Development of a Functional Spinal Unit for Evaluation of Sports and Automotive Protective Equipment

Globally, millions of spinal cord injuries (SCIs) and traumatic brain injuries (TBIs) occur annually [WHO, 2013], [Dewan, 2019], most commonly in vehicular crashes, falls and sports [Cripps, 2011], [Singh, 2014]. These injuries lead to paralysis, a decrease in mental health [DeVivo, 1991], [Losoi, 2016], and/or financial hardship [McGregor, 1997], [Lenehan, 2012]. SCIs and TBIs are most likely to occur in men [Singh, 2014], [Nguyen, 2016], [CDC, 2016], at the C4-C5 level [Prasad, 1999]. As SCIs and TBIs have a high occurrence and dire health consequences, it is crucial that they are prevented.

Safety equipment meant to prevent head and neck injuries, such as helmets and seatbelts, are evaluated using anthropometric test devices (ATDs). Unfortunately, there is no ATD neck that is biofidelic for the multiplane loading that occurs in real-world scenarios [Nelson, 2010]. As such, the aim of this research was to take a step towards creating a biofidelic omnidirectional surrogate neck for the evaluation of these safety devices. This first step was to design and construct an anatomically accurate sub-axial functional spinal unit (FSU) that produced a repeatable biofidelic response in quasi-static flexion-extension (FE), axial rotation (AR), lateral bending (LB), and coupled motion.

This research was carried out in three main phases. The first was to design, construct and test synthetic sub-axial cervical segments in AR and FE to obtain a basic understanding of their inherent complex motion. The second was to perform compression and tension testing on potential surrogate intervertebral disc and ligament materials, respectively. This was to identify the structural properties of the components in order to select biofidelic materials, when compared to published cadaveric results, for use in the final FSU. In the final stage, anatomically accurate C4 and C5 vertebrae were constructed from the CT scans of a 31-year-old male. An FSU was built using the previously selected soft tissues and when compared to published cadaveric results, showed acceptable biofidelity in AR, FE, LB and coupled motion. The process of constructing this biofidelic FSU will inform future construction of a full surrogate neck to be used in the testing of head and neck safety equipment.

Year	Entry
2004	Goertzen DJ, Lane C, Oxland TR. Neutral zone and range of motion in the spine are greater with stepwise loading than with a continuous loading protocol: an in vitro porcine investigation. J Biomech. February 2004;37(2):257-261.
2001	Panjabi MM, Miura T, Cripton PA, Wang J-L, Nain AS, DuBois C. Development of a system for in vitro neck muscle force replication in whole cervical spine experiments. Spine. October 15, 2001;26(20):2214-2219.
1987	Adams MA, Dolan P, Hutton WC. Diurnal variations in the stresses on the lumbar spine. Spine. March 1987;12(2):130-137.
2000	Yoganandan N, Pintar F, Stemper BD, Schlick MB, Philippens M, Wisman J. Biomechanics of human occupants in simulated rear crashes: documentation of neck injuries and comparison of injury criteria. Stapp Car Crash J. 2000;44:189-204. SAE 2000-01-SC14.
2000	Bogduk N, Mercer S. Biomechanics of the cervical spine, I: normal kinematics. Clin Biomech (Bristol, Avon). November 2000;15(9):633-648.
2002	Nightingale RW, Winkelstein BA, Knaub KE, Richardson WJ, Luck JF, Myers BS. Comparative strengths and structural properties of the upper and lower cervical spine in flexion and extension. J Biomech. June 2002;35(6):725-732.
2011	Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng. July 2011;133(7):071010.
2007	Nightingale RW, Chancey VC, Ottaviano D, Luck JF, Tran L, Prange M, Myers BS. Flexion and extension structural properties and strengths for male cervical spine segments. J Biomech. 2007;40(3):535-542.
2006	Yaguchi M, Ono K, Kubota M, Matsuoka F. Comparison of biofidelic responses to rear impact of the head/neck/torso among human volunteers, PMHS, and dummies. In: Proceedings of the 2006 International IRCOBI Conference on the Biomechanics of Impact. September 20-22, 2006; Madrid, Spain.183-197.
1996	Antoniou J, Steffen T, Nelson F, Winterbottom N, Hollander AP, Poole RA, Aebi M, Alini M. The human lumbar intervertebral disc: evidence for changes in the biosynthesis and denaturation of the extracellular matrix with growth, maturation, ageing, and degeneration. J Clin Invest. August 15, 1996;98(4):996-1003.
2001	Panjabi MM, Crisco JJ, Vasavada A, Oda T, Cholewicki J, Nibu K, Shin E. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine. December 2001;26(24):2692-2700.
1986	Gilad I, Nissan M. A study of vertebra and disc geometric relations of the human cervical and lumbar spine. Spine. March 1986;11(2):154-157.
1977	Foster JK, Kortge JO, Wolanin MJ. Hybrid III: a biomechanically-based crash test dummy. In: Proceedings of the 21st Stapp Car Crash Conference. October 19-21, 1977; New Orleans, LA. Warrendale, PA: Society of Automotive Engineers:975-1014. SAE 770938.
1986	Pooni JS, Hukins DWL, Harris PF, Hilton RC, Davies KE. Comparison of the structure of human intervertebral discs in the cervical, thoracic and lumbar regions of the spine. Surg Radiol Anat. September 1986;8(3):175-182.
2011	Yoganandan N, Pintar FA, Schlick M, Moore J, Maiman DJ. Comparison of head-neck responses in frontal impacts using restrained human surrogates. In: 55th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 3-5, 2011; Paris, France.181-191.
2001	Yoganandan N, Kumaresan S, Pintar FA. Biomechanics of the cervical spine, II: cervical spine soft tissue responses and biomechanical modeling. Clin Biomech (Bristol, Avon). January 2001;16(1):1-27.
1996	Adams MA, McNally DS, Dolan P. “Stress” distributions inside intervertebral discs: the effects of age and degeneration. J Bone Joint Surg. November 1996;78B(6):965-972.
2010	Gwin JT, Chu JJ, Diamond SG, Halstead PD, Crisco JJ, Greenwald RM. An investigation of the NOCSAE linear impactor test method based on in vivo measures of head impact acceleration in American football. J Biomech Eng. January 2010;132(1):011006.
2006	Wheeldon JA, Pintar FA, Knowles S, Yoganandan N. Experimental flexion/extension data corridors for validation of finite element models of the young, normal cervical spine. J Biomech. 2006;39(2):375-380.
2011	Mattucci S. Strain Rate Dependent Properties of Younger Human Cervical Spine Ligaments [Master's thesis]. University of Waterloo; 2011.
1990	Bahling GS, Bundorf RT, Kaspzyk GS, Moffatt EA, Orlowski KF, Stocke JE. Rollover and drop tests: the influence of roof strength on injury mechanics using belted dummies. In: Proceedings of the 34th Stapp Car Crash Conference. November 4-7, 1990; Orlando, FL. Warrendale, PA: Society of Automotive Engineers:101-112. SAE 902314.
2010	Nelson TS, Cripton PA. A new biofidelic sagittal plane surrogate neck for head-first impacts. Traffic Inj Prev. June 2010;11(3):309-319.
2011	Nelson TS. Towards a Neck Injury Prevention Helmet for Head-First Impacts: A Mechanical Investigation [PhD thesis]. Vancouver, BC: University of British Columbia; December 2011.
1991	Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K. Cervical human vertebrae: quantitative three-dimensional anatomy of the middle and lower regions. Spine. August 1991;16(8):861-869.
2007	Pintar FA, Yoganandan N, Stemper BD, Bostrom O, Rouhana SW, Digges KH, Fildes BN. Comparison of PMHS, WorldSID, and THOR-NT responses in simulated far side impact. Stapp Car Crash J. 2007;51:313-360. SAE 2007-22-0014.
2001	Sekhon LH, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine. December 15, 2001;26(24)(suppl):S2-S12.
2003	Moffatt E, Hare B, Hughes R, Lewis L, Iiyama H, Curzon A, Cooper E. Head excursion of restrained human volunteers and Hybrid III dummies in steady state rollover tests. In: 47th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 22-24, 2003; Lisbon, Portugal.445-465.
1997	Camacho DL, Nightingale RW, Robinette JJ, Vanguri SK, Coates DJ, Myers BS. Experimental flexibility measurements for the development of a computational head-neck model validated for near-vertex head impact. In: Proceedings of the 41st Stapp Car Crash Conference. November 13-14, 1997; Lake Buena Vista, FL. Warrendale, PA: Society of Automotive Engineers:473-486. SAE 973345.
1992	Panjabi MM. The stabilizing system of the spine, II: neutral zone and instability hypothesis. J Spinal Disord. December 1992;5(4):390-396.
2006	Viano DC, Pellman EJ, Withnall C, Shewchenko N. Concussion in professional football: performance of newer helmets in reconstructed game impacts: part 13. Neurosurgery. September 2006;59(3):591-606.
2009	Ejima S, Zama Y, Ono K, Kaneoka K, Shiina I, Asada H. Prediction of pre-impact occupant kinematic behavior based on the muscle activity during frontal collision. In: Proceedings of the 21st International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 15-18, 2009; Stuttgart, Germany.
1975	Panjabi MM, White AA III, Johnson RM. Cervical spine mechanics as a function of transection of components. J Biomech. September 1975;8(5):327-336.
1990	Beebe MS. What is Biosid? In: Proceedings of the SAE International Congress & Exposition. February 26–March 2, 1990; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 900377.

Year

Entry

2004

Goertzen DJ, Lane C, Oxland TR. Neutral zone and range of motion in the spine are greater with stepwise loading than with a continuous loading protocol: an in vitro porcine investigation. J Biomech. February 2004;37(2):257-261.

2001

Panjabi MM, Miura T, Cripton PA, Wang J-L, Nain AS, DuBois C. Development of a system for in vitro neck muscle force replication in whole cervical spine experiments. Spine. October 15, 2001;26(20):2214-2219.

1987

Adams MA, Dolan P, Hutton WC. Diurnal variations in the stresses on the lumbar spine. Spine. March 1987;12(2):130-137.

2000

Yoganandan N, Pintar F, Stemper BD, Schlick MB, Philippens M, Wisman J. Biomechanics of human occupants in simulated rear crashes: documentation of neck injuries and comparison of injury criteria. Stapp Car Crash J. 2000;44:189-204. SAE 2000-01-SC14.

2000

Bogduk N, Mercer S. Biomechanics of the cervical spine, I: normal kinematics. Clin Biomech (Bristol, Avon). November 2000;15(9):633-648.

2002

Nightingale RW, Winkelstein BA, Knaub KE, Richardson WJ, Luck JF, Myers BS. Comparative strengths and structural properties of the upper and lower cervical spine in flexion and extension. J Biomech. June 2002;35(6):725-732.

2011

Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics and mechanotransduction in normal, injury and degenerative conditions. J Biomech Eng. July 2011;133(7):071010.

2007

Nightingale RW, Chancey VC, Ottaviano D, Luck JF, Tran L, Prange M, Myers BS. Flexion and extension structural properties and strengths for male cervical spine segments. J Biomech. 2007;40(3):535-542.

2006

Yaguchi M, Ono K, Kubota M, Matsuoka F. Comparison of biofidelic responses to rear impact of the head/neck/torso among human volunteers, PMHS, and dummies. In: Proceedings of the 2006 International IRCOBI Conference on the Biomechanics of Impact. September 20-22, 2006; Madrid, Spain.183-197.

1996

Antoniou J, Steffen T, Nelson F, Winterbottom N, Hollander AP, Poole RA, Aebi M, Alini M. The human lumbar intervertebral disc: evidence for changes in the biosynthesis and denaturation of the extracellular matrix with growth, maturation, ageing, and degeneration. J Clin Invest. August 15, 1996;98(4):996-1003.

2001

Panjabi MM, Crisco JJ, Vasavada A, Oda T, Cholewicki J, Nibu K, Shin E. Mechanical properties of the human cervical spine as shown by three-dimensional load-displacement curves. Spine. December 2001;26(24):2692-2700.

1986

Gilad I, Nissan M. A study of vertebra and disc geometric relations of the human cervical and lumbar spine. Spine. March 1986;11(2):154-157.

1977

Foster JK, Kortge JO, Wolanin MJ. Hybrid III: a biomechanically-based crash test dummy. In: Proceedings of the 21st Stapp Car Crash Conference. October 19-21, 1977; New Orleans, LA. Warrendale, PA: Society of Automotive Engineers:975-1014. SAE 770938.

1986

Pooni JS, Hukins DWL, Harris PF, Hilton RC, Davies KE. Comparison of the structure of human intervertebral discs in the cervical, thoracic and lumbar regions of the spine. Surg Radiol Anat. September 1986;8(3):175-182.

2011

Yoganandan N, Pintar FA, Schlick M, Moore J, Maiman DJ. Comparison of head-neck responses in frontal impacts using restrained human surrogates. In: 55th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). October 3-5, 2011; Paris, France.181-191.

2001

Yoganandan N, Kumaresan S, Pintar FA. Biomechanics of the cervical spine, II: cervical spine soft tissue responses and biomechanical modeling. Clin Biomech (Bristol, Avon). January 2001;16(1):1-27.

1996

Adams MA, McNally DS, Dolan P. “Stress” distributions inside intervertebral discs: the effects of age and degeneration. J Bone Joint Surg. November 1996;78B(6):965-972.

2010

Gwin JT, Chu JJ, Diamond SG, Halstead PD, Crisco JJ, Greenwald RM. An investigation of the NOCSAE linear impactor test method based on in vivo measures of head impact acceleration in American football. J Biomech Eng. January 2010;132(1):011006.

2006

Wheeldon JA, Pintar FA, Knowles S, Yoganandan N. Experimental flexion/extension data corridors for validation of finite element models of the young, normal cervical spine. J Biomech. 2006;39(2):375-380.

2011

Mattucci S. Strain Rate Dependent Properties of Younger Human Cervical Spine Ligaments [Master's thesis]. University of Waterloo; 2011.

1990

Bahling GS, Bundorf RT, Kaspzyk GS, Moffatt EA, Orlowski KF, Stocke JE. Rollover and drop tests: the influence of roof strength on injury mechanics using belted dummies. In: Proceedings of the 34th Stapp Car Crash Conference. November 4-7, 1990; Orlando, FL. Warrendale, PA: Society of Automotive Engineers:101-112. SAE 902314.

2010

Nelson TS, Cripton PA. A new biofidelic sagittal plane surrogate neck for head-first impacts. Traffic Inj Prev. June 2010;11(3):309-319.

2011

Nelson TS. Towards a Neck Injury Prevention Helmet for Head-First Impacts: A Mechanical Investigation [PhD thesis]. Vancouver, BC: University of British Columbia; December 2011.

1991

Panjabi MM, Duranceau J, Goel V, Oxland T, Takata K. Cervical human vertebrae: quantitative three-dimensional anatomy of the middle and lower regions. Spine. August 1991;16(8):861-869.

2007

Pintar FA, Yoganandan N, Stemper BD, Bostrom O, Rouhana SW, Digges KH, Fildes BN. Comparison of PMHS, WorldSID, and THOR-NT responses in simulated far side impact. Stapp Car Crash J. 2007;51:313-360. SAE 2007-22-0014.

2001

Sekhon LH, Fehlings MG. Epidemiology, demographics, and pathophysiology of acute spinal cord injury. Spine. December 15, 2001;26(24)(suppl):S2-S12.

2003

Moffatt E, Hare B, Hughes R, Lewis L, Iiyama H, Curzon A, Cooper E. Head excursion of restrained human volunteers and Hybrid III dummies in steady state rollover tests. In: 47th Annual Proceedings, Association for the Advancement of Automotive Medicine (AAAM). September 22-24, 2003; Lisbon, Portugal.445-465.

1997

Camacho DL, Nightingale RW, Robinette JJ, Vanguri SK, Coates DJ, Myers BS. Experimental flexibility measurements for the development of a computational head-neck model validated for near-vertex head impact. In: Proceedings of the 41st Stapp Car Crash Conference. November 13-14, 1997; Lake Buena Vista, FL. Warrendale, PA: Society of Automotive Engineers:473-486. SAE 973345.

1992

Panjabi MM. The stabilizing system of the spine, II: neutral zone and instability hypothesis. J Spinal Disord. December 1992;5(4):390-396.

2006

Viano DC, Pellman EJ, Withnall C, Shewchenko N. Concussion in professional football: performance of newer helmets in reconstructed game impacts: part 13. Neurosurgery. September 2006;59(3):591-606.

2009

Ejima S, Zama Y, Ono K, Kaneoka K, Shiina I, Asada H. Prediction of pre-impact occupant kinematic behavior based on the muscle activity during frontal collision. In: Proceedings of the 21st International Technical Conference on the Enhanced Safety of Vehicles (ESV). June 15-18, 2009; Stuttgart, Germany.

1975

Panjabi MM, White AA III, Johnson RM. Cervical spine mechanics as a function of transection of components. J Biomech. September 1975;8(5):327-336.

1990

Beebe MS. What is Biosid? In: Proceedings of the SAE International Congress & Exposition. February 26–March 2, 1990; Detroit, MI. Warrendale, PA: Society of Automotive Engineers. SAE 900377.

Year	Entry
2021	Romani S. The Development of an Upper Cervical Spine Model for Use in an Omnidirectional Surrogate Neck [Master's thesis]. Vancouver, BC: University of British Columbia; July 2021.

Year

Entry

2021

Romani S. The Development of an Upper Cervical Spine Model for Use in an Omnidirectional Surrogate Neck [Master's thesis]. Vancouver, BC: University of British Columbia; July 2021.