Development of Computer Aided 3D Model From Computed Tomography Images and its Finite Element Analysis for Lumbar Interbody Fusion with Instrumentation

  • Deoghare, Ashish (Department of Mechanical Engineering, Visvesvaraya National Institute of Technology) ;
  • Padole, Pramod (Department of Mechanical Engineering, Visvesvaraya National Institute of Technology)
  • Published : 2010.04.01

Abstract

The purpose of this study is to clarify the mechanical behavior of human lumbar vertebrae (L3/L4) with and without fusion bone under physiological axial compression. The author has developed the program code to build the patient specific three-dimensional geometric model from the computed tomography (CT) images. The developed three-dimensional model provides the necessary information to the physicians and surgeons to visually interact with the model and if needed, plan the way of surgery in advance. The processed data of the model is versatile and compatible with the commercial computer aided design (CAD), finite element analysis (FEA) software and rapid prototyping technology. The actual physical model is manufactured using rapid prototyping technique to confirm the executable competence of the processed data from the developed program code. The patient specific model of L3/L4 vertebrae is analyzed under compressive loading condition by the FEA approach. By varying the spacer position and fusion bone with and without pedicle instrumentation, simulations were carried out to find the increasing axial stiffness so as to ensure the success of fusion technique. The finding was helpful in positioning the fusion bone graft and to predict the mechanical stress and deformation of body organ indicating the critical section.

Keywords

References

  1. Bio, Q.B. Mccullen, G.M. Higham, P.A. Dumbleton, J.H. and Yuan, H.A., "The artificial disc: theory, design and materials," J. Biomaterials, Vol. 17, No.12, pp.1157-1167, Jun.1996. https://doi.org/10.1016/0142-9612(96)84936-2
  2. Cao, K.D. Grimm, M.J. and Yang, K., "Load sharing within a human lumbar vertebral body using finite element method," Spine, Vol. 26, pp. 253–260, 2001.
  3. Closkey, R. Parsons, J. Lee, C. Blacksin, M. and Zimmerman, M., "Mechanics of interbody spinal fusion. Analysis of critical bone graft area," Spine, Vol. 18, No. 8, pp.1011-1015, Jun.1993. https://doi.org/10.1097/00007632-199306150-00010
  4. Denoziere, G. and Ku, D.N., "Biomechanical comparison between fusion of two vertebrae and implantation of an artificial intervertebral disc," J. Biomech. Vol. 39 No.4, pp. 766-775, July. 2006. https://doi.org/10.1016/j.jbiomech.2004.07.039
  5. Gilad, I. and Nissan, M., "A study of vertebra and disc geometric relations of the human cervical and lumbar spine," Spine, Vol. 11 No.2, pp. 154-157, Mar. 1986. https://doi.org/10.1097/00007632-198603000-00010
  6. Goto, K. Tajima, N. Chosa, E. Totoribe, K. Kubo, S. Kuroki, H. and Arai, T., "Effects of lumbar spinal fusion on the other lumbar intervertebral levels (threedimensional finite element analysis)." J. Orthop .Sci. Vol. 8, No.4, pp. 577-584, 2003. https://doi.org/10.1007/s00776-003-0675-1
  7. Haralick, R.M. and Shapiro, L.G., "Survey, Image segmentation techniques," Computer Vision, Graphics, and Image processing, Vol. 29, No.1, pp. 100-132, Jan.1985. https://doi.org/10.1016/S0734-189X(85)90153-7
  8. Homminga, J. McCreadie, B.R. Ciarelli, T.E. Weinans, H. Goldstein, S.A. and Huiskes, R., "Cancellous bone mechanical properties from normals and patients with hip fractures differ on the structure level, not on the bone hard tissue level," Bone, Vol. 30, No.5, pp. 759-764, May. 2002. https://doi.org/10.1016/S8756-3282(02)00693-2
  9. Lee, K.K. Teo, E.C. Fuss, F.K. Vanneville, V. Qiu, T.X. Ng, H.W. Yang, K. and Sabizer, R.J., "Finite-element analysis for lumbar interbody fusion under axial loading," IEEE Trans. Biomed. Eng. Vol.51, No.3, pp. 393-400, Mar. 2004. https://doi.org/10.1109/TBME.2003.820994
  10. Lee, K.K. Teo, E.C. Qiu, T.X. Ng, H.W. and Yang, K., " Finite element modeling of L2-L3 using digitizer," Int. J. Computer Application Technology (IJCAT) (Special issue on Biomedical Engineering and I.T.), Vol. 20, pp 1-9, 2003.
  11. Lund, T. Oxland, T.R. Jost, B. Cripton, P. Grassmann, S. Etter, C. and Nolte, L.P., " Interbody cage stabilisation in the lumbar spine: biomechanical evaluation of cage design, posterior instrumentation and bone density," J. Bone Joint Surg. Br., Vol. 80, No.2, pp. 351-359, Mar. 1998. https://doi.org/10.1302/0301-620X.80B2.7693
  12. Mosekilde, L., "Vertebral structure and strength in vivo and in vitro," Calcif. Tissue Int. Vol.53, Suppl. 1, S121-S125, 1993. https://doi.org/10.1007/BF01673420
  13. Nabhani, F. and Wake, M., "Computer modeling and stress analysis of lumbar spine," Journal of Materials Processing Technology, Vol. 127, pp. 40-47, 2002. https://doi.org/10.1016/S0924-0136(02)00195-4
  14. Panjabi, M.M. Chen, N.C. Shin, E.K. and Wang, J.L., "The cortical shell architecture of human cervical vertebral bodies," Spine, Vol. 26, No.22, pp. 2478-2484, Nov. 2001. https://doi.org/10.1097/00007632-200111150-00016
  15. Reuber, M. Schultz, A. Denis, F. and Spencer, D., "Bulging of lumbar intervertebral disks," J. Biomech. Eng. Vol. 104 No.3, pp. 187-192, Aug.1982. https://doi.org/10.1115/1.3138347
  16. Rolander, S.D. and Blair, W.E., "Deformation and fracture of the lumbar vertebral end plate," Orthop. Clin. North Am., Vol. 6, No.1, pp. 75-81, Jan.1975.
  17. Sahoo, P.K. Soltani, S. and Wong, A.K.C., "A survey of thresholding techniques," Computer vision, Graphics, and Image processing, Vol. 41, No.2. pp. 233-260, Feb.1988. https://doi.org/10.1016/0734-189X(88)90022-9
  18. Shin, D.S. Lee, K. and Kim, D., " Biomechanical study of lumbar spine with dynamic stabilization device using finite element method," Journal of Computer- Aided Design, Vol. 39, pp.559-567, Mar.2007. https://doi.org/10.1016/j.cad.2007.03.005
  19. Shirazi-Adl, S.A. Shrivastava, S.C. and Ahmed, A.M., "Stress analysis of the lumbar disc-body unit in compression. A three-dimensional nonlinear finite element study," Spine, Vol. 9, No.2, pp.120-134, Mar.1984. https://doi.org/10.1097/00007632-198403000-00003
  20. Silva, M.J. Wang, C. Keaveney, T.M. and Hayes, W.C., "Direct and computed tomography thickness measurements of the human, lumbar vertebral shell and endplate," Bone, Vol. 15, No.4, pp. 409-414, Jul-Aug., 1994. https://doi.org/10.1016/8756-3282(94)90817-6
  21. Simmons, J., Utilization of the Simmons plating system for stabilization of the spine. In: Fessler, R.G and Haid, R.W (ed.), Current Techniques in Spinal Stabilization, McGraw-Hill, New York pp. 325-332, 1996.
  22. Skaggs, D.L. Weidenbaum, M. Iatridis, J.C. Ratcliffe, A. Mow, V.C., "Regional variation in tensile properties and biochemical composition of the human lumbar anulus fibrosus," Spine, Vol. 20, No.9, pp.1103-1104, May.1995.
  23. Wang, X. and Dumas, G.A., "Evaluation of effects of selected factor on inter-vertebral fusion- a simulation study," Journal of Medical Engineering and Physics, Vol. 27,No.3, pp.197-207, 2005. https://doi.org/10.1016/j.medengphy.2004.10.010
  24. Wetzel, F.T. and LaRocca, H., "The failed posterior lumbar interbody fusion," Spine, Vol. 16,No.7, pp.839-845, Jul.1991. https://doi.org/10.1097/00007632-199107000-00027
  25. White, A.A. and Panjabi, M.M., "Clinical biomechanics of the spine," Second ed. J. B. Lipponcott Company, Philadelphia, pp. 237-244, 1990.