Annals of Biomedical Engineering最新文献

{"title":"The Impact of Venovenous Extracorporeal Membrane Oxygenation Cannulation Configuration on Hemodynamic Characteristics and Risks of Hemolysis.","authors":"Yifeng Xi, Yuan Li, Hongyu Wang, Xiaofei Wang, Jianchao Li, Bingyang Ji, Zengsheng Chen","doi":"10.1007/s10439-025-03862-4","DOIUrl":"https://doi.org/10.1007/s10439-025-03862-4","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the impact of veno-venous extracorporeal membrane oxygenation (VV-ECMO) cannula configuration and ECMO blood flow on intravascular hemodynamic environment, oxygen saturation, hemolysis, and thrombotic risk under varying perfusion conditions.</p><p><strong>Methods: </strong>Four different VV-ECMO cannulation configurations (femoro-jugular double cannulation, femoro-femoral double cannulation, dual-lumen single bicaval cannulation, and dual-lumen single bicaval cannulation blocking the atrial connecting vessel) commonly used in clinical practice were modeled and analyzed under different ECMO flow support conditions using computational fluid dynamics method. Oxygen saturation and flow rate at the ECMO outlet were used to determine the recirculation fraction (RF). The red blood cell damage model was used to explore the hemolysis risk. A thrombosis model considering platelet activation and deposition was proposed to quantify platelet activation and thrombosis risk.</p><p><strong>Results: </strong>Different cannula configurations and ECMO flowrates significantly affect the RF, proximal wall vascular injury, and hemolysis risk in VV-ECMO. At low ECMO flow rates (≤3 L/min), all cannula configurations exhibit reduced recirculation and blood injury, while oxygen saturation at the pulmonary artery outlet is lower. Higher ECMO flows increase recirculation and shear stress while enhancing oxygen delivery. The use of the dual-lumen cannula instead of two-cannula configuration can simultaneously minimize recirculation and blood vascular injury while achieving higher oxygen saturation in the pulmonary artery under the same ECMO flow rate condition. The effect of drainage cannula side-hole blockage on the surrounding hemodynamic environment differs significantly across cannulation configurations. Side-hole blockage of the drainage cannula had the greatest impact on femoro-jugular double cannulations, with less hemodynamic impact on other cannula configurations, especially in double-lumen cannulation. In femoro-jugular double cannulas, side-hole blockage leads to increased RF and decreased pulmonary oxygen saturation, resulting in reduced effective oxygen supply from ECMO, while it also reduces vessel wall shear stress and hemolysis risk.</p><p><strong>Conclusion: </strong>For VV-ECMO, the dual-lumen cannula configuration maintains lower recirculation and blood damage while ensuring adequate oxygen supply, outperforming two-cannula configurations. Among the two-cannula configurations, femoro-femoral cannulation yields the lowest recirculation but the highest shear-related injury. Pulmonary artery oxygen content is a more reliable indicator of VV-ECMO oxygenation capacity than RF. Notably, there exists a high risk of thrombosis in proximity to the drainage cannula, and the blockage of the drainage cannula increases the ECMO RF and decreases the oxygenation efficiency. These findings provide guidance for selecting and de","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Process Modeling of Workflow and Performance in Image-Guided Bronchoscopy.","authors":"Tatiana A Rypinski, Roberto F Casal, Parvathy S Pillai, Anshuj Deva, Bhavin Soni, Owais Sarwar, Aaron C Milhorn, Aaron K Jones, Gouthami Chintalapani, Gerhard Kleinszig, David E Ost, Horiana B Grosu, Jeffrey H Siewerdsen","doi":"10.1007/s10439-025-03861-5","DOIUrl":"https://doi.org/10.1007/s10439-025-03861-5","url":null,"abstract":"<p><strong>Purpose: </strong>Emerging technologies to improve transbronchial sampling of lung lesions include mobile C-arm cone-beam CT (CBCT) and robotic assistance. Surgical Process Modeling (SPM) was used to quantify performance in such procedures performed using a conventional bronchoscope with guidance via 2D fluoroscopy and radial probe endobronchial ultrasound (RP-EBUS) (\"Conventional Bronchoscopy\") compared to robot-assisted bronchoscopy with CBCT guidance (\"CBCT-Guided RAB\").</p><p><strong>Method: </strong>Statistical SPMs were implemented for Conventional Bronchoscopy and CBCT-Guided RAB for simulation and analysis of procedural outcomes, including cycle time, radiation dose, and geometric accuracy. The SPMs were parameterized and validated with respect to clinical observation, published literature, and expert input. 9000 simulation runs were computed for each method, analyzing differences in performance and evaluating the influence of body mass index (BMI), lesion location (upper, middle, or lower lobe), and lesion size.</p><p><strong>Results: </strong>The SPMs exhibited reasonable agreement with retrospective clinical evaluation of cycle time and dose, and variations in geometric accuracy were consistent with clinical literature. CBCT-Guided RAB resulted in a 14% increase in median cycle time (45.3 min) compared to Conventional Bronchoscopy (39.6 min) and increased median dose to the patient by 3.2 × (41.6 Gy cm² compared to 12.9 Gy cm²). Geometric targeting improved with CBCT-Guided RAB, reducing the rate of geometric miss from 22% under Conventional Bronchoscopy to 2%. 3D visualization of individual runs gave clear depiction of median and outlier performance and a basis for communicating and standardizing complex workflows.</p><p><strong>Conclusions: </strong>SPMs yielded quantitative performance comparison in lung lesion biopsy by conventional and robot-assisted bronchoscopy. The approach quantified increases in cycle time and dose for CBCT-Guided RAB, accompanied by substantial gains in geometric accuracy. Such modeling provided valuable insight on the benefits of emerging technologies at early stages of implementation and a means to optimize and standardize clinical workflow.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ex Vivo Quantification of Calcification Stiffness in Aortic Stenosis: Biomechanical Data from Resected Human Valves.","authors":"Takashi Shirakawa, Kazuo Shimamura, Koichi Maeda, Shin Yajima, Ai Kawamura, Takuji Kawamura, Daisuke Yoshioka, Shigeru Miyagawa","doi":"10.1007/s10439-025-03869-x","DOIUrl":"https://doi.org/10.1007/s10439-025-03869-x","url":null,"abstract":"<p><strong>Purpose: </strong>Aortic stenosis (AS) is characterized by progressive calcification of the aortic valve. While imaging can assess the extent and localization of calcification, intraoperative findings suggest substantial variability in mechanical stiffness. Quantitative biomechanical evaluation is needed to inform optimized treatment strategies. We aimed to quantify the mechanical stiffness of calcified nodules in human AS.</p><p><strong>Methods: </strong>We performed ex vivo compression testing on 129 calcified nodules resected from 46 patients undergoing surgical aortic valve replacement for severe AS. Stress-strain relationships were measured to characterize the mechanical behavior of the nodules, and two stiffness parameters-compression strength (CS) and compression energy (CE)-were defined. These parameters were compared with the computed tomography (CT) density of the region from which each nodule was resected.</p><p><strong>Results: </strong>Calcified nodules exhibited wide variation in reactive stress, with maximum values in low strain regions ranging from 60 to 100-fold higher than the minimum. The stress-strain curves demonstrated three-phase pattern consisting of an initial increase, plateau phase, and steep rise in stress. The median CS increased from 0.38 MPa at 10% strain to 1.73 MPa at 50% strain, and median CE from 0.020 to 0.43 J/cm³ across the same range. The Pearson's correlation coefficients between CT density and these parameters ranged from 0.291 to 0.454.</p><p><strong>Conclusion: </strong>Some nodules demonstrated marked reactive stress even at low strain levels, indicating strong resistance to compression with minimal deformation. This study provides reference data on the biomechanical stiffness of calcification in human AS.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urological benchtop and in silico models validated by human penile tissue inflation tests.","authors":"Majid Akbarzadeh Khorshidi, Shirsha Bose, Brian Watschke, Evania Mareena, Thomas Sinnott, Caitríona Lally","doi":"10.1007/s10439-025-03852-6","DOIUrl":"https://doi.org/10.1007/s10439-025-03852-6","url":null,"abstract":"<p><strong>Purpose: </strong>Inflatable penile prosthesis (IPP) implantation is a well-established treatment for erectile dysfunction. A comprehensive understanding of the mechanical interactions between the IPP and penile tissues is crucial for improving surgical outcomes and device performance. This study aims to develop and validate preclinical testbeds, including a polymer-based benchtop model and a finite element (FE) model, to replicate the biomechanical behaviour of penile tissues during IPP inflation.</p><p><strong>Methods: </strong>A polymer-based benchtop model was developed using porous and non-porous polyvinyl alcohol (PVA) hydrogels, with the porous PVA mimicking the spongy corpus cavernosum (CC) and the non-porous PVA representing the tunica albuginea and fascial layers. IPP inflation tests were conducted on three benchtop models and three human penile tissue segments. Additionally, 3D FE simulations of IPP inflation were performed on both the benchtop and human tissue models for comparative analysis.</p><p><strong>Results: </strong>The experimental results demonstrated strong agreement between the human penile tissues, the benchtop model, and the FE simulations, validating the preclinical testbeds. Parametric studies using the FE model revealed that CC layer size and stiffness significantly influence IPP inflation mechanics, highlighting the importance of these factors in device performance. These validated preclinical testbeds provide a robust platform for optimising IPP design, guiding surgical procedures, and mitigating associated post-implantation complications.</p><p><strong>Conclusion: </strong>The developed benchtop and FE models effectively replicate human penile tissue responses to IPP inflation and can serve as valuable preclinical tools for device manufacturers and clinicians. Their use may enhance surgical decision-making and improve long-term IPP outcomes.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statistical Shape and Fibre Orientation Model for Muscle Architecture Characterisation of the Medial Gastrocnemius.","authors":"Salim Bin Ghouth, Thor Besier, Geoffrey Handsfield","doi":"10.1007/s10439-025-03866-0","DOIUrl":"https://doi.org/10.1007/s10439-025-03866-0","url":null,"abstract":"<p><strong>Purpose: </strong>Cerebral palsy (CP) is a heterogeneous, neurodevelopmental disorder arising from a static brain lesion and leading to progressive muscle degeneration. Quantitative understanding of 3D muscle morphology and fibre architecture effects of CP are lacking. Here, we present a novel imaging and computational method to investigate morphology and 3D fibre orientations of skeletal muscles in adolescents with CP.</p><p><strong>Methods: </strong>Principal component analysis was performed on data derived from conventional MRI and diffusion tensor MRI; principal components (PCs) described dominant variations in each cohort. We applied this method to the medial gastrocnemius muscles of seven young people with CP and eight typically developing controls to quantitatively assess deviations in muscle structure associated with CP.</p><p><strong>Results: </strong>Morphology and architecture models in each cohort had similar variance of dominant features, with size being the predominant mode of variation in both cohorts. The first three PCs accounted for a cumulative variance of CP and TD cohort of 96 and 97%, and 95 and 97% for shape models and shape and fibre orientation models, respectively. Size differences were greatest in the proximal and distal regions, rather than middle, of the muscle. Models revealed localised variation in 3D fibre orientations between the two cohorts in medial-distal region of the muscle. Local variations were observed in the medial- distal regions of the mean muscle of about 10° in the TD model compared to the CP model. PCs of architecture models indicated that greater localised angular differences in the 3D fibre orientations were associated with larger-than-average muscles.</p><p><strong>Conclusion: </strong>This work offers insights into both muscle morphology and architecture of the medial gastrocnemius in individuals with CP, including variations of overall size and localised muscle fibre orientations. The quantitative descriptions of muscle architecture we present here may contribute to greater understanding of muscle function and dysfunction and may motivate imaging-informed perspectives on therapeutic interventions for CP.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reading is Thinking, Too.","authors":"Timothy Daly","doi":"10.1007/s10439-025-03879-9","DOIUrl":"https://doi.org/10.1007/s10439-025-03879-9","url":null,"abstract":"<p><p>Like writing, reading is thinking, too. Academics must promote the reading of scholarly literature, protect academic literacy and resist delegating this essential process to large language models so as to cultivate their own intellectual virtues and those of their students.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chitosan Nanofibrous Dressing Increased Angiogenesis and Anti-inflammatory Response in an Acute Wound Model in Rats: A Comparative Study.","authors":"Yury Salkovskiy, Mahboubeh Ghanbari, Carlos P Jara, Sara Cartwright, Pinaki Mondal, Colman Freel, Sayed Ahmadreza Razian, Jason MacTaggart, Mark A Carlson","doi":"10.1007/s10439-025-03842-8","DOIUrl":"https://doi.org/10.1007/s10439-025-03842-8","url":null,"abstract":"<p><strong>Purpose: </strong>Chitosan-based materials are promising for wound healing because of their antibacterial efficacy, biocompatibility, and biodegradability, though their healing mechanisms remain unclear. This study explores the cellular and molecular mechanisms of wound healing with chitosan nanofibrous dressings.</p><p><strong>Methods: </strong>Thirty-nine Sprague Dawley rats were divided into three groups based on the type of dressings administered: (1) chitosan nanofibrous dressing + transparent film, (2) commercial scaffold + transparent film, and (3) transparent film alone (control). Full-thickness wounds (2 cm × 2 cm) were created on the dorsum, splinted, and covered with dressings. Evaluations at 7, 14, and 21 days included histological analysis, and measurements of TNF-α and iNOS levels in the wounds.</p><p><strong>Results: </strong>On day 21, epithelialization was significantly higher in the chitosan group than in the scaffold group (87.5% vs. 42.0%, p = 0.03). TNF-α levels were lower in both treatment groups compared to the controls. In the chitosan group, the CD68+/CD163+ ratio was lower than in the scaffold group (0.28 vs. 0.62, p = 0.037), and blood vessel formation was greater than in the controls.</p><p><strong>Conclusion: </strong>These results suggest that chitosan nanofibrous dressings enhance acute wound healing in rats by promoting re-epithelialization, neovasculogenesis, and maintaining low TNF-α levels in the later phases of healing.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145249368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"mRUST Estimation of Tibial Fracture Healing After Intramedullary Nailing Using Deep Forest Model with a Genetically Optimized Wearable Sensor Layout.","authors":"Wenxuan Chen, Mingxia Gong, Fang Pu, Weiyan Ren, Jie Tan, Yubo Fan","doi":"10.1007/s10439-025-03873-1","DOIUrl":"https://doi.org/10.1007/s10439-025-03873-1","url":null,"abstract":"<p><strong>Purpose: </strong>The assessment of tibial shaft fracture healing using the mRUST score is limited by radiation exposure and subjective interpretation. This study aimed to develop a quantitative model to estimate mRUST scores using continuous plantar pressure data from a portable insole system and to identify an optimal, cost-effective sensor layout.</p><p><strong>Methods: </strong>23 Patients with tibial shaft fractures treated with intramedullary nails were enrolled. Plantar pressure data and corresponding mRUST scores were collected across 103 follow-up visits. During each visit, data from 5 gait analysis segments were recorded, yielding a total of 515 gait analysis segments. A Deep Forest Regression (DFR) model was developed to estimate mRUST from continuous gait data. A Genetic Algorithm (GA) optimized the sensor layout using the model's coefficient of determination (R²) as the fitness function. Model interpretability was assessed using Shapley Additive Explanations (SHAP).</p><p><strong>Results: </strong>The optimization process identified an optimal 6-sensor layout, which achieved a Mean Absolute Error of 0.641 and an R² of 0.902-performance comparable to the full 99-sensor array. The model demonstrated high estimation accuracy across early, intermediate, and late healing stages. SHAP analysis validated the model's clinical relevance, revealing that sensor contributions shifted from the heel to the forefoot as healing progressed.</p><p><strong>Conclusion: </strong>A DFR model with a GA-optimized plantar pressure insole provides an accurate, objective assessment of patients following intramedullary nailing of tibial fractures. This portable, data-driven approach presents a viable alternative to traditional radiographic methods, offering potential for timely and convenient clinical monitoring.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review Study of Causes of Sudden Infant Death Syndrome.","authors":"Fleur T Tehrani","doi":"10.1007/s10439-025-03871-3","DOIUrl":"https://doi.org/10.1007/s10439-025-03871-3","url":null,"abstract":"<p><strong>Purpose: </strong>The Sudden Infant Death Syndrome (SIDS) is the unexpected death of an apparently healthy infant for which no reason can be found after a postmortem examination. The primary causes of SIDS have not been determined. The purpose of this study was to examine the primary causes of this syndrome by reviewing the research results and new theories and in view of recent experimental findings.</p><p><strong>Methods: </strong>The theories on SIDS were reviewed. The results of computer simulations of this disorder using an isomorphic model that were published in the past were compared to new experimental results and hypotheses.</p><p><strong>Results: </strong>The most important factors contributing to periodic breathing and prolonged apneic spells in infants were confirmed to be the factors related to the development of the respiratory control system, including the maturity factors of arterial and central receptors in response to carbon dioxide, the maturity factor of arterial receptors to oxygen, as well as the lung functional residual capacity (FRC), which is affected by the infant's age. The lung shunt ratio in preterm infants and poor gas exchange in the lungs were also significant factors, but to a lesser degree.</p><p><strong>Conclusion: </strong>SIDS is primarily caused by the prematurity of arterial and central respiratory receptors during a developmental period and the size of FRC. Infants who are at high risk of SIDS may be monitored using pulse oximetry during sleep. Low oxygen levels in those infants can be detected and trigger an alarm, which may save the lives of those infants.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Different Bipolar Construct Configurations for the Correction of Adult Spine Deformity: A Finite Element Analysis.","authors":"Claudio Vergari, Sylvain Persohn, Stéphane Wolff, Pierre-Emmanuel Moreau, Lotfi Miladi, Guillaume Riouallon","doi":"10.1007/s10439-025-03867-z","DOIUrl":"https://doi.org/10.1007/s10439-025-03867-z","url":null,"abstract":"<p><strong>Purpose: </strong>A minimally invasive bipolar spinal fixation was recently developed to correct the deformity in pediatric neuromuscular scoliosis and has recently been adapted for adult scoliosis. Although the clinical results are promising, mechanical complications are still not negligible. In this work, alternative configurations of bipolar constructs were compared through numerical simulation, in order to evaluate stress distribution along the implant according to each configuration.</p><p><strong>Methods: </strong>The configurations included doubling the rods, adding lumbar screws to strengthen the distal anchorage, and combining two different materials (titanium and chromium-cobalt alloy). This resulted in seven different configurations, which were implemented in a subject-specific and experimentally validated finite element model, based on the geometry of an asymptomatic subject. Von Mises stresses were compared between configurations.</p><p><strong>Results: </strong>The results confirm that doubling the rods reduced mid-rod stresses, as expected, but also shifted some of the load from the distal anchorage to the rods, which is a common site of implant failure. The addition of pedicle screws also reduced the stress in the distal anchorage. The configuration showing the best compromise between stress reduction and the mini-invasive character of surgery included a doubling of both rods in titanium.</p><p><strong>Conclusions: </strong>These results should be confirmed by clinical results, but they already provide clear guidelines for the surgeon.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}