title: Simulation of an anterior spine instrumentation in adolescent idiopathic scoliosis using a flexible multi-body model.
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 degrees 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.
authors.affiliation: Department of Mechanical Engineering, Ecole Polytechnique de Montréal, Station Centre-Ville, PO Box 6079, Montreal, QC, Canada H3C 3A7.
authors.forename: Geneviève
authors.initials: G
authors.lastname: Desroches
authors.forename: Carl-Eric
authors.initials: CE
authors.lastname: Aubin
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Sucato
authors.forename: Charles-Hilaire
authors.initials: CH
authors.lastname: Rivard
mesh_terms: D000293:Adolescent; D001696:Biomechanical Phenomena; D002648:Child; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008953:Models, Anatomic; D009984:Orthopedic Fixation Devices; D011859:Radiography; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation* / Q000379:methods; D013904:Thoracic Vertebrae / Q000601:surgery