Prediction of Load-Sharing Mechanisms and Patterns of Human Cervical Spine Injuries Due to High-Velocity Impact Using Finite Element Method

The purpose of the current study was to investigate the loading rate dependency, loadsharing and injury mechanisms of the C2-C3 cervical spine unit. A ligamentous biorealistic finite element model was constructed considering comprehensive geometrical representation at tissue level components and material laws that include strain rate effect, bone fracture and ligament failure. The model has been validated for both quasi-static and dynamic loading scenarios. The study demonstrated four important findings: 1) Cervical segment response is rate dependent as it showed distinctive responses under different rates of loading; 2) Ligaments are the primary load-bearing structure for in plane and out of plane loading; 3) Depending on the loading rate and direction, capsular ligaments, articular facets represent vulnerable sites and they possess risk of failure under impact complex loading. 4) This model provides detailed biofidelic kinematic and local tissue response up to failure, leading to injury prediction in major and/minor injury conditions.

Year	Entry
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.
1990	Yoganandan N, Sances A Jr, Pintar F, Maiman DJ, Reinartz J, Cusick JF, Larson SJ. Injury biomechanics of the human cervical column. Spine. October 1990;15(10):1031-1039.
2002	van der Horst MJ. Human Head Neck Response in Frontal, Lateral and Rear End Impact Loading: Modelling and Validation [PhD thesis]. Eindhoven, The Netherlans: Technische Universiteit Eindhoven; 2002.
1997	Maurel N, Lavaste F, Skalli W. A three-dimensional parameterized finite element model of the lower cervical spine, study of the influence of the posterior articular facets. J Biomech. September 1997;30(9):921-931.
2000	Bogduk N, Mercer S. Biomechanics of the cervical spine, I: normal kinematics. Clin Biomech (Bristol, Avon). November 2000;15(9):633-648.
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.
1988	Yang KH, Kish VL. Compressibility measurement of human intervertebral nucleus pulposus. J Biomech. 1988;21(10):865.
2012	Barker J, Chandrashekar N, Cronin D. High rate behaviour of the cervical spine segments. In: Proceedings of the 8th Ohio State University Injury Biomechanics Symposium. May 13-15, 2012; Columbus, OH.
2012	DeWit JA, Cronin DS. Cervical spine segment finite element model for traumatic injury prediction. J Mech Behav Biomed Mater. June 2012;10:138-150.
2012	Mattucci SFE, Moulton JA, Chandrashekar N, Cronin DS. Strain rate dependent properties of younger human cervical spine ligaments. J Mech Behav Biomed Mater. June 2012;10:216-226.
1998	Kopperdahl DL, Keaveny TM. Yield strain behavior of trabecular bone. J Biomech. July 1998;31(7):601-608.
2006	Panzer MB. Numerical Modelling of the Human Cervical Spine in Frontal Impact [Master's thesis]. University of Waterloo; 2006.
2000	Halldin PH, Brolin K, Kleiven S, von Holst H, Jakobsson L, Palmertz C. Investigation of conditions that affect neck compression-flexion injuries using numerical techniques. Stapp Car Crash J. 2000;44:127-138. SAE 2000-01-SC10.
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.
1989	Yoganandan N, Pintar F, Butler J, Reinartz J, Sances A Jr, Larson SJ. Dynamic response of human cervical spine ligaments. Spine. October 1989;14(10):1102-1110.
1986	Panjabi MM, Summers DJ, Pelker RR, Videman T, Friedlaender GE, Southwick WO. Three-dimensional load-displacement curves due to forces on the cervical spine. J Orthop Res. 1986;4(2):152-161.
1993	Fung YC. Biomechanics: Mechanical Properties of Living Tissues. 2nd ed. New York, NY: Springer-Verlag; 1993.
1982	Panjabi MM, Goel VK, Takata K. Physiologic strains in the lumbar spinal ligaments: an in vitro biomechanical study. Spine. May 1982;7(3):192-203.
1996	de Jager MKJ. Mathematical Head-Neck Models for Acceleration Impacts [PhD thesis]. Eindhoven, The Netherlands: Eindhoven University of Technology; 1996.
2011	Jaumard NV, Bauman JA, Weisshaar CL, Guarino BB, Welch WC, Winkelstein BA. Contact pressure in the facet joint during sagittal bending of the cadaveric cervical spine. J Biomech Eng. July 2011;133(7):071004.
2001	Teo EC, Ng HW. Evaluation of the role of ligaments, facets and disc nucleus in lower cervical spine under compression and sagittal moments using finite element method. Med Eng Phys. April 2001;23(3):155-164.
2009	Dibb AT, Nightingale RW, Luck JF, Chancey VC, Fronheiser LE, Myers BS. Tension and combined tension-extension structural response and tolerance properties of the human male ligamentous cervical spine. J Biomech Eng. August 2009;131(8):081008.
2009	Panzer MB, Cronin DS. C4–C5 segment finite element model development, validation, and load-sharing investigation. J Biomech. March 11, 2009;42(4):480-490.
1991	Yoganandan N, Pintar FA, Sances A Jr, Reinartz J, Larson SJ. Strength and kinematic response of dynamic cervical spine injuries. Spine. 1991;16(suppl 10):S511-S517.
1999	Kumaresan S, Yoganandan N, Pintar FA. Finite element analysis of the cervical spine: a material property sensitivity study. Clin Biomech (Bristol, Avon). January 1999;12(1):41-53.
1998	Kumaresan S, Yoganandan N, Pintar FA. Finite element modeling approaches of human cervical spine facet joint capsule. J Biomech. April 1998;31(4):371-376.
1993	Crowell RR, Shea M, Edwards WT, Clothiaux PL, White AA III, Hayes WC. Cervical injuries under flexion and compression loading. J Spinal Disord. April 1993;6(2):175-181.
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.
1986	Shirazi-Adl A, Ahmed AM, Shrivastava SC. Mechanical response of a lumbar motion segment in axial torque alone and combined with compression. Spine. November 1986;11(9):914-927.
1988	McElhaney JH, Doherty BJ, Paver JG, Myers BS, Gray L. Combined bending and axial loading responses of the human cervical spine. In: Proceedings of the 32nd Stapp Car Crash Conference. October 17-19, 1988; Atlanta, GA. Warrendale, PA: Society of Automotive Engineers:21-28. SAE 881709.
2011	Fice JB, Cronin DS, Panzer MB. Cervical spine model to predict capsular ligament response in rear impact. Ann Biomed Eng. August 2011;39(8):2152-2162.
1974	Reilly DT, Burstein AH, Frankel VH. The elastic modulus for bone. J Biomech. May 1974;7(3):271-275.
2004	Meyer F, Bourdet N, Deck C, Willinger R, Raul JS. Human neck finite element model development and validation against original experimental data. Stapp Car Crash J. 2004;48:177-206. SAE 2004-22-0008.
1998	Goel VK, Clausen JD. Prediction of load sharing among spinal components of a C5-C6 motion segment using the finite element approach. Spine. March 15, 1998;23(6):684-691.
2002	Cusick JF, Yoganandan N. Biomechanics of the cervical spine, IV: major injuries. Clin Biomech (Bristol, Avon). January 2002;17(1):1-20.
1999	Kumaresan S, Yoganandan N, Pintar FA, Maiman DJ. Finite element modeling of the cervical spine: role of intervertebral disc under axial and eccentric loads. Med Eng Phys. December 1999;21(10):689-700.
2002	Robertson A, Branfoot T, Barlow IF, Giannoudis PV. Spinal injury patterns resulting from car and motorcycle accidents. Spine. December 15, 2002;27(24):2825-2830.
1997	Kumaresan S, Yoganandan N, Pintar FA, Voo LM, Cusick JF, Larson SJ. Finite element modeling of cervical laminectomy with graded facetectomy. J Spinal Disord. February 1997;10(1):40-46.

Year

Entry

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.

1990

Yoganandan N, Sances A Jr, Pintar F, Maiman DJ, Reinartz J, Cusick JF, Larson SJ. Injury biomechanics of the human cervical column. Spine. October 1990;15(10):1031-1039.

2002

van der Horst MJ. Human Head Neck Response in Frontal, Lateral and Rear End Impact Loading: Modelling and Validation [PhD thesis]. Eindhoven, The Netherlans: Technische Universiteit Eindhoven; 2002.

1997

Maurel N, Lavaste F, Skalli W. A three-dimensional parameterized finite element model of the lower cervical spine, study of the influence of the posterior articular facets. J Biomech. September 1997;30(9):921-931.

2000

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

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.

1988

Yang KH, Kish VL. Compressibility measurement of human intervertebral nucleus pulposus. J Biomech. 1988;21(10):865.

2012

Barker J, Chandrashekar N, Cronin D. High rate behaviour of the cervical spine segments. In: Proceedings of the 8th Ohio State University Injury Biomechanics Symposium. May 13-15, 2012; Columbus, OH.

2012

DeWit JA, Cronin DS. Cervical spine segment finite element model for traumatic injury prediction. J Mech Behav Biomed Mater. June 2012;10:138-150.

2012

Mattucci SFE, Moulton JA, Chandrashekar N, Cronin DS. Strain rate dependent properties of younger human cervical spine ligaments. J Mech Behav Biomed Mater. June 2012;10:216-226.

1998

Kopperdahl DL, Keaveny TM. Yield strain behavior of trabecular bone. J Biomech. July 1998;31(7):601-608.

2006

Panzer MB. Numerical Modelling of the Human Cervical Spine in Frontal Impact [Master's thesis]. University of Waterloo; 2006.

2000

Halldin PH, Brolin K, Kleiven S, von Holst H, Jakobsson L, Palmertz C. Investigation of conditions that affect neck compression-flexion injuries using numerical techniques. Stapp Car Crash J. 2000;44:127-138. SAE 2000-01-SC10.

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.

1989

Yoganandan N, Pintar F, Butler J, Reinartz J, Sances A Jr, Larson SJ. Dynamic response of human cervical spine ligaments. Spine. October 1989;14(10):1102-1110.

1986

Panjabi MM, Summers DJ, Pelker RR, Videman T, Friedlaender GE, Southwick WO. Three-dimensional load-displacement curves due to forces on the cervical spine. J Orthop Res. 1986;4(2):152-161.

1993

Fung YC. Biomechanics: Mechanical Properties of Living Tissues. 2nd ed. New York, NY: Springer-Verlag; 1993.

1982

Panjabi MM, Goel VK, Takata K. Physiologic strains in the lumbar spinal ligaments: an in vitro biomechanical study. Spine. May 1982;7(3):192-203.

1996

de Jager MKJ. Mathematical Head-Neck Models for Acceleration Impacts [PhD thesis]. Eindhoven, The Netherlands: Eindhoven University of Technology; 1996.

2011

Jaumard NV, Bauman JA, Weisshaar CL, Guarino BB, Welch WC, Winkelstein BA. Contact pressure in the facet joint during sagittal bending of the cadaveric cervical spine. J Biomech Eng. July 2011;133(7):071004.

2001

Teo EC, Ng HW. Evaluation of the role of ligaments, facets and disc nucleus in lower cervical spine under compression and sagittal moments using finite element method. Med Eng Phys. April 2001;23(3):155-164.

2009

Dibb AT, Nightingale RW, Luck JF, Chancey VC, Fronheiser LE, Myers BS. Tension and combined tension-extension structural response and tolerance properties of the human male ligamentous cervical spine. J Biomech Eng. August 2009;131(8):081008.

2009

Panzer MB, Cronin DS. C4–C5 segment finite element model development, validation, and load-sharing investigation. J Biomech. March 11, 2009;42(4):480-490.

1991

Yoganandan N, Pintar FA, Sances A Jr, Reinartz J, Larson SJ. Strength and kinematic response of dynamic cervical spine injuries. Spine. 1991;16(suppl 10):S511-S517.

1999

Kumaresan S, Yoganandan N, Pintar FA. Finite element analysis of the cervical spine: a material property sensitivity study. Clin Biomech (Bristol, Avon). January 1999;12(1):41-53.

1998

Kumaresan S, Yoganandan N, Pintar FA. Finite element modeling approaches of human cervical spine facet joint capsule. J Biomech. April 1998;31(4):371-376.

1993

Crowell RR, Shea M, Edwards WT, Clothiaux PL, White AA III, Hayes WC. Cervical injuries under flexion and compression loading. J Spinal Disord. April 1993;6(2):175-181.

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.

1986

Shirazi-Adl A, Ahmed AM, Shrivastava SC. Mechanical response of a lumbar motion segment in axial torque alone and combined with compression. Spine. November 1986;11(9):914-927.

1988

McElhaney JH, Doherty BJ, Paver JG, Myers BS, Gray L. Combined bending and axial loading responses of the human cervical spine. In: Proceedings of the 32nd Stapp Car Crash Conference. October 17-19, 1988; Atlanta, GA. Warrendale, PA: Society of Automotive Engineers:21-28. SAE 881709.

2011

Fice JB, Cronin DS, Panzer MB. Cervical spine model to predict capsular ligament response in rear impact. Ann Biomed Eng. August 2011;39(8):2152-2162.

1974

Reilly DT, Burstein AH, Frankel VH. The elastic modulus for bone. J Biomech. May 1974;7(3):271-275.

2004

Meyer F, Bourdet N, Deck C, Willinger R, Raul JS. Human neck finite element model development and validation against original experimental data. Stapp Car Crash J. 2004;48:177-206. SAE 2004-22-0008.

1998

Goel VK, Clausen JD. Prediction of load sharing among spinal components of a C5-C6 motion segment using the finite element approach. Spine. March 15, 1998;23(6):684-691.

2002

Cusick JF, Yoganandan N. Biomechanics of the cervical spine, IV: major injuries. Clin Biomech (Bristol, Avon). January 2002;17(1):1-20.

1999

Kumaresan S, Yoganandan N, Pintar FA, Maiman DJ. Finite element modeling of the cervical spine: role of intervertebral disc under axial and eccentric loads. Med Eng Phys. December 1999;21(10):689-700.

2002

Robertson A, Branfoot T, Barlow IF, Giannoudis PV. Spinal injury patterns resulting from car and motorcycle accidents. Spine. December 15, 2002;27(24):2825-2830.

1997

Kumaresan S, Yoganandan N, Pintar FA, Voo LM, Cusick JF, Larson SJ. Finite element modeling of cervical laminectomy with graded facetectomy. J Spinal Disord. February 1997;10(1):40-46.

Year	Entry
2019	Mustafy T. The Short and Long Term Effects of in Vivo Cyclic Axial Compression Applied During Puberty on Bone Growth, Morphometry and Biomechanics [PhD thesis]. École polytechnique de Montréal; July 2019.

Year

Entry

2019

Mustafy T. The Short and Long Term Effects of in Vivo Cyclic Axial Compression Applied During Puberty on Bone Growth, Morphometry and Biomechanics [PhD thesis]. École polytechnique de Montréal; July 2019.