title: Cervical Spine Injuries: A Whole-Body Musculoskeletal Model for the Analysis of Spinal Loading.
abstract: Cervical spine trauma from sport or traffic collisions can have devastating consequences for individuals and a high societal cost. The precise mechanisms of such injuries are still unknown as investigation is hampered by the difficulty in experimentally replicating the conditions under which these injuries occur. We harness the benefits of computer simulation to report on the creation and validation of i) a generic musculoskeletal model (MASI) for the analyses of cervical spine loading in healthy subjects, and ii) a population-specific version of the model (Rugby Model), for investigating cervical spine injury mechanisms during rugby activities. The musculoskeletal models were created in OpenSim, and validated against in vivo data of a healthy subject and a rugby player performing neck and upper limb movements. The novel aspects of the Rugby Model comprise i) population-specific inertial properties and muscle parameters representing rugby forward players, and ii) a custom scapula-clavicular joint that allows the application of multiple external loads. We confirm the utility of the developed generic and population-specific models via verification steps and validation of kinematics, joint moments and neuromuscular activations during rugby scrummaging and neck functional movements, which achieve results comparable with in vivo and in vitro data. The Rugby Model was validated and used for the first time to provide insight into anatomical loading and cervical spine injury mechanisms related to rugby, whilst the MASI introduces a new computational tool to allow investigation of spinal injuries arising from other sporting activities, transport, and ergonomic applications. The models used in this study are freely available at simtk.org and allow to integrate in silico analyses with experimental approaches in injury prevention.
authors.affiliation: Department for Health, University of Bath, Bath, United Kingdom.
authors.forename: Dario
authors.identifier: http://orcid.org/0000-0001-7877-6755
authors.initials: D
authors.lastname: Cazzola
authors.affiliation: Centre for Orthopaedic Biomechanics, Department of Mechanical Engineering, University of Bath, Bath, United Kingdom.|College of Engineering, Mathematics & Physical Sciences, University of Exeter, Exeter, United Kingdom.
authors.forename: Timothy P
authors.initials: TP
authors.lastname: Holsgrove
authors.affiliation: Department for Health, University of Bath, Bath, United Kingdom.
authors.forename: Ezio
authors.initials: E
authors.lastname: Preatoni
authors.affiliation: Centre for Orthopaedic Biomechanics, Department of Mechanical Engineering, University of Bath, Bath, United Kingdom.
authors.forename: Harinderjit S
authors.initials: HS
authors.lastname: Gill
authors.affiliation: Department for Health, University of Bath, Bath, United Kingdom.
authors.forename: Grant
authors.initials: G
authors.lastname: Trewartha
mesh_terms: D001696:Biomechanical Phenomena; D002574:Cervical Vertebrae / Q000293:injuries* / Q000503:physiopathology*; D003198:Computer Simulation; D005538:Football / Q000293:injuries; D006801:Humans; D007596:Joints / Q000503:physiopathology; D008954:Models, Biological; D009141:Musculoskeletal System / Q000503:physiopathology*; D015203:Reproducibility of Results; D013124:Spinal Injuries / Q000503:physiopathology*; D016474:Weight-Bearing; D055815:Young Adult