title: Geometry strongly influences the response of numerical models of the lumbar spine--a probabilistic finite element analysis.
abstract: Typical FE models of the human lumbar spine consider a single, fixed geometry. Such models cannot account for potential effects of the natural variability of the spine's geometry. In this study, we performed a probabilistic uncertainty and sensitivity analysis of a fully parameterized, geometrically simplified model of the L3-L4 segment. We examined the impact of the uncertainty in all 40 geometry parameters, estimated lower and upper bounds for the required sample size and determined the most important geometry parameters. The natural variability of the spine's geometry indeed strongly affects intradiscal pressure, range of motion and facet joint contact forces. Deriving generalized statements from fixed-geometry models as well as transferring those results to different cases thus can easily lead to wrong conclusions and should only be performed with extreme caution. We recommend a sample size of ≈ 100 to obtain reasonable accurate point estimates and a sufficient overview of the remaining uncertainties. Yet, only few parameters, especially those determining the disc geometry (disc height, end-plate width and depth) and the facets' position (intra-articular space, pedicle length, facet angles), proved to be truly important. Accurate measurement and modeling of those structures should therefore be prioritized.
authors.affiliation: Institute of Orthopaedic Research and Biomechanics, University of Ulm, Helmholtzstrasse 14, 89081 Ulm, Germany. frank.niemeyer@uni-ulm.de
authors.forename: Frank
authors.initials: F
authors.lastname: Niemeyer
authors.forename: Hans-Joachim
authors.initials: HJ
authors.lastname: Wilke
authors.forename: Hendrik
authors.initials: H
authors.lastname: Schmidt
mesh_terms: D003198:Computer Simulation; D055119:Elastic Modulus / Q000502:physiology; D020342:Finite Element Analysis; D006801:Humans; D007403:Intervertebral Disc / Q000502:physiology*; D008159:Lumbar Vertebrae / Q000502:physiology*; D008954:Models, Biological; D015233:Models, Statistical; D011312:Pressure; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016474:Weight-Bearing / Q000502:physiology*; D021801:Zygapophyseal Joint / Q000502:physiology*