Influence of different postures under vertical impact load on thoracolumbar burst fracture
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ORIGINAL ARTICLE
Influence of different postures under vertical impact load on thoracolumbar burst fracture Wu-Jie Li 1 & Li-Xin Guo 1 Received: 13 January 2020 / Accepted: 23 August 2020 # International Federation for Medical and Biological Engineering 2020
Abstract Clinical studies have extensively shown that burst fractures can cause severe and long-term neurological deficits. However, the mechanism of burst fracture is not clear, and the influence of different spinal postures on burst fracture is still unidentified. The study aimed at investigating the influence of different postures under vertical impact load on thoracolumbar burst fracture. A detailed nonlinear finite element model of T12-L2 segment was developed to investigate these problems. In this work, a rigid ball was used to vertically impact the finite element spinal segment, which emulated the process of burst fracture as in experimental condition. During the process, amounting to 9 different postures (normal, flexion, extension, right/left lateral bending of 8°, right/ left axial rotation of 4° and 8°) were studied. Totally five failure modes were observed. Six different parameters, including vertebral height, vertebral bulge, interpedicular widening, vertebral kyphotic angle, posterior vertebral body angle, and joint facet contact force, were observed to evaluate the corresponding severity of burst fracture. Burst fracture in extension was the severest, and the loss of vertebral height in flexion was the most. The different postures in these simulations changed the morphology of intervertebral disc and facet joints force, resulting in different types of fracture. Keywords Burst fracture . Thoracolumbar spine . Finite element method . Different postures . Nonlinear material property
1 Introduction Approximately half of spinal fractures occur in the region of thoracolumbar junction (TLJ), comprising of T11-L2. Almost 10 to 20% spinal fracture occurs through the incidence of burst fracture (BF) [1],where in 60% of the cases, BF can cause the neurological injury [1, 2]. The rate of burst fracture Highlight • Reproducing burst fracture in different postures. • Burst fracture in extension was the severest. • The loss of vertebral height in flexion was the most. • 5 fracture types defined in the clinical medicine were obtained in 9 postures. • The severity of fracture was analyzed by quantitative method in some parameters. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11517-020-02254-1) contains supplementary material, which is available to authorized users. * Li-Xin Guo [email protected] 1
School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China
is on the rise in young patients and leads to major socioeconomic problems for healthcare systems [2]. BF is defined as retropulsion of bony fragments from fracture or comminution of both the anterior and middle columns into spinal canal under vertical compression to slightly flexed spine. Fracture is usually the consequenc
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