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Biomedical subjects

N Yoganandan

Publications and source records attributed to N Yoganandan.

89 records · Page 5Linked to original sources

Biomechanics of sequential posterior lumbar surgical alterations.

Compromise of the functional integrity of the posterior lumbar ligaments and facet joints is a common occurrence after repeated lumbar operative procedures. To evaluate the biomechanical effects of sequential surgical alterations, this investigation analyzed bilateral facetectomies (medial, total, and total with posterior ligament section) in three segments of human cadaveric lumbar spines under increasing compression-flexion. These iatrogenic alterations, designed to replicate common methods of surgical exposure, were created at the lower intervertebral joint (L4-5) while the upper joint (L3-4) remained intact. Overall strength characteristics in the physiological range of 400 N and 600 N demonstrated significant differences (p less than 0.05) in applied compressions for all preparations compared to the intact specimen. Comparison of sequential surgeries, however, did not demonstrate this tendency. Significant changes in the movement of the spinous processes at the upper (unaltered) level occurred only after posterior ligament section, whereas the lower (altered) level showed markedly increasing distraction of both the facets and the spinous processes with sequential operations. Sectioning of the supraspinous/interspinous ligament and associated fascial attachments resulted in a marked transfer of motion to the altered level. This was manifested by the increased anterior displacement of the centrode at the lower level associated with probable posterior migration of the centrode at the upper level. These data suggest that the effects of progressive surgical alterations of the lumbar facet joints are controllable in a preparation undergoing acute compression-flexion loads until the supraspinous/interspinous ligaments, with associated residual tendinous, midline muscle, and fascial attachments, are violated.

Aged↗

Traumatic facial injuries with steering wheel loading.

This study was conducted to evaluate the biomechanics of facial fractures caused by steering wheel loading. Twelve intact fresh human cadaver heads were impacted onto standard or energy-absorbing steering wheels with a custom-designed and validated vertical-drop apparatus. Either zygoma was impacted once at a velocity of 2.0-6.9 m/s. The specimens were oriented to permit a direct comparison between pretest and posttest radiography, and two-dimensional and three-dimensional CT images. Bone mineral content was determined, and biomechanical forces, accelerations, and deformations were recorded. More severe fractures were associated with higher forces on the zygoma. With increasing velocities, fractures initiated at the zygomatic region propagated to other unilateral regions such as the mandible and orbit or to the contralateral side. Less facial trauma was observed with energy-absorbing steering wheels compared with standard wheels at similar impact velocities. Bone mineral content did not correlate well with specimen age or with fracture severity. Clinically significant fractures were identifiable on 3-D CT images. The flexibility of 3-D CT in evaluating the spatial extent of facial abnormalities in different orientations may have significant impact in planning surgical procedures.

Accidents, Traffic↗

Strength and kinematic response of dynamic cervical spine injuries.

This study was conducted to evaluate the biodynamic strength and localized kinematic response of the human cervical spine under axial loading applied to the head. Intact ligamentous fresh human cadaveric head-neck complexes were subjected to dynamic compressive forces with a custom-designed electrohydraulic testing device at varying rates. The structure included the effects of anterior and posterior cervical spine muscles with a system of pulleys, dead weights, and spring tension. Localized kinematic data were obtained from retroreflective targets placed on the bony landmarks of the specimen at every level of the spinal column. Input forces, accelerations, displacement, and output generalized force histories were recorded as a function of time with a digital data acquisition system at dynamic sampling rates in excess of 8,000 Hz. High-speed photography at 1,000-1,200 frames/sec also was used. Pathologic alterations to the head-neck complex were evaluated with conventional radiography, computed tomography, and cryomicrotomy. In all specimens, cervical spine injuries occurred as a result of impact. Compressive forces recorded at the distal end of the preparation indicated large-duration, short-magnitude pulses in contrast to short-duration, high-amplitude input waveforms at the head, suggesting decoupling characteristics of the head-neck system. Cervical vertebral body accelerations were consistently smaller than the accelerations recorded on the head. Kinematic data demonstrated temporal deformation characteristics as well as a plausible sequence of spinal deformations leading to injury, which were correlated with the pathoanatomic alterations documented with the post-test computed tomographic and sequential cryomicrotome sections.

Acceleration↗

Strength and motion analysis of the human head-neck complex.

This study was conducted to correlate the pathology of the experimentally tested human cervical spine with biomechanical strength information and localized temporal movements of the various spinal components. Eight fresh human cadaveric head-neck complexes were subjected to compressive forces at a quasistatic rate of 2.5 mm/s until failure. Biomechanical force and deflection data were collected. Localized kinematic data as a function of time were obtained from retroreflective targets placed in the anterior and posterior regions of the vertebral body, facet column, and spinous process at every level of the cervical spine. The specimens were radiographed prior to, during, and following failure; they were then deep frozen at the level of failure to preserve the localized tissue deformations. Specimens underwent computed tomography scanning and sequential sectioning using a cryomicrotome. The failure forces and compressions ranged from 1.3 to 3.6 kN and 0.9 to 3.7 cm. Stiffness and energy-absorbing characteristics ranged from 96.1 to 220.5 kN/m and 12.2 to 53.6 J, respectively. Varying localized temporal motions among spinal components were found to exist at all levels of the head-neck complex. With increasing compressive loads, the specimen components reorient as demonstrated by kinematic changes in the spinal elements; failure was imminent when the structure no longer resisted any further increase in external load. The study demonstrated that an evaluation of the human head-neck complex in a relaxed state, as in clinical observations on posttraumatic radiographs, is often different from that documented immediately following the traumatic insult; this underscores the importance of conducting controlled in vitro investigations to determine the injury biomechanics of the human cervical spine.

Aged↗

In vitro biomechanical study of female geriatric cervical vertebral bodies.

Compressive strength tests were conducted on fresh human geriatric female cervical vertebral bodies. Nineteen specimens were compressed to 50% of their initial height using an electrohydraulic testing device. The mechanical force-deflection response was sigmoidal with continuously changing resistance. The mean cross-sectional area and bone mineral content (BMC) of the vertebral bodies progressively increased from C3 (area: 333.8 mm2, BMC: 1.56 g) to C6 (area: 499.7 mm2, BMC: 2.18 g). The maximum compressive force increased from 1060 N at C3 to 1787 N at C6. The stiffness and the energy absorbed at failure also increased from C3 to C6 (stiffness: 279.95 to 556.41 N mm-1, energy: 2.45 to 4.16 J). These parameters demonstrated a decreasing tendency from C6 to C7. The relatively higher biomechanical parameters at the sixth vertebral level compared with its caudad and cephalad counterparts may be due to the fact the transition of the cervical lordosis to thoracic kyphosis begins at this level. Furthermore, the change in the anatomy of the unicinate processes in the cervical column around this region may also be a contributing factor.

Aged↗

Biomechanics of lumbar pedicle screw/plate fixation in trauma.

This investigation was conducted to determine alterations in the biomechanical strength and stiffness characteristics of the lumbar spine fixated with Steffee instrumentation. Comparative studies of these parameters were conducted using seven lumbar columns from fresh human cadavers. Three runs were conducted on each T12-L5 column: control, injured, and fixated. The specimens were loaded under the compression-flexion mode until failure (control run) and then reloaded (injury run) to the failure deformation determined in the control run. Screw/plates were then inserted one level proximal and distal to injury, and the specimens were reloaded (fixation run). Radiographs were taken before and after each trial. Data on deformation and force histories were gathered. The load-deflection response of the injured and fixated specimens were bimodal with two representative stiffnesses. Control failure loads and stiffnesses were higher than those for the injured (P less than 0.001) or fixated (P less than 0.01) spine. Initial stiffness was significantly higher for the fixated than for injured columns (P less than 0.001), but the final stiffnesses were similar. The increase in the initial stiffness in the fixated specimen compared to the injured specimen indicates the strength added to the posterior region of the spine. The relatively smaller alteration in the final stiffness between the fixated and the injured columns, corresponding to the load shared by the anterior column, may suggest that, above a critical strain level, the anterior column absorbs a higher portion of the external load and posterior fixation may be inadequate as sole treatment in trauma.

Adult↗

Injury biomechanics of the human cervical column.

In this study, the authors have developed a technique to replicate clinically relevant traumatic cervical spine injuries and determined the injury biomechanics. Because of the importance of compressive forces in neck injuries, this research was conducted using compression as the primary load vector. Six fresh human cadaveric head-neck complexes were prepared by fixing the distal end in methylmethacrylate. Tests were done with varying loading rates to include quasistatic and dynamic conditions. For quasistatic experiments, the proximal end was fixed to the piston of the testing device. In dynamic tests, the cranium was unconstrained, and to maintain stability, the effects of the spinal musculature were simulated by means of pulleys, deadweights, and springs in the anterior and posterior parts of the head-neck complex. Quasistatic tests conducted at a rate of 2.0 mm/sec produced cervical spine trauma at forces ranging from 1.7 to 2.3 kN, with deformations ranging from 2.2 to 3.7 cm. The specimens were deep-frozen at the level of injury, preserving the local deformation of the tissues to enable a detailed evaluation immediately after the injury. Dynamic tests conducted at velocities of 3.2 to 5.7 m/sec resulted in impact injuries at one level of the head-neck complex. The applied forces at the vertex were considerably higher than those recorded at the distal end. The failure deformations for both the quasistatic (2.2-3.7 cm) and dynamic (1.7-3.2 cm) tests, however, were found to be similar, suggesting that the human head-neck complex is a deformation-sensitive structure.

Aged↗

Effect of axial loading on neural foramina and nerve roots in the lumbar spine.

The hypothesis that the neural foramina in some patients are critically narrowed by axial compression of the spine has not been studied with direct imaging techniques. Frozen cadaveric motion segments of the lumbar spine (intervertebral disk and contiguous vertebrae) were imaged with computed tomography (CT). The segments were thawed and compressed in a hydrostatic press to simulate axial loading, and then the segments were frozen and imaged again. The motion segments were subsequently sectioned with a cryomicrotome, and the chronic degenerative changes present in the disks were classified. Pre- and post-compression CT images were compared, and anatomic relationships were studied. In 41 randomly selected segments (some with preexisting radial, transverse, and concentric annular tears), compression diminished the diameters and cross-sectional areas of the spinal canal and neural foramina. In no cases were nerve roots displaced, distorted, or compressed by axial loading. This study suggests that axial loading, such as that produced by ordinary weight bearing, does not critically compromise the neural foramina even in the presence of chronic degenerative disk changes.

Adult↗

Stiffness and strain energy criteria to evaluate the threshold of injury to an intervertebral joint.

This study is focused to evaluate the threshold of injury to an intervertebral joint based on its mechanical response. The load-deflection behavior of the intervertebral joint indicated non-linear and sigmoidal characteristics with continuously changing stiffness (a measure of the ability to withstand external force). The load corresponding to the point of zero stiffness was identified, according to the classical theories of mechanics, as the maximum load carrying capacity. Further, the initiation of trauma was defined to occur at the point on the load-deflection curve at which the stiffness begins to decrease for the first time. The load, stiffness and energy absorbing capabilities of normal and degenerated intervertebral joints at the initiation of trauma was determined. Axial compressive load experiments were conducted on nine intervertebral joints of fresh human male cadavers and the resulting load-deflection responses were transformed into stiffness-deflection responses using the derivative principle. Energy characteristics were also derived. Load, stiffness and energy at the initiation of trauma were found to be 9.0 kN, 2850 N mm-1, and 10.2 J for normal and 4.4 kN, 1642 N mm-1, and 5.8 J for degenerated segments, respectively. The load and energy values at failure were 11.0 kN, and 18.0 J for normal and 5.3 kN and 5.7 J for degenerated intervertebral joints, respectively.

Biomechanical Phenomena↗

Dynamic response of human cervical spine ligaments.

This study was undertaken to investigate the dynamic response of human cervical spine ligaments. Uniaxial tensile failure tests were conducted on anterior longitudinal ligament (AL) and ligamentum flavum (LF) structures. These ligaments were tested under in situ conditions by transecting all the elements except the one (AL or LF) under study. A fixture was designed to properly align the specimen to induce a uniaxial mode of loading. A six-axis load cell was placed at the distal end of the specimen. The proximal end of the specimen was attached to the piston of a specially designed electrohydraulic testing device. The biomechanical properties of the ligaments were determined at four different loading rates of 8.89, 25.0, 250.0 and 2500 mm/sec. The mechanical response indicated nonlinear and sigmoidal characteristics. The ultimate tensile failure load, stiffness, and energy-absorbing capacity at failure were found to increase with increasing loading rates for both the AL and LF. However, the distractions at failure did not indicate this tendency. While the ultimate tensile force and ultimate energy-absorbing capacity varied nonlinearly with the logarithm of the loading rate, the stiffness varied linearly.

Aged↗

Biomechanical evaluation of the axial compressive responses of the human cadaveric and manikin necks.

Cervical spine injuries such as wedge, burst, and tear drop fractures are often associated with compressive axial loads delivered to the human head-neck complex. Understanding the injury mechanisms, the kinematics of the anatomic structure, and the tissue tolerances can improve clinical prognosis and facilitate a better design for anthropomorphic devices. The axial compressive response of human cadaveric preparations was compared with the 50th percentile anthropomorphic Hybrid III manikin under various loading rates. Ten fresh human cadavers were used in the study. Intact cadaver torsos, head-cervical spines, and ligamentous cervical columns were tested. The head-neck structure and the neck (without head) of the Hybrid III manikin were also tested. Responses of the human cadaveric preparations and manikin structures were nonlinear at all rates of loading. However, axial stiffness, a measure of the ability of the structure to withstand external force, was higher under all rates of loading for manikin preparations when compared with the human cadaveric tissues.

Aged↗

Biomechanics of cervical spine facetectomy and fixation techniques.

Facetectomy, either unilateral or bilateral, significantly altered the capacity of cervical spine functional units to withstand increasing compression-flexion loads applied in a constant mode to different specimen configurations. Unilateral facetectomy resulted in an average 31.6 +/- 9.7 percent decrease in strength whereas bilateral disruption caused an average 53.1 +/- 11 percent decrease in strength. Motion analysis in a two-dimensional plane after facetectomy indicated an anterior displacement of the instantaneous axis of rotation (IAR) with a resultant increased load on the vertebral bodies and disc. This anterior shift of the IAR in the horizontal plane was significantly but not completely resolved by wire fixation of the facet joints. These fixation techniques, consisting of either facet to facet or facet to spinous process wiring, demonstrated a similar capability to restore strength to the functional units as well as reducing excessive motion in the vertical and anterior axes induced by the facetectomies.

Aged↗

Microtrauma in the lumbar spine: a cause of low back pain.

Excessive mechanical stress on the intervertebral disc may be one of the causes of low back pain. Most studies testing this thesis, however, have been based on quantification of the mechanical response of functional units at failure. Typically, radiography is used to demonstrate trauma to the vertebral body at the failure load. The description of failure and radiographic demonstration of damage are meaningful in specifying the tolerance limits of the structure. It is important, however, to understand the sequence underlying the initiation of injury, which may occur at subfailure physiological loads. In this study, we identified the initiation of injury to the lumbar spine by subjecting functional units to axial compressive loads using the mechanical response as a basis. Because conventional radiography failed to detect trauma at this level, advanced sectioning techniques were used. The initiation of injury (microtrauma) is defined as the point on the load-deflection curve where the structure exhibits a decreasing level of resistance for the first time before reaching its ultimate load-carrying capacity. The load deflection curve on this basis was classified into the ambient or preload phase, physiological loading phase, traumatic phase, and post-traumatic phase. Structures loaded to the end of the physiological loading phase did not exhibit any yielding or microtrauma. Injury in the form of microfractures of the endplate not detected on radiography, however, was observed under cryomicrotomy for structures loaded into the traumatic loading phase.

Adult↗

Tensile strength of spinal ligaments.

Spinal ligaments from 41 fresh human male cadavers were tested. The ligaments were tested in situ by sectioning all elements except the one under study. The force deflection curves demonstrated a sigmoidal shape, and the point at which an increase in deflection was obtained with decreasing force was taken as failure. The force and deformation at failure are shown for each ligament as a function of spinal level.

Aged↗

Mathematical and finite element analysis of spine injuries.

A critical review of the anatomical, physiological, epidemiological, and biomechanical aspects of spine injuries are presented. These are discussed in light of the mechanical load that produces the trauma. Emphasis is given to the mathematical and finite element modeling aspects of spinal injury that focuses on the tolerance criteria. In the area of spinal mechanics, static and dynamic models are reviewed. Included are the continuum and discrete parameter models of the intact spine and finite element models of its components. A section on the role of constituent law in the assessment of trauma to the spine is given. Finally, a discussion follows on the future research in this domain.

Humans↗

Experimental spinal injuries with vertical impact.

Fifteen fresh, intact, human male cadavers suspended head down were dropped vertically from a height of 0.9-1.5 meters. In eight specimens the heads were restrained to simulate muscle forces. The head-neck complex was oriented for maximal axial loading of the cervical and upper thoracic spine. In several cadavers, load cells were placed in cervical bodies. Head impact forces of 3,000-7,000 N in the unrestrained, and 9,800-14,600 N in the restrained, cadavers were recorded. There were more cervical and upper thoracic fractures in the restrained cadavers than in the nonrestrained subjects. The biomechanic and pathologic findings, including results of cryomicrotomography and computed tomography (CT), are discussed.

Aged↗