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Simulation of an anterior spine instrumentation in adolescent idiopathic scoliosis using a flexible multi-body model

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Abstract

Anterior spinal instrumentation is an alternative option to posterior instrumentation for surgical treatment of adolescent idiopathic scoliosis (AIS). However, optimal instrumentation configuration and strategies are not yet clearly defined. A biomechanical kinematic model using flexible mechanism was developed to study instrumentation strategies. Preoperative 3D reconstruction of scoliotic patient’s spine was used to define the patient-specific geometry of the model. Mechanical properties were adjusted to consider the discectomy and surgical manoeuvres were reproduced. Anterior spine surgeries of ten patients were simulated and results were compared to immediate post-operative data and showed differences of <5° for the Cobb angles. The validated model was used to find optimal instrumentation configurations for one patient prior to surgery. Six strategies were tested out of which the optimal one was identified while two were not recommended for surgery since screw forces exceeded published pullout forces. This study demonstrates the possibility to simulate anterior spine instrumentations.

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Acknowledgments

Funded by the Natural Sciences and Engineering Research Council of Canada (Collaborative Research and Development Program jointly funded by an unrestricted educational/research grant from Medtronic Sofamor Danek).

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Authors and Affiliations

  1. Department of Mechanical Engineering, Ecole Polytechnique de Montréal, Station “Centre-Ville”, P.O. Box 6079, Montreal, QC, Canada, H3C 3A7

    Geneviève Desroches & Carl-Eric Aubin

  2. Sainte-Justine University Hospital Center, 3175 Côte-Ste-Catherine Rd., Montreal, QC, Canada, H3T 1C5

    Geneviève Desroches, Carl-Eric Aubin & Charles-Hilaire Rivard

  3. Texas Scottich Rite Hospital for Chidren, 2222 Welborn Street, Dallas, TX, 75219, USA

    Daniel J. Sucato

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  1. Geneviève Desroches
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  2. Carl-Eric Aubin
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  3. Daniel J. Sucato
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  4. Charles-Hilaire Rivard
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Correspondence to Carl-Eric Aubin.

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Desroches, G., Aubin, CE., Sucato, D.J. et al. Simulation of an anterior spine instrumentation in adolescent idiopathic scoliosis using a flexible multi-body model. Med Bio Eng Comput 45, 759–768 (2007). https://doi.org/10.1007/s11517-007-0214-x

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  • DOI: https://doi.org/10.1007/s11517-007-0214-x

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