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Biomedical subjects

F Lavaste

Publications and source records attributed to F Lavaste.

At least 37 records · Page 2Linked to original sources
PubMed2002

The role of disc, facets and fibres in degenerative process: a sensitivity study.

In order to have a better knowledge on the behaviour of the lumbar spine, we investigated the response under loads (flexion, extension, lateral bending and torsion) of a finite element model (L3-L5 segment) submitted to changes of parameters (disc height, nucleus Poisson coefficient, posterior disc fibres, facet orientation and asymmetry and gap). These changes were selected using a Taguchi planning method and the results obtained show that some parameters (disc height, gap, facet orientation) take a high part on motion and stresses while others have a slight influence. It also appears that some interactions between parameters play a significant role.

Humans↗
PubMed2002

Finite element simulation of various strategies for CD correction.

The scoliosis surgery using the Cotrel-Dubousset instrumentation is a complex three dimensional correction. This surgery was first simulated for a given patient using a personalized finite element model: the geometry was extracted from a 3D stereoradiographic reconstruction and mechanical properties were personalized using lateral bending tests. Finally, three alternative surgical strategies were simulated in order to analyze their effects on spine postoperative configuration. First results are promising and should allow surgeons to objectively analyze various strategies or techniques.

Biomechanical Phenomena↗
PubMed2001

Computer-assisted assessment of spinal sagittal plane radiographs.

The sagittal shape of the spine, particularly its sagittal balance, currently is being extensively investigated. The major purpose of this study is to examine the measurement repeatability of SpineView software, which calculates 13 independent variables, to shorten and facilitate the measurement of lateral spinal radiographs; another purpose is to collect physiological data for nonpathologic spines, which can be used as a reference in future research. This article also presents two new parameters and discusses their possible role in forthcoming investigations. The interobserver repeatability study shows that most of the variables are more repeatable (less than +/-1.5 degrees ) when the operator is experienced. A less (+/-6.5 degrees ) repeatable measurement is T4-T12 kyphosis, which may be because of the poor contrast generally observed on radiographs of the upper thoracic vertebrae. The intraobserver repeatability study also demonstrates that subjective failures do not influence the results significantly, but the quality of the radiographs may have significant effect on long-term repeatability. The mean values were generally different between male and female subjects, and significant differences between the two sexes were only noticed for pelvic thickness and global spinal inclination. Normal range values and correlations between some pelvic and spinal parameters were similar to data found in the literature. The results of the current study provide evidence that the SpineView software is useful for experimental investigation of sagittal spinal alignment.

Adult↗
PubMed2001

[Quantitative 3D anatomy of the lumbar spine].

PURPOSE OF THE STUDY: There are many anatomic descriptions of the spine, but most concentrate on qualitative information. Quantitative data is however important to achieve a better clinical approach, to adapt implant size and to construct geometric models of spine mechanics. MATERIAL AND METHODS: We examined 32 dry spines (160 lumbar vertebrae) obtained from the Orfila Museum anatomy laboratory at the Saints-Pères School of Medicine in Paris. We drew 178 landmarks on the surface of each vertebra and recorded the 3D spatial coordinates of each point using a Fastrack electromagnetic system operating with +/- 0.2 mm precision. The coordinates of the digitalized points were expressed in a local x-y-z axis field (x=posteroanterior axis, y=right-left axis, z=caudocranial axis). The origin O was half way between the "centers" of the vertebral plates. After calculating 112 linear, angular and surface parameters, results were analyzed with the Statview statistics system. RESULTS: All parameters exhibited gaussian distribution. The transpedicular vertebral depth, corresponding to the maximal penetration of a pedicular screw before touching the anterior wall, was nearly constant: 48 mm (mean). The mean height of the pedicle was approximately 16 mm for L1 to L4 and 21 mm for L5. Pedicle width was 7 mm for L1 and L2 then rapidly widened to reach 10 mm for L5. It was noteworthy that the narrowest pedicle (4 mm) was found in 10% of the L1 vertebrae. There was an exponential rise in the sagittal tilt of the pedicles from L1 to L5, measuring approximately 8 degrees for L1 and rising to 24 degrees for L5. DISCUSSION: Our sample of human spines with unknown clinical characteristics (age, sex) is representative of anatomy laboratory populations, generally composed of subjects over 40 years of age, and is thus adapted for studies of the degenerative spine. Our findings are generally in agreement with data reported in the literature and also provided complementary quantitative data concerning the transpedicular vertebral depth that was found to be a rather constant feature of the lumbar spine. It measured between 40 and 56 mm for 95% of the study population. The dimensions of the pedicle is particularly important: the width must be known to determine the size of pedicle screws; it measured between 7 and 12 mm in 95% of the population. The largest mean cross section of the pedicle was found for L5 (82mm(2)), but measured less than 60 mm(2) in 10% of the vertebrae, suggesting predisposition to spondylolysis.

Anthropometry↗
PubMed2000

3D reconstruction method from biplanar radiography using non-stereocorresponding points and elastic deformable meshes.

Standard 3D reconstruction of bones using stereoradiography is limited by the number of anatomical landmarks visible in more than one projection. The proposed technique enables the 3D reconstruction of additional landmarks that can be identified in only one of the radiographs. The principle of this method is the deformation of an elastic object that respects stereocorresponding and non-stereocorresponding observations available in different projections. This technique is based on the principle that any non-stereocorresponding point belongs to a line joining the X-ray source and the projection of the point in one view. The aim is to determine the 3D position of these points on their line of projection when submitted to geometrical and topological constraints. This technique is used to obtain the 3D geometry of 18 cadaveric upper cervical vertebrae. The reconstructed geometry obtained is compared with direct measurements using a magnetic digitiser. The order of precision determined with the point-to-surface distance between the reconstruction obtained with that technique and reference measurements is about 1 mm, depending on the vertebrae studied. Comparison results indicate that the obtained reconstruction is close to the actual vertebral geometry. This method can therefore be proposed to obtain the 3D geometry of vertebrae.

Cervical Vertebrae↗
PubMed2000

The anatomic basis for the concept of lateralized femoral stems: a frontal plane radiographic study of the proximal femur.

We determined the range of sizes for a system of monoblock femoral prostheses that would provide adequate (a term defined in the text) fill in the frontal plane and restore femoral offset and leg length. We performed an anatomic study, based on measurements in 200 anteroposterior pelvic radiographs. If diaphyseal filling implants are to be used, 9 sizes are sufficient to obtain excellent canal filling and restoration of femoral offset in >80% of cases, assuming that the level of neck osteotomy can vary over a 1-cm range. When using metaphyseal filling implants, only a limited adjustment can be obtained from the level of neck osteotomy. A system limited to 8 sizes approximates the anatomy of the femoral canal with satisfactory precision in 73% of cases. If such a system is provided with only a single neck shaft angle for each stem size, it does not allow restoration of the biomechanical center of the hip in >67% of cases. A system of 8 sizes of 1 neck/shaft angle and a 22-mm modular head restores the anatomy in only 49% of cases. Approximating the frontal anatomy of 85% of femora with an implant filling the metaphysis requires at least 15 sizes distributed in 3 metaphyseal configurations, each supplied with 2 different neck shalt angles.

Aged↗
PubMed1999

[Cadaver study of acetabular cup mobility in the healthy hip and prosthesis by monopodal pressure simulation ].

PURPOSE OF THIS STUDY: The purpose of this study was to quantify relative displacement of anterior and posterior horn of the acetabulum lunate surface using Omega strain gauges while increasing loads were applied to the hip joint. Measurement were performed on fresh cadaver bones in unipodal stance using experimental method before and after socket's implantation. MATERIAL AND METHODS: [corrected] Nine skeletons, from fresh non-embalmed cadavers, including pelvis, the three last lumbar vertebrae and both femurs were maintained in unipodal equilibrium using metallic cables for muscle passive simulation. Loads were applied up to 700 N. Specific extensometric Omega strain gauges were created and tested, with 5 mu of sensibility. Measurement of displacement between horns were studied on two sides of each pelvic before and after implantation of conventional and prototype cemented or press fit implants. RESULTS: Among 81 loads on 18 acetabulum healthy and implanted, displacement was significant in 58 cases with a spacing of horn of 7 to 140 mu with average 31.1 mu and non significant in 25 cases. On healthy acetabulum, spacing was variable from 12 to 140 mu (average 43.2 mu) in 18 of 26 loads. On implanted acetabulum by different sockets, spacing was variable from 7 to 100 mu (average 27.4 mu) in 40 of 55 loads. Displacement was function of rotation hip, smaller in internal rotation and larger in external rotation. Spacing of horns was reduced in oversize sockets. DISCUSSION: The data obtains by omega strain gauge suggest acetabular displacement is not univocal under load. There were a widening of the acetabular notch on load. This can be explained by the modification of primary incongruity of the two components of the hip joint because of acetabular deformation. Such results are in agreement with recently published data obtained about length of the transverse acetabular ligament.

Acetabulum↗
PubMed1998

Effects of freezing on the biomechanics of the intervertebral disc.

Storage of anatomic specimens is possible only if there is a reliable method for preservation of the tissues. The establishment of such a procedure is thus of twofold importance: clinical (transplantation of segments of the vertebral column) and experimental (research and teaching programs). Simple freezing at -18 degrees C is the simplest and least expensive method for storing spinal specimens compared to other modes of storage such as cryo-preservation and lyophilization. Does this mode of storage affect the biomechanics of frozen anatomic specimens, in particular those of the intervertebral disc? This experiment dealt with the comparative biomechanical analysis before and after three months of freezing of 19 segments of the sheep vertebral column (4 functional C4-C5 units, 3 C7-T1 units, 6 T13-L1 units and 6 L5-L67 units). The results showed that there was no significant difference (risk of error 5%) between frozen and fresh segments of vertebral column in terms of amplitude and rigidity, except for the C7-T12 segment where the conditions of validity of the statistical tests were not met. The results of this experiment allowed us to validate a biomechanical model to assay the effects of freezing.

Animals↗
PubMed1998

Characterization of the mechanical behaviour parameters of the costo-vertebral joint.

This in vitro study introduces a new method to determine quantitative parameters characterizing the mechanical behaviour of the costo-vertebral joint. These parameters are useful in building numerical models of the thoracic spine, taking into account the thoracic cage. Nine thoracic cages were isolated from fresh human cadavers. From each cage, three functional units were tested: T1-T2, T5-T6, T9-T10. Loads were applied according to the joint local coordinate system. Every functional unit was tested first intact and again after section of successive costo-transverse ligaments. We used an opto-electronic system to follow the three-dimensional motion of the joint, and obtained non-linear load/displacement curves according to the primary rotation axis. A statistical analysis of these curves allowed the calculation of parameters describing the joint mechanical behaviour: total range of motion, motion in the low-stiffness zone, and flexibilities in the positive and negative quasi-linear zones. These values can be used as a database for mechanical modeling of the spine.

Adult↗
PubMed1998

[In vivo study of kinematics of the elbow using electromagnetic goniometer].

We used an electromagnetic goniometer to study the angular and translations displacements between the humerus and the 2 bones of the forearm. The electromagnetic gionometer allows acquisition of the coordinates and analysis of the 6 degrees of motion. To validate our external fixation apparatus, we used a fresh body upper limb. At first, a series of measurements was conducted with the apparatus. We then performed a series of measurements, by fixing the transmitter and receiver with external fixation pins directly inserted into the bones of the arm and forearm. To assess the reproducibility of our method, we chose a healthy subject. We performed 20 measurements over his right and left elbows. In order to study normal elbow kinematics, we performed measurements on 10 healthy subjects. The study of rotation showed that the apparatus was adapted to measure flexion-extension. It limited pronation-supination movement to about 26.7 degrees. Abduction was increased by 19.7 degrees by our apparatus during flexion-extension, but abduction was reliable within a 2 degrees range for pronation-supination. The sliding movements recorded during flexion-extension were reliable within approximately 3 mm for frontal translations, 6 mm for fitting, and 1 mm for external translations. For the sliding movements recorded in pronation-supination, frontal translations were reliable within about 7 mm, fitting was reliable within 1.9 mm and external translations were reliable within about 2.9 mm. During flexion-extension of the elbow, flexion-extension, frontal translations and external translations were reproducible. The reproducibility test showed that only 6 measurements were reproducible. The kinematic elbow study of a healthy subject showed that the average amplitude of flexion-extension was close to the measurement observed with the manual goniometer. The results in the healthy subject showed that the elbow is more stable during pronation-supination than during flexion-extension. This preliminary study should allow us, in the near future, to study elbow prosthesis kinematics.

Cadaver↗
PubMed1997

Intraoperative optoelectronic analysis of three-dimensional vertebral displacement after Cotrel-Dubousset rod rotation. A preliminary report.

STUDY DESIGN: This study analyzed intraoperatively the three-dimensional displacement of vertebrae during rotation of the Cotrel-Dubousset rod for scoliosis correction, using an optoelectronic method. OBJECTIVE: To evaluate three-dimensional transitions and rotations of instrumented and uninstrumented vertebrae, produced by the Cotrel-Dubousset instrumentation "derotation" maneuver. SUMMARY OF BACKGROUND DATA: Published reports indicate that Cotrel-Dubousset instrumentation has been more effective in producing spinal derotation than vertebral axial derotation, but no study analyzed intraoperatively the effects on the vertebrae produced solely by rotation of the rod. METHODS: Eight patients with idiopathic scoliosis treated with Cotrel-Dubousset instrumentation underwent intraoperative optoelectronic monitoring using infrared cameras (Vicon). Markers were implanted in the spinous processes of the lower and upper instrumented vertebrae (LIV, UIV), the adjacent uninstrumented vertebrae below and above (-LIV, +UIV), and the apical vertebra. During rod rotation, acquisition and processing of cameras data were performed to obtain three-dimensional displacements of vertebrae. RESULTS: Translations and rotations of LIV and UIV were in identical directions to those of -LIV and +UIV, respectively. Orientation of the LIV hook influenced the displacement of LIV and -LIV. Posterior translation of the apical vertebra was commonly observed in thoracic King II, III, or V curvatures (apical vertebra = T9), and anterior translation in King I and IV and thoracolumbar curvatures (apical vertebra = T11-T12). Axial rotation of the apical vertebra was increased in thoracic curvatures and decreased in thoracolumbar and lumbar curvatures. Lateral translation was the major displacement observed. CONCLUSIONS: Rotation of the rod produces rotational and translational changes along each axis. These results are preliminary, but substantial. Technical improvement would allow more accurate results in the near future.

Adolescent↗
PubMed1997

A three-dimensional parameterized finite element model of the lower cervical spine. Study of the influence of the posterior articular facets.

In this study, we present a three-dimensional geometrical and mechanical finite element model of the complete lower cervical spine. The geometry of the vertebrae is parameterized which allows the model to fit different morphologies of vertebrae. The results obtained with a reduced functional unit model (without posterior arch) and with a complete functional unit model were compared with those obtained from experimental studies, when moments of flexion, extension lateral flexion and axial torque were applied. General agreement was observed. Since the model was parameterized, it was possible to study the influence of some geometrical parameters on the mechanical behavior of the cervical spine. Particularly, we focused on the influence of the posterior articular facets as their geometry is very different from those of the other spinal levels and as large inter-individual variability can be observed. The orientation of the facets with regard to the horizontal plane appeared to have a large influence on the 'coupled rotation to principal rotation' ratio, notably in lateral flexion.

Biomechanical Phenomena↗
PubMed1997

Intervertebral disc prosthesis. Results and prospects for the year 2000.

Presently, the kinematic disc prosthesis model (SB Charité) is the best disc replacement compromise, and is the basis of the evolution of the prosthetic concept at the dawning of the year 2000. Clinical results of a homogeneous series of 105 cases with a mean followup of 51 months show 79% of the patients had an excellent result and 87% returned to work, radiologically, these results correlated with restoration of a well balanced lordosis and with segmental mobility. Factors leading to failure are posterior facet arthritis, osteoporosis, structural deformities, and secondary facet pain. Two- and 3-dimensional numeric modeling enables one to study the total facet joint loading and the maximal local loading on the facet. Dissociation of the stiffness in pure rotation and stiffness in translation of the disc are the bases of the technologic improvement.

Activities of Daily Living↗
PubMed1997

[Acetabulum deformations after implantation of a cemented cup with or without metal-back component. An in vitro comparative study of monopodal load].

PURPOSE OF THE STUDY: The purpose of this study was to find a biomechanical explanation for a clinical failure of metal backed acetabular components. Periacetabular deformations were measured on fresh cadaver bones equipped with strain-gauge rosettes. MATERIAL AND METHODS: Two skeletons, including pelvic bone, the two last lumbar vertebrae, and both femurs were maintained in unipodal equilibrium using metallic cables for muscle simulation. Loads were applied up to 700 N the approximating average body weight. A comparative study of periacetabular deformations was performed: right sides of each pelvic bone were implanted with conventional cemented implants, and left sides with metal backed cemented implants of same diameter and size. RESULTS: Significant differences were noted: whereas no modification was brought by implantation of conventional cemented sockets, periacetabular deformations were reduced and smoothed after implantation of cemented metal backed implants. Such results are in agreement with recently published data obtained, using the finite element analysis method. DISCUSSION: A study of pelvic ring and acetabular walls displacement was performed, but the authors couldn't find any clinical relevance to this biomechanical study.

Acetabulum↗
PubMed1997

[A protocol of in vivo 3D experimental evaluation of global posture and motion of the spine].

PURPOSE: The aim of his study was to assess 3D global posture and movement of body segments, especially for scoliotic subjects. As scoliosis is a three-dimensional deformity, it needs three-dimensional evaluation and correction, but there is no mean today to get 3D dynamic examination of the whole body. MATERIAL AND METHODS: Using opto-electronic methods, an experimental protocol was established to compare the pre- and post-operative results of treatment. Firstly, the reliability of the protocol was tested in healthy adult subject. Secondly, a reference group of 15 healthy teenagers was analysed Besides, first scoliotic subject in pre- and post-operative situations were followed. The markers fixed on the skin allowed us to calculate the position of the head, the pelvic, the shoulders and the spinal axis, during a static trial and motions. RESULTS: The reliability of the protocol was satisfactory (standard deviation (s) < 5.4 degrees in a flexion movement). The inter-subject variability was greater for the position of the head than for the pelvis, the shoulders or the spinal axis. The scoliotic patient showed a straightening of the whole body in the three anatomic planes. One month after treatment, the range of motion were reduced (+13.8 degrees for the pelvic flexion during a flexion movement), but six months after surgery they were greater than before (+14.7 degrees). CONCLUSION-DISCUSSION: Many systems have been proposed to measure the motion of the trunk, but they were not three-dimensional. The opto-electronic method is a non invasive, external and dynamic system.

Adult↗
PubMed1997

[Computer graphic analysis of the three dimensional deformities of scoliotic vertebrae].

GOAL: A computer graphics method that permits the reconstruction, visualization and measure of the vertebral deformities of the scoliotic spine is presented. MATERIALS: Medical imaging techniques utilizing computerized tomography is at the foundation of the reconstruction technique. The studied morphometric parameters are: 1) vertebral body wedging, 2) transverse and spinous process orientation and dimensions and 3) bilateral variation of pedicular dimensions. RESULTS: The reconstructed specimen showed the usefulness of this technique for visualizing and measuring vertebral deformities. Preliminary results seem to be in agreement with the literature concerning the deformities of scoliotic vertebrae. CONCLUSION: This tool will be useful in morphometric investigations for the evaluation of the deformations of scoliotic vertebrae.

Computer Graphics↗
PubMed1996

In-vitro biomechanical study of a dorso-lumbo-sacral posterior supple instrumentation with variable section.

This study is designed to analyse the behavior, in the sagittal plane, of a complete human dorso-lumbar rachis, made rigid by the posterior instrumentation used for the treatment of scoliosis, on subjects suffering from DMD (Duchenne Muscular Dystrophy). The object of this analysis is to demonstrate the reliability of early surgery made possible by new instrumentation. Close review of the literature shows that the currently used Harrington or Luque instrumentations lead to mechanical complications, especially rod breaking, at the thoraco-lumbar junction. 8 specimens were non-destructively tested in-vitro. Compression and flexion were applied. For each test, rachis movements with and then without instrumentation, and also rod restraints were noted. The results show a linear stiffness multiplied by 8.3 in flexion and 11.6 in extension. The maximum restraint recorded for physiological displacements is 77 MPa. This remains largely under the fatigue-breaking limit of the metal used (stainless steel hammer-hardened 316 L, Young's modulus = 200,000 MPa, Poisson's ratio = 0.21, endurance limit = 350 MPa at 5 x 10(6) cycles). The results of this study encourage us to continue and develop early surgery in children affected by myopathy, with fixation of the complete rachis, including a lumbo-sacral arthrodesis and a supple dorsal part of the mounting, in the sagittal plane.

Aged↗