title: Validation and use of a finite element model of C-2 for determination of stress and fracture patterns of anterior odontoid loads.
abstract: OBJECTIVE
  The finite element (FE) method is a powerful tool for the analysis of stress patterns of anatomical structures. In this study a highly refined FE model of C-2 was created and validated. The model was then used to characterize stress patterns, predicted fracture patterns, and transitions between Type II and Type III odontoid fractures.
  
  
  METHODS
  An anatomically accurate three-dimensional model of C-2 was created from computerized tomography data obtained from the Visible Human Project. The C-2 model was broken down into an FE mesh consisting of 32,815 elements and 40,969 nodes. For validation, the FE model was constrained and loaded to simulate that used in previous biomechanical studies. The validated model was then loaded in an iterative fashion, varying the orientation of the load within the validated range. A matrix of stress plots was created for comparative analysis. Results of the validation testing closely correlated with those obtained in previous biomechanical testing. Pure extension loading produced a Type III stress pattern with maximum stress of 134 MPa. Loading at 45 degrees produced a Type II stress distribution with a maximum stress of 123 MPa. These stresses are within 3% and 11%, respectively, of the reported yield stress of cortical bone (138 MPa). In the second portion of the study, systematic variation in the orientation of the load vector revealed that higher stresses were associated with increased lateral angulation and increasing upward inclination of the load vectors. A transition from a Type III to Type II pattern occurred with lateral orientations greater than 15 degrees and with compressive loads of 45 degrees.
  
  
  CONCLUSIONS
  The validated C-2 FE model described in this study both qualitatively and quantitatively was able to simulate the behavior of the C-2 vertebra in biomechanical testing. In this study the authors demonstrate the utility of the FE method when used in conjunction with traditional biomechanical testing.
authors.affiliation: Division of Neurosurgery, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298, USA. sgraham@nsc1.nsc.vcu.edu
authors.forename: R S
authors.initials: RS
authors.lastname: Graham
authors.forename: E K
authors.initials: EK
authors.lastname: Oberlander
authors.forename: J E
authors.initials: JE
authors.lastname: Stewart
authors.forename: D J
authors.initials: DJ
authors.lastname: Griffiths
mesh_terms: D000465:Algorithms; D019412:Anatomy, Cross-Sectional; D001368:Axis, Cervical Vertebra / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology; D019245:Compressive Strength; D003198:Computer Simulation; D020342:Finite Element Analysis; D005544:Forecasting; D006801:Humans; D008954:Models, Biological; D009809:Odontoid Process / Q000293:injuries* / Q000473:pathology / Q000503:physiopathology; D015203:Reproducibility of Results; D016103:Spinal Fractures / Q000145:classification / Q000473:pathology / Q000503:physiopathology*; D013314:Stress, Mechanical; D014057:Tomography, X-Ray Computed