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Biomedical subjects

N Yoganandan

Publications and source records attributed to N Yoganandan.

At least 19 recordsLinked to original sources

Experimental production of extra- and intra-articular fractures of the os calcis.

Although studies have been conducted in the past to duplicate traumatic fractures of the os calcis, biomechanical force data as a function of extra- and intra-articular fractures are not available. Consequently, in this study, a dynamic single impact model was used to provide such information. Using intact human cadaver lower extremities, impact loading was applied to the plantar surface of the foot using a mini-sled pendulum equipment. The proximal tibia was fixed in polymethylmethacrylate. Following impact, pathology to the os calcis was classified into intact (no injury; 14 cases), and extra-articular (6 cases) and intra-articular (6 cases) fractures. Peak dynamic forces were used to conduct statistical analysis. Mean forces for the intact and (both) fracture groups were 4144 N (standard error, SE: 689) and 7802 N (SE: 597). Mean forces for the extra- and intra-articular fracture groups were 7445 N (SE: 711) and 8159 N (SE: 1006). The peak force influenced injury outcome (ANOVA, p<0.005). Differences in the forces were found between intact and injured specimens (p<0.01); intact specimens and specimens with extra-articular pathology (p<0.001); intact specimens and specimens with intra-articular pathology (p<0.005). The present experimental protocol, which successfully reproduced clinically relevant os calcis pathology, can be extended to accommodate other variables such as the simulation of Achilles tendon force, the inclusion of other angles of force application, and the application of the impact force to limited regions of the plantar force of the foot in order to study other injury mechanisms.

Achilles Tendon↗

Biomechanical study of pediatric human cervical spine: a finite element approach.

Although considerable effort has been made to understand the biomechanical behavior of the adult cervical spine, relatively little information is available on the response of the pediatric cervical spine to external forces. Since significant anatomical differences exist between the adult and pediatric cervical spines, distinct biomechanical responses are expected. The present study quantified the biomechanical responses of human pediatric spines by incorporating their unique developmental anatomical features. One-, three-, and six-year-old cervical spines were simulated using the finite element modeling technique, and their responses computed and compared with the adult spine response. The effects of pure overall structural scaling of the adult spine, local component developmental anatomy variations that occur to the actual pediatric spines, and structural scaling combined with local component anatomy variations on the responses of the pediatric spines were studied. Age- and component-related developmental anatomical features included variations in the ossification centers, cartilages, growth plates, vertebral centrum, facet joints, and annular fibers and nucleus pulposus of the intervertebral discs. The flexibility responses of the models were determined under pure compression, pure flexion, pure extension, and varying degrees of combined compression-flexion and compression-extension. The pediatric spine responses obtained with the pure overall (only geometric) scaling of the adult spine indicated that the flexibilities consistently increase in a uniform manner from six- to one-year-old spines under all loading cases. In contrast, incorporation of local anatomic changes specific to the pediatric spines of the three age groups (maintaining the same adult size) not only resulted in considerable increases in flexibilities, but the responses also varied as a function of the age of the pediatric spine and type of external loading. When the geometric scaling effects were added to these spines, the increases in flexibilities were slightly higher; however, the pattern of the responses remained the same as found in the previous approach. These results indicate that inclusion of developmental anatomical changes characteristic of the pediatric spines has more of a predominant effect on biomechanical responses than extrapolating responses of the adult spine based on pure overall geometric scaling.

Adult↗

Morphology of young and old cervical spine intervertebral disc tissues.

The intervertebral disc of the cervical spine undergoes degenerative changes during the aging process. Although many studies have reported the qualitative changes in the disc, methodology to quantify these changes is lacking. The present study was designed to quantify the geometrical variations of the nucleus pulposus, annulus fibrosus and uncovertebral joints. The age groups of specimens were classified as juvenile, adult and aged. Fresh intervertebral discs with adjacent vertebral bodies of the lower cervical spine of primates were isolated. The specimens were sectioned sequentially in a coronal plane. Sections were stained with Hematoxylin and Eosin, Verhoeff's, Safranin O, and Trichrome methods to distinguish the nucleus, annulus and uncovertebral joints. Histological images were examined using light microscopy and processed using a computer imaging program to trace the boundaries of the disc components. Dorsal-to-ventral depth and medial-to-lateral width of the nucleus pulposus, and its relative location to the annulus pulposus were also obtained. In the juvenile and adult discs, the nucleus appeared as a light opaque region with scattered notochordal cells with a clear distinction from the annulus region. In contrast, in the aged discs, the nucleus appeared as a dense region of amorphous, irregular collagen materials with less distinction from the annulus region. With the progression of aging, the dorsal-to-ventral depth of the nucleus decreased considerably compared to medial-to-lateral width. The uncovertebral joints were clear in the adult discs. The joints were less distinct in the aged discs and their size decreased. Quantification of three-dimensional geometrical variations will assist in better defining the disc tissue in the mathematical models.

Aging↗

Head-neck finite element model for motor vehicle inertial impact: material sensitivity analysis.

The aim of this study was to conduct a material sensitivity analysis using a head-neck finite element model (FEM). The model included the skull, C1-T1 vertebrae, intervertebral discs, facet joints, and biomechanically relevant ligaments. Poisson's ratio and elastic modulus of the head-neck components were varied. The loading condition included the impact load applied to the first thoracic vertebra. Commercially available software (LS-DYNA) was used for the analysis. Head angle versus time, head center of gravity trajectory, and head center of gravity angular acceleration responses were computed. In general, the variation of elastic modulus had a higher effect on the response compared to variation of Poisson's ratio. As the elastic modulus was increased, the head angle and angular acceleration increased. The present findings form a first step in the study of computational biomechanics of vehicular-related trauma.

Acceleration↗

Finite element model of human cervical spinal column.

The purpose of this study was to develop a detailed anatomically accurate finite element model (FEM) of the whole cervical column (C2-T1) using sagittal and coronal computed tomography (CT) scan images and cryomicrotome anatomical sections. The bony vertebrae were defined using CT scan images. The geometrical details of intervertebral discs, uncovertebral joints and ligaments were obtained from cryomicrotome sections. The following steps were used to develop the FEM: wire mesh, surface model and solid model. The wire mesh of each vertebra and disc was generated from the CT and cryomicrotome sections, respectively. The surface model was developed by connecting the wire mesh lines. The solid model was obtained by filling the volume enclosed by the surface model. Finally, the FEM was constructed by discretizing the solid model using the mapped-mesh option. Appropriate finite element types were assigned to each component. For example, the isoparametric eight-noded solid elements were used to define the cancellous bone of a vertebra. The material properties reported in literature were adopted in the model. Commercially available software (IDEAS and ABAQUS) was used to develop the FEM.

Adult↗

Evaluation of cervical laminectomy and laminoplasty. A longitudinal study in the goat model.

STUDY DESIGN: An evaluation of the longitudinal radiologic changes up to 6 months induced by multilevel laminectomy and laminoplasty and the biomechanical responses in the goat model, complemented by biomechanical studies of intact specimens. OBJECTIVES: To determine the long-term radiographic differences and biomechanical responses of laminectomy and laminoplasty in an in vivo animal model. SUMMARY OF BACKGROUND DATA: Previous clinical and laboratory studies have indicated that multilevel laminectomy can cause increased flexibility in the cervical spinal column. Although the potential for laminoplasty to resolve these changes has been suggested, other evaluations have not supported this contention. Clarification of this controversy with long-term in vivo studies has not been performed. METHODS: Ten adult goats were divided into two groups, one undergoing C3-C5 laminectomy and the other open-door laminoplasty. Lateral cervical spine radiographs were obtained at 4-week intervals for a 6-month period. After the goats were killed, biomechanical testing was performed using pure moment loading on the surgically treated specimens and on three intact (without surgery) cervical spinal columns. RESULTS: In the laminectomy preparations, the cervical curvature index was noted to decrease by 59% at 16 weeks (P < 0.028) and by 70% at 24 weeks (P < 0.002), whereas the decrease in laminoplasty was not significantly different. Biomechanical testing indicated a significantly increased sagittal-plane slack motion in the laminectomy group (55 degrees) compared with that in intact specimens (39 degrees), but no significant difference between the laminoplasty and intact groups with respect to this motion. Laminectomy was found to be significantly stiffer (36%) in flexion than in extension, whereas the contrary was true for laminoplasty (37%). CONCLUSIONS: Radiographic and biomechanical results in the goat model suggest that laminoplasty is superior to laminectomy in maintaining cervical alignment and preventing postoperative spinal deformities.

Animals↗

Finite element analysis of the cervical spine: a material property sensitivity study.

OBJECTIVE: The study determined the effect of variations in the material properties of the cervical spinal components on the output of the finite element analysis (external and internal responses of the cervical spine) under physiologic load vectors. DESIGN: A three-dimensional (3D) anatomically accurate finite element model comprising of the C4-C5-C6 cervical spine unit including the three vertebrae, two interconnecting intervertebral discs, and the anterior and posterior ligament complex is used. BACKGROUND: The effect of material property variations of spinal components on the human lumbar spine biomechanics is extensively studied. However, a similar investigation of the cervical spine is lacking. METHODS: Parametric studies on the variations in the material properties of all the cervical spine components including the cortical shell, cancellous core, endplates, intervertebral disc, posterior elements and ligaments were conducted by exercising the 3D finite element model under flexion, extension, lateral bending and axial torsion loading modes. Low, basic and high material property cases for each of the six components under all the four physiologic loading modes were considered in the finite element analysis. A total of 432 results were evaluated to analyze the external angular rotation, and the internal stresses in the middle vertebral body, the superior and inferior endplates and the two intervertebral discs. RESULTS: Variations in the material properties of the different cervical spinal components produced dissimilar changes in the external and internal responses. Variations in the material properties of the cancellous core, cortical shell, endplates and posterior element structures representing the hard tissues did not affect the external angular motion, and the internal stresses of the inferior and superior intervertebral discs under all four loading modes. In contrast, variations in the material properties of the intervertebral disc and ligament structures representing the soft tissues significantly altered the angular motion, and the stresses in the inferior and superior intervertebral discs of the cervical spine. CONCLUSION: The material properties of the soft tissue structures have a preponderant effect on the external and internal responses of the cervical spine compared with the changes in the material properties of the hard tissue structures. RELEVANCE: Bone remodeling (e.g., osteophyte) secondary to degeneration of the human cervical joints may be explained by a change in the material property of the soft tissues, coupled with an increase in stress (due to these material property variations) in the spinal components. Consequently, to accurately predict the biomedical effects of cervical spine degeneration, it is critical to accurately determine the material property of these components.

Adult↗

Finite element modeling of the cervical spine: role of intervertebral disc under axial and eccentric loads.

An anatomically accurate, three-dimensional, nonlinear finite element model of the human cervical spine was developed using computed tomography images and cryomicrotome sections. The detailed model included the cortical bone, cancellous core, endplate, lamina, pedicle, transverse processes and spinous processes of the vertebrae; the annulus fibrosus and nucleus pulposus of the intervertebral discs; the uncovertebral joints; the articular cartilage, the synovial fluid and synovial membrane of the facet joints; and the anterior and posterior longitudinal ligaments, interspinous ligaments, capsular ligaments and ligamentum flavum. The finite element model was validated with experimental results: force-displacement and localized strain responses of the vertebral body and lateral masses under pure compression, and varying eccentric anterior-compression and posterior-compression loading modes. This experimentally validated finite element model was used to study the biomechanics of the cervical spine intervertebral disc by quantifying the internal axial and shear forces resisted by the ventral, middle, and dorsal regions of the disc under the above axial and eccentric loading modes. Results indicated that higher axial forces (compared to shear forces) were transmitted through different regions of the disc under all loading modes. While the ventral region of the disc resisted higher variations in axial force, the dorsal region transmitted higher shear forces under all loading modes. These findings may offer an insight to better understand the biomechanical role of the human cervical spine intervertebral disc.

Adult↗

Biomechanical effect of anterior cervical spine fusion on adjacent segments.

The biomechanical effects of superior (C4-C5) and inferior (C5-C6) level fusions with different graft materials on the adjacent unaltered components were quantified using an anatomically accurate and experimentally validated C4-C5-C6 finite element model. Smith-Robinson and Bailey-Badgley fusion procedures were analyzed with five different types of inter-body fusion materials with varying stiffnesses. Intact and surgically altered finite element models were subjected to physiologic compression, flexion, extension and lateral bending. The external axial and angular stiffness, and the internal unaltered intervertebral disc (C5-C6 for the superior and C4-C5 for inferior fusion) and C5 vertebral body stresses were determined. The superior level fusion resulted in the highest increase in external response in lateral bending for all implant materials in both surgical procedures. In contrast, the inferior level fusion produced a higher increase in the C4-C5 disc and C5 vertebral body stresses in compression than the superior level fusion in both surgical procedures. The increased internal stress responses reflecting the changes in the load-sharing following inferior level fusion may explain clinical observations such as enhanced degeneration subsequent to surgery. Because of the inclusion of three levels in the present multi-segment finite element model, it was possible to determine these responses in the unaltered adjacent components of the cervical spine.

Biocompatible Materials↗

Effect of age and loading rate on human cervical spine injury threshold.

STUDY DESIGN: Statistical analysis of human cadaver cervical spine compression experiments. OBJECTIVES: To quantify the cervical spine compressive injury threshold as a function of the person's age, gender, and external loading rate. SUMMARY OF BACKGROUND DATA: Results of epidemiologic studies have indicated that most survivors of cervical spinal cord injury have spinal column fractures and dislocations that result from a compression or compression-flexion force vector. Cervical spinal column injury thresholds are dependent on many factors. Delineation of the injury thresholds according to age, gender, and loading rate is necessary to improve clinical assessments and prevention strategies. METHODS: Twenty-five human cadaver head-neck compression tests were included in the analysis. Two statistical models were used to quantify the effects of age, gender, and loading rate on the force required to induce failure in the cervical spine. A multiple linear regression model provided a direct equation that quantified the effects of the variables, and a proportional hazards model was used to quantify probability of injury with each factor. RESULTS: The regression model had a correlation coefficient of 0.87. There was an interactive effect between age and loading rate: Increasing age reduced the effect of loading rate and at approximately 82 years, loading rate had no effect. Men were consistently 600 N stronger than women. The 50% probability of failure for a 50-year-old man at a 4.5-m/sec loading rate was approximately 3.9 kN. Differences in probability curves followed the same trends as seen in the regression model. CONCLUSIONS: The effects of age on cervical spine injury threshold are coupled with the rate of loading experienced through the external force vector that causes the trauma. Assessment of injury mechanisms and thresholds should be based on the person's age, gender, and loading rate to determine treatment and prevent injuries.

Adult↗

Finite element modeling approaches of human cervical spine facet joint capsule.

The human cervical spine facet joint capsule was modeled using four nonlinear finite element approaches: slideline, contact surface, hyperelastic, and fluid models. Slideline elements and contact surface definitions were used in the first two models to simulate the synovial fluid between the articulating cartilages. Incompressible solid elements approximated the synovial fluid in the hyperelastic model. Hydrostatic fluid elements idealized the synovial fluid in the fluid model. The finite element analysis incorporated geometric, material and contact nonlinearities. All models were subjected to compression, flexion, extension, and lateral bending. The fluid model idealization better approximates the actual facet joint anatomy and its behavior than the gap assumption in the slideline and contact surface models, and the solid element simulation in the hyperelastic model.

Biomechanical Phenomena↗

Cervical spine vertebral and facet joint kinematics under whiplash.

Whiplash injuries sustained during a rear-end automobile collision have significant societal impact. The scientific literature on whiplash loading is both diverse and confusing. Definitive studies are lacking to describe the local mechanisms of injury that induce either acute or chronic pain symptoms. A methodology has been presented to quantify the kinematics of the cervical spine components by inducing controlled whiplash-type forces to intact human head-neck complexes. The localized facet joint kinematics and the overall segmental motions of the cervical spine are presented. It is anticipated that the use of this methodology will assist in a better delineation of the localized mechanisms of injury leading to whiplash pain.

Acceleration↗

Biomechanics of human thoracic ribs.

Considerable advances have been made to determine the failure biomechanical properties of the human thoracic spinal column and its components. Except for a few fundamental studies, there is a paucity of such data for the costovertebral elements. The present study was designed to determine the biomechanics of the human thoracic spine ribs from a large population. Seventh and eighth ribs bilaterally were tested from 30 human cadavers using the principles of three-point bending techniques to failure. Biomechanical test parameters included the cross-sectional area (core, marrow, and total), moment of inertia, failure load, deflection, and the Young's elastic modulus. The strength-related results indicated no specific bias with respect to anatomical level and hemisphere (right or left), although the geometry-related variables demonstrated statistically significant differences (p < 0.05) between the seventh and the eighth ribs. This study offers basic biomechanical information on the ultimate failure and geometric characteristics of the human thoracic spine ribs.

Adult↗

Static and dynamic bending responses of the human cervical spine.

The quasi-static and dynamic bending responses of the human mid-lower cervical spine were determined using cadaver intervertebral joints fixed at the base to a six-axis load cell. Flexion bending moment was applied to the superior end of the specimen using an electrohydraulic piston. Each specimen was tested under three cycles of quasi-static load-unload and one high-speed dynamic load. A total of five specimens were included in this study. The maximum intervertebral rotation ranged from 11.0 to 15.4 deg for quasi-static tests and from 22.9 to 34.4 deg for dynamic tests. The resulting peak moments at the center of the intervertebral joint ranged from 3.8 to 6.9 Nm for quasi-static tests and from 14.0 to 31.8 Nm for dynamic tests. The quasi-static stiffness ranged from 0.80 to 1.35 Nm/deg with a mean of 1.03 Nm/deg (+/- 0.11 Nm/deg). The dynamic stiffness ranged from 1.08 to 2.00 Nm/deg with a mean of 1.50 Nm/deg (+/- 0.17 Nm/deg). The differences between the two stiffnesses were statistically significant (p < 0.01). Exponential functions were derived to describe the quasi-static and dynamic moment-rotation responses. These results provide input data for lumped-parameter models and validation data for finite element models to better investigate the biomechanics of the human cervical spine.

Aged↗

Finite element analysis of cervical facetectomy.

STUDY DESIGN: Moment-rotation responses and disc anulus stresses of intact and facetectomized C4-C6 cervical spinal units were analyzed using detailed, three-dimensional, finite element models. OBJECTIVES: To evaluate biomechanical effects of progressive unilateral and bilateral facet resections on cervical spine segmental mobility (external response) and disc anulus stress (internal response). SUMMARY OF BACKGROUND DATA: Experimental studies have demonstrated that facetectomy significantly increases segmental mobility of the cervical spine. The biomechanical effects of facetectomy on the internal response, however, have not been investigated. METHODS: Moment-rotation responses of C4 with respect to C6 and von Mises stress in the disc anulus were examined using finite element models of a 0% (intact), 25%, 50%, 75%, and 100% unilaterally and bilaterally facetectomized cervical spinal unit. The model simulations were conducted under the pure-moment loading of 1.8 Nm in flexion, extension, lateral bending, and axial torsion. The intact model also was validated experimentally under the same conditions. RESULTS: The moment-rotation responses of the intact unit were within the ranges of experimental data. Cervical rotations increased with the increased degree of facet resection. The greatest change occurred between 50% and 75% facet resections in bilateral facetectomy. Similar patterns were found for disc anulus stresses, but to a greater extent. The maximum increase in rotation (11%) and in anulus stress (30%) occurred in lateral bending. Torsion was the least affected loading mode. The effects of unilateral facetectomy were considerably less than those of 75% bilateral facetectomy. CONCLUSIONS: Facetectomy has a greater effect on anulus stress than on intervertebral joint stiffness. Significant increase in anulus stresses and segmental mobility may occur when bilateral facet resection exceeds 50%.

Adult↗

Wire fixation techniques of the cervical facets.

STUDY DESIGN: The changes in the biomechanical responses of the cervical spine altered by multilevel laminectomy to various facet wiring techniques were evaluated. OBJECTIVE: To determine the effectiveness of various proposed techniques of cervical facet wiring used to offer rigid internal fixation after multilevel laminectomy. METHODS: Eight human cadaveric spine segments from C2-11 underwent combined flexion-compression loading. After testing intact and three-level laminectomy (C4-C6) preparations, two techniques of facet wiring fixation were evaluated in an identical manner. Force, displacement, and kinematics data at every level of the column were obtained. RESULTS: The mean stiffness of the intact column was significantly greater than the mean stiffness for laminectomized specimens. Individual facet wiring to the bone graft and through the spinous process below the laminectomy failed to restore stiffness to the laminectomized preparations, whereas the Luque rectangle method restored the stiffness to that found in the intact column. The increases in segmental and overall sagittal rotations resulting from multilevel laminectomy were not decreased significantly by the individual facet wiring technique, but the Luque rectangle technique demonstrated a reduction of sagittal rotations compared with laminectomy without fixation. CONCLUSIONS: The significant increases in total column flexibility and segmental flexural rotations after multilevel laminectomy were not corrected by techniques that depend on individual facet wires secured to an overlying strut, including wiring to the inferior intact segment. Crosslinking of the facet wire fixation above and below the laminectomized segments, as exemplified by the Luque rectangle technique, restored column stiffness and reduced segmental sagittal rotations.

Biomechanical Phenomena↗

Dynamic analysis of penetrating trauma.

BACKGROUND: Whereas considerable literature exists on the wounding mechanics of high velocity projectiles in the military domain, there is a paucity of such data from projectiles routinely encountered in the civilian population in the United States. This study was undertaken to develop a methodology and to determine the dynamics of penetrating trauma secondary to low velocity projectiles (200-300 m/sec). To demonstrate the feasibility of the methodology and the experimental protocol, two markedly different projectiles were chosen in the study. METHODS: Two projectiles were discharged into a human tissue simulant; one projectile was smooth and the other was of the expansion type. High-speed video photographic analysis and synchronized trigger techniques were used to describe the path of the projectile during its travel within the simulant. The temporal transient and residual profiles demonstrating the "wound involvement" were computed. RESULTS: Results indicated a stark contrast between the two cases. There was a ratio of approximately three-to-one in the maximum wound involvement due to penetration. Transient wave oscillations during penetration and perforation of the projectile from the tissue simulant demonstrated significant differences in amplitudes and time durations. In addition, the residual wound involvement profiles indicated differences in the injury potential. CONCLUSIONS: This study has provided an experimental methodology to delineate the temporal dynamic behavior of penetrating projectiles. To fully quantify and differentiate the dynamic differences in the temporal behaviors of the numerous available projectiles (with various combinations in design, type of equipment, and discharge), further research in this area is clearly necessary. The present protocol lends itself to be used to systematically analyze all these behaviors. Quantified data may assist clinical personnel in the management of penetrating trauma.

Biomechanical Phenomena↗