI on CSF pressure and spinal cord motion in a normal and in a stenosis model of the SAS. A three-dimensional patient specific model of the SAS and spinal cord were constructed from MR anatomical images and CSF flow rate measurements obtained from a healthy human being. The area of SAS at spinal level T4 was constricted by 20% to represent the stenosis model. FSI simulations in both models were performed by running ANSYS CFX and ANSYS Mechanical in tandem. Results from this study show that the effect of FSI on CSF pressure is only about 1% in both the normal and stenosis models and therefore show that FSI has a negligible effect on CSF pressure.     

The mechanical properties of neonatal rat spinal cord in vitro,and comparisons with adult

A number of studies have investigated the mechanical properties of adult spinal cord under tension, however it is not known whether age has an effect on these properties. This is of interest to those aiming to understand the clinical differences between adults and children with spinal cord injury (e.g. severity and recovery), and those developing experimental or computational models for paediatric spinal cord injury. Entire spinal cords were freshly harvested from neonatal rats (14 days) and tested in vitro under uniaxial tension at a range of strain rates (0.2, 0.02, 0.002/s) to a range of strains (2%, 3.5%, 5%), with relaxation responses being recorded for 15 min. These mechanical properties were compared to previously reported data from similar experiments on adult rat spinal cords, and the peak stress and the stress after 15 min of relaxation were found to be significantly higher for spinal cords from adults than neonates (p<0.001). A non-linear viscoelastic model was developed and was observed to adequately predict the mechanical behaviour of this tissue. The model developed in this study may be of use in computational models of paediatric spinal cord. The significant differences between adult and neonatal spinal cord properties may explain the higher initial severity of spinal cord injury in children and may have implications for the development of experimental animal models for paediatric spinal cord injury, specifically for those aiming to match the injury severity with adult experimental models.     

A Study on the Finite Element Model for Head Injury in Facial Collision Accident

In order to predict and evaluate injury mechanism and biomechanical response of the facial impact on head injury in a crash accident. With the combined modern medical imaging technologies, namely computed tomography (CT) and magnetic resonance imaging (MRI), both geometric and finite element (FE) models for human head-neck with detailed cranio-facial structure were developed. The cadaveric head impact tests were conducted to validate the headneck finite element model. The intracranial pressure, skull dynamic response and skull-brain relative displacement of the whole head-neck model were compared with experimental data. Nine typical cases of facial traffic accidents were simulated, with the individual stress wave propagation paths to the intracranial contents through the facial and cranial skeleton being discussed thoroughly. Intracranial pressure, von Mises stress and shear stress distribution were achieved. It is proved that facial structure dissipates a large amount of impact energy to protect the brain in its most natural way. The propagation path and distribution of stress wave in the skull and brain determine the mechanism of brain impact injury, which provides a theoretic basis for the diagnosis, treatment and protection of craniocerebral injury caused by facial impact.     

The development of an improved physical surrogate model of the human spinal cord—Tension and transverse compression

To prevent spinal cord injury, optimize treatments for it, and better understand spinal cord pathologies such as spondylotic myelopathy, the interaction between the spinal column and the spinal cord during injury and pathology must be understood. The spinal cord is a complex and very soft tissue that changes properties rapidly after death and is difficult to model. Our objective was to develop a physical surrogate spinal cord with material properties closely corresponding to the in vivo human spinal cord that would be suitable for studying spinal cord injury under a variety of injurious conditions. Appropriate target material properties were identified from published studies and several candidate surrogate materials were screened, under uniaxial tension, in a materials testing machine. QM Skin 30, a silicone elastomer, was identified as the most appropriate material. Spinal cords manufactured from QM Skin 30 were tested under uniaxial tension and transverse compression. Rectangular specimens of QM Skin 30 were also tested under uniform compression. QM Skin 30 produced surrogate cords with a Young's modulus in tension and compression approximately matching values reported for in vivo animal spinal cords (0.25 and 0.20 MPa, respectively). The tensile and compressive Young's modulus and the behavior of the surrogate cord simulated the nonlinear behavior of the in vivo spinal cord.     

Biomechanics of vibration reception in the bullfrog,Rana catesbeiana

The opercularis system (OPS) of amphibians consists of an opercularis muscle that connects the shoulder girdle skeleton to the operculum, a movable element in the oval window of the otic capsule. The role of the OPS in reception of vibrations was examined in bullfrogs (Rana catesbeiana) tested in various postures that manipulated differential motion between the shoulder girdle (the origin of the opercularis muscle) and skull (including the inner ear). Amplitude and phase relationship of motions of the suprascapular cartilage of the shoulder girdle and the posterior skull were also measured during these tests. 1. Microphonic responses to vertical vibrations from 25-200 Hz were typically highest when frogs were in a normal, sitting posture with the head held off the vibrating platform. Responses from animals in which the head directly contacted the platform were often less (by up to 10 dB at certain frequencies). Responses from all test positions were highest at lower frequencies, especially between 50-100 Hz. 2. Suprascapular accelerations were typically highest in the normal, sitting posture, and at lower frequencies (50-75 Hz) were often greater than that of the vibrating platform by up to 8 dB. The shoulder girdle skeleton of the bullfrog is therefore readily affected by vertical substrate motion. 3. The amplitude of microphonic responses in the different test postures did not correspond well with head acceleration. Rather, response amplitude corresponded best with the absolute difference between shoulder and head motion. For example, in the normal posture, suprascapular motion was much greater than head motion, and responses were relatively high. If only the head was vibrated, head motion was high and shoulder motion low, and responses also were relatively high. If the head and body were vibrated together, their motions were similar, and responses to the same platform accelerations were often reduced. Phase differences between shoulder and head motions were small at the frequencies examined and may be of little functional significance. The importance of differences in shoulder and head motion suggests that the resulting differential motion of the operculum and inner ear fluids can produce waves that stimulate appropriate end organs (such as the saccule). 4. Removal of the opercularis muscle reduced responses up to 18 dB at certain frequencies in some of the test postures. The most significant reductions were observed in those postures with a significant difference between shoulder and head motion (such as the normal posture).(ABSTRACT TRUNCATED AT 400 WORDS)     

Deformation of the human brain induced by mild angular head acceleration

Deformation of the human brain was measured in tagged magnetic resonance images (MRI) obtained dynamically during angular acceleration of the head. This study was undertaken to provide quantitative experimental data to illuminate the mechanics of traumatic brain injury (TBI). Mild angular acceleration was imparted to the skull of a human volunteer inside an MR scanner, using a custom MR-compatible device to constrain motion. A grid of MR "tag" lines was applied to the MR images via spatial modulation of magnetization (SPAMM) in a fast gradient echo imaging sequence. Images of the moving brain were obtained dynamically by synchronizing the imaging process with the motion of the head. Deformation of the brain was characterized quantitatively via Lagrangian strain. Consistent patterns of radial-circumferential shear strain occur in the brain, similar to those observed in models of a viscoelastic gel cylinder subjected to angular acceleration. Strain fields in the brain, however, are clearly mediated by the effects of heterogeneity, divisions between regions of the brain (such as the central fissure and central sulcus) and the brain's tethering and suspension system, including the dura mater, falx cerebri, and tentorium membranes.     

Can sulci protect the brain from traumatic injury?

The influence of sulci in dynamic finite element simulations of the human head has been investigated. First, a detailed 3D FE model was constructed based on an MRI scan of a human head. A second model with a smoothed brain surface was created based on the same MRI scan as the first FE model. These models were validated against experimental data to confirm their human-like dynamic responses during impact. The validated FE models were subjected to several acceleration impulses and the maximum principle strain and strain rate in the brain were analyzed. The results suggested that the inclusion of sulci should be considered for future FE head models as it alters the strain and strain distribution in an FE model.     

Load-sharing in the lumbosacral spine in neutral standing & flexed postures – A combined finite element and inverse static study

Understanding load-sharing in the spine during in-vivo conditions is critical for better spinal implant design and testing. Previous studies of load-sharing that considered actual spinal geometry applied compressive follower load, with or without moment, to simulate muscle forces. Other studies used musculoskeletal models, which include muscle forces, but model the discs by simple beams or spherical joints and ignore the articular facet joints.This study investigated load-sharing in neutral standing and flexed postures using a detailed Finite Element (FE) model of the ligamentous lumbosacral spine, where muscle forces, gravity loads and intra-abdominal pressure, as predicted by a musculoskeletal model of the upper body, are input into the FE model. Flexion was simulated by applying vertebral rotations following spine rhythm measured in a previous in-vivo study, to the musculoskeletal model. The FE model predicted intradiscal pressure (IDP), strains in the annular fibers, contact forces in the facet joints, and forces in the ligaments. The disc forces and moments were determined using equilibrium equations, which considered the applied loads, including muscle forces and IDP, as well as forces in the ligaments and facet joints predicted by the FE model. Load-sharing was calculated as the portion of the total spinal load carried along the spine by each individual spinal structure. The results revealed that spinal loads which increased substantially from the upright to the flexed posture were mainly supported by the discs in the upright posture, whereas the ligaments’ contribution in resisting shear, compression, and moment was more significant in the flexed posture.     

Measurement of strain in physical models of brain injury: a method based on HARP analysis of tagged magnetic resonance images (MRI)

Two-dimensional (2-D) strain fields were estimated non-invasively in two simple experimental models of closed-head brain injury. In the first experimental model, shear deformation of a gel was induced by angular acceleration of its spherical container In the second model the brain of a euthanized rat pup was deformed by indentation of its skull. Tagged magnetic resonance images (MRI) were obtained by gated image acquisition during repeated motion. Harmonic phase (HARP) images corresponding to the spectral peaks of the original tagged MRI were obtained, following procedures proposed by Osman, McVeigh and Prince. Two methods of HARP strain analysis were applied, one based on the displacement of tag line intersections, and the other based on the gradient of harmonic phase. Strain analysis procedures were also validated on simulated images of deformed grids. Results show that it is possible to visualize deformation and to quantify strain efficiently in animal models of closed head injury.     

An anatomically detailed and personalizable head injury model: Significance of brain and white matter tract morphological variability on strain

Finite element head (FE) models are important numerical tools to study head injuries and develop protection systems. The generation of anatomically accurate and subject-specific head models with conforming hexahedral meshes remains a significant challenge. The focus of this study is to present two developmental works: first, an anatomically detailed FE head model with conforming hexahedral meshes that has smooth interfaces between the brain and the cerebrospinal fluid, embedded with white matter (WM) fiber tracts; second, a morphing approach for subject-specific head model generation via a new hierarchical image registration pipeline integrating Demons and Dramms deformable registration algorithms. The performance of the head model is evaluated by comparing model predictions with experimental data of brain–skull relative motion, brain strain, and intracranial pressure. To demonstrate the applicability of the head model and the pipeline, six subject-specific head models of largely varying intracranial volume and shape are generated, incorporated with subject-specific WM fiber tracts. DICE similarity coefficients for cranial, brain mask, local brain regions, and lateral ventricles are calculated to evaluate personalization accuracy, demonstrating the efficiency of the pipeline in generating detailed subject-specific head models achieving satisfactory element quality without further mesh repairing. The six head models are then subjected to the same concussive loading to study the sensitivity of brain strain to inter-subject variability of the brain and WM fiber morphology. The simulation results show significant differences in maximum principal strain and axonal strain in local brain regions (one-way ANOVA test, p < 0.001), as well as their locations also vary among the subjects, demonstrating the need to further investigate the significance of subject-specific models. The techniques developed in this study may contribute to better evaluation of individual brain injury and the development of individualized head protection systems in the future. This study also contains general aspects the research community may find useful: on the use of experimental brain strain close to or at injury level for head model validation; the hierarchical image registration pipeline can be used to morph other head models, such as smoothed-voxel models.

     

Characteristics of the tonic stretch reflex in spastic spinal cord and head-injured patients

Spasticity is a known sequelae of spinal cord injury and head injury. We sought to examine whether there were any significant differences in the characteristics or underlying mechanisms of spasticity in these two groups in the chronic period which may be related to the level of injury of the neuraxis. The response to vibration applied to the muscle, or the tonic vibratory reflex, has been shown to be related to the degree of spasticity, and was therefore studied along with phasic reflexes and passive movements. These studies were carried out on cooperative, stabilized patients who were otherwise healthy, 5 with head injuries, and 5 with spinal cord injuries. The patients were examined in a supine position while surface EMG recordings were made of quadriceps and triceps surae muscles bilaterally. Tendon jerk responses, passive and volitional movements, and responses to a powerful vibratory stimulator were measured. In both head injury and spinal cord injury patient groups, a large EMG response was elicited by passive maneuvers, and tendon jerks were exaggerated. The tonic vibratory response, previously shown to be dependent upon brain influence, was present in both groups. These observations suggest that similar suprasegmental mechanisms may be responsible for hypertonia in both head-injured and spinal cord-injured patients.