title: Towards determining soft tissue properties for modelling spine surgery: current progress and challenges.
abstract: Current complication rates for adolescent scoliosis surgery necessitate the development of better surgical planning tools to improve outcomes. Here we present our approach to developing finite element models of the thoracolumbar spine for deformity surgery simulation, with patient-specific model anatomy based on low-dose pre-operative computed tomography scans. In a first step towards defining patient-specific tissue properties, an initial 'benchmark' set of properties were used to simulate a clinically performed pre-operative spinal flexibility assessment, the fulcrum bending radiograph. Clinical data for ten patients were compared with the simulated results for this assessment and in cases where these data differed by more than 10%, soft tissue properties for the costo-vertebral joint (CVJt) were altered to achieve better agreement. Results from these analyses showed that changing the CVJt stiffness resulted in acceptable agreement between clinical and simulated flexibility in two of the six cases. In light of these results and those of our previous studies in this area, it is suggested that spinal flexibility in the fulcrum bending test is not governed by any single soft tissue structure acting in isolation. More detailed biomechanical characterisation of the fulcrum bending test is required to provide better data for determination of patient-specific soft tissue properties.
authors.affiliation: Paediatric Spine Research Group, Queensland University of Technology, GPO Box 2434, Brisbane, QLD 4001, Australia. j2.little@qut.edu.au
authors.forename: J Paige
authors.initials: JP
authors.lastname: Little
authors.forename: Clayton
authors.initials: C
authors.lastname: Adam
mesh_terms: D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D020342:Finite Element Analysis; D006801:Humans; D007403:Intervertebral Disc / Q000503:physiopathology; D008023:Ligaments, Articular / Q000503:physiopathology; D008297:Male; D008954:Models, Biological; D057234:Preoperative Period; D016059:Range of Motion, Articular / Q000502:physiology; D012600:Scoliosis / Q000000981:diagnostic imaging / Q000601:surgery*; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D055815:Young Adult