Incorporating ligament laxity in a finite element model for the upper cervical spine

Publication date: Available online 30 June 2017
Source:The Spine Journal
Author(s): Timothy L Lasswell, Duane S Cronin, John B Medley, Parham Rasoulinejad
Background ContextPredicting physiological range of motion (ROM) using a finite element (FE) model of the upper cervical spine requires the incorporation of ligament laxity. The effect of ligament laxity can only be observed on a macro level of joint motion and is lost once ligaments have been dissected and preconditioned for experimental testing. As a result, although ligament laxity values are recognized to exist, specific values are not directly available in the literature for use in FE models.PurposeThe purpose of the current study is to propose an optimization process that can be used to determine a set of ligament laxity values for upper cervical spine FE models. Furthermore, an FE model that includes ligament laxity is applied and the resulting ROM values are compared with experimental data for physiological ROM as well as experimental data for the increase in ROM when a type II odontoid fracture is introduced.Study Design/SettingThe upper cervical spine FE model was adapted from a fiftieth percentile male full body model developed with the Global Human Body Models Consortium (GHBMC). FE modeling was performed in LS-DYNA (Livermore Software Technology Group, Livermore CA) and LS-OPT (Livermore Software Technology Group, Livermore CA) was used for ligament laxity optimization.MethodsOrdinate-based curve matching was used to minimize the mean squared error (MSE) between computed load-rotation curves and experimental load-rotation curves under flexion, extension and axial rotation with pure moment loads from 0-3.5Nm. Lateral bending was excluded from the optimization since the upper cervical spine was considered to be primarily responsible for flexion, extension and axial rotation. Based on recommendations from the literature, four varying inputs representing laxity in select ligaments were optimized in order to minimize the MSE. Funding was provided by the Natural Sciences and Engineering Research Council of Canada as well as GHMBC. The present study was funded by the Natural Sciences and Engineering Research Council of Canada to support the work of one graduate student. There are no conflicts of interest to be reported.ResultsThe MSE was reduced to 0.28 in the FE model with optimized ligament laxity compared to an MSE 0f 4.16 in the FE model without laxity. In all load cases, incorporating ligament laxity improved the agreement between the ROM of the FE model and the ROM of the experimental data. The ROM for axial rotation and extension was within one standard deviation of the experimental data. The ROM for flexion and lateral bending was outside one standard deviation of the experimental data but a compromise was required in order to use one set of ligament laxity values to achieve a best fit to all load cases. Atlanto-occiptial motion was compared as a ratio to overall ROM and only in extension did the inclusion of ligament laxity not improve the agreement. After a type II odontoid fracture was incorporated into the model, the increase in ROM was consistent with experimental data from the literature.ConclusionsThe optimization approach used in this study provided values for ligament laxities that, when incorporated into the FE model, generally improved the ROM response when compared with experimental data. Successfully modeling a type II odontoid fracture showcased the robustness of the FE model which can now be used in future biomechanics studies.



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