{"title":"Experimental Assessment of Traction Force and Associated Fetal Brain Deformation in Vacuum-Assisted Delivery.","authors":"Estelle Pitti, Lotta Herling, Xiaogai Li, Gunilla Ajne, Matilda Larsson","doi":"10.1007/s10439-024-03665-z","DOIUrl":"https://doi.org/10.1007/s10439-024-03665-z","url":null,"abstract":"<p><p>Vacuum-assisted delivery (VAD) uses a vacuum cup on the fetal scalp to apply traction during uterine contractions, assisting complicated vaginal deliveries. Despite its widespread use, VAD presents a higher risk of neonatal morbidity compared to natural vaginal delivery and biomechanical evidence for safe VAD traction forces is still limited. The aim of this study is to develop and assess the feasibility of an experimental VAD testing setup, and investigate the impact of traction forces on fetal brain deformation. A patient-specific fetal head phantom was developed and subjected to experimental VAD in two testing setups: one with manual and one with automatic force application. The skull phantom was 3D printed using multi-material Polyjet technology. The brain phantom was cast in a 3D-printed mold using a composite hydrogel, and sonomicrometry crystals were used to estimate the brain deformation in three brain regions. The experimental VADs on the fetal head phantom allowed for quantifying brain strain with traction forces up to 112 N. Consistent brain crystal movements aligned with the traction force demonstrated the feasibility of the setup. The estimated brain deformations reached up to 4% and correlated significantly with traction force (p < 0.05) in regions close to the suction cup. Despite limitations such as the absence of scalp modeling and a simplified strain computation, this study provides a baseline for numerical studies and supports further research to optimize the safety of VAD procedures and develop VAD training platforms.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875966","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":"Developing a Structurally Modified Mechanical Lumped Model of the Human Tibia and Shin Guard Using Modal Analysis.","authors":"Ehsan Moghaddam, Aref Afsharfard","doi":"10.1007/s10439-024-03668-w","DOIUrl":"https://doi.org/10.1007/s10439-024-03668-w","url":null,"abstract":"<p><p>Shins are one of the most vulnerable bones in human body. Shin guards are evaluated by their effectiveness in reducing the force applied to the bone. In this study, a structural modified mechanical lumped model of the shin guard was developed to provide maximum force distribution using physical parameter change modification technique and genetic algorithm. Modal analysis and finite element methods were used to determine the dynamic behavior of the system in the frequency range of 0-3000 Hz. In this research, FE results had an encouraging agreement with those in experimental test with a Mean Absolute Error (MAE) found as 34.94. The results proposed two design zones to select the stiffness of the shin guard. The stiffnesses K<sub>1</sub> and K<sub>2</sub> were selected between the values in the design zones. For situation, K<sub>1</sub> = 7.9 × 10<sup>5</sup> N/m and K<sub>2</sub> = 6.3 × 10<sup>5</sup> N/m, the distribution parameter was equal to 76% and f<sub>1</sub> = 1.87F, f<sub>2</sub> = 0.71F f<sub>3</sub> = 1.81F, meaning the force was effectively distributed.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142875963","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}
Delin Zeng, Andrew V Basilio, Leanne A Pichay, Gerard A Ateshian, Olivia S Hansen, Alexander Romanov, Barclay Morrison
{"title":"Experimental Measurement and Mathematical Quantification of Fixed-Charged Density in Rat and Pig Brain Tissue.","authors":"Delin Zeng, Andrew V Basilio, Leanne A Pichay, Gerard A Ateshian, Olivia S Hansen, Alexander Romanov, Barclay Morrison","doi":"10.1007/s10439-024-03666-y","DOIUrl":"https://doi.org/10.1007/s10439-024-03666-y","url":null,"abstract":"<p><p>Cerebral edema is associated with poor prognosis because brain swelling within the rigid skull raises intracranial pressure, exacerbating secondary injuries following traumatic brain injury. Brain swelling can be characterized by triphasic biomechanics, which models brain tissue as a mixture of a deformable porous solid matrix with a negative fixed-charged density (FCD), water, and monovalent counterions. When brain cells die, the intracellular FCD is exposed, attracting cations into the cells. The increase in intracellular solute concentration generates osmotic pressure via the Gibbs-Donnan effect, driving water into cells and causing swelling. This study quantifies the FCD of rat and pig brain tissue by measuring the pressure generated by tissue within a confined volume as cells died. Rat brain tissue generated an averaged swelling pressure of 52.92 ± 20.40 mmHg (mean ± one standard deviation). Variations were observed between pig cortical white matter (7.14 ± 4.79 mmHg) and cortical gray matter (33.86 ± 11.89 mmHg). The corresponding FCD values were 42.54 ± 8.14 mEq/L for rat brain tissue, and 15.18 ± 5.38 mEq/L and 34.22 ± 6.31 mEq/L for pig cortical white and gray matter, respectively. Treating the rat brain tissue with DNAse, heparinase I, heparinase III, and chondroitinase ABC to degrade FCD significantly reduced swelling pressure. Good agreement between the experimental and numerically simulated responses supported the role of the FCD in cerebral edema formation. The reported FCD values can improve the biofidelity of computational models to predict post-traumatic cerebral edema, aiding the improvement of safety systems.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142863163","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}
Annika R Bergstrom, Matthew G Glimm, Eden A Houske, Gwendolyn Cooper, Ethan Viles, Marrin Chapman, Katherine Bourekis, Hope D Welhaven, Priyanka P Brahmachary, Alyssa K Hahn, Ronald K June
{"title":"Metabolic Profiles of Encapsulated Chondrocytes Exposed to Short-Term Simulated Microgravity.","authors":"Annika R Bergstrom, Matthew G Glimm, Eden A Houske, Gwendolyn Cooper, Ethan Viles, Marrin Chapman, Katherine Bourekis, Hope D Welhaven, Priyanka P Brahmachary, Alyssa K Hahn, Ronald K June","doi":"10.1007/s10439-024-03667-x","DOIUrl":"https://doi.org/10.1007/s10439-024-03667-x","url":null,"abstract":"<p><p>The mechanism by which chondrocytes respond to reduced mechanical loading environments and the subsequent risk of developing osteoarthritis remains unclear. This is of particular concern for astronauts. In space the reduced joint loading forces during prolonged microgravity (10<sup>-6</sup> g) exposure could lead to osteoarthritis (OA), compromising quality of life post-spaceflight. In this study, we encapsulated human chondrocytes in an agarose gel of similar stiffness to the pericellular matrix to mimic the cartilage microenvironment. We then exposed agarose-chondrocyte constructs to simulated microgravity (SM) for four days using a rotating wall vessel (RWV) bioreactor to better assess the cartilage health risks associated with spaceflight. Metabolites extracted from media and agarose gel constructs were analyzed on liquid chromatography-mass spectrometry. Global metabolomic profiling detected a total of 1205 metabolite features, with 497 significant metabolite features identified by ANOVA (FDR-corrected p-value < 0.05). Specific metabolic shifts detected in response to SM exposure resulted in clusters of co-regulated metabolites, with glutathione, nitrogen, histidine, vitamin B<sub>3</sub>, and aminosugars metabolism identified by variable importance in projection scores. Microgravity-induced metabolic shifts in gel constructs and media were indicative of protein synthesis, energy and nucleotide metabolism, and oxidative catabolism. Microgravity associated-metabolic shifts were consistent with our previously published early osteoarthritic metabolomic profiles in human synovial fluid, suggesting that even short-term exposure to microgravity (or other reduced mechanical loading environments) may lead to the development of OA. This work further suggests the potential to detect these metabolic perturbations in synovial fluid in vivo to ascertain osteoarthritis risk in astronauts.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852237","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}
Chih-Tai Ting, Jaw-Wen Chen, Mau-Song Chang, Frank C-P Yin
{"title":"Pulmonary Impedance and Wave Reflections in Adults with Mitral Stenosis: Immediate and Follow-Up Effects of Balloon Valvuloplasty.","authors":"Chih-Tai Ting, Jaw-Wen Chen, Mau-Song Chang, Frank C-P Yin","doi":"10.1007/s10439-024-03661-3","DOIUrl":"https://doi.org/10.1007/s10439-024-03661-3","url":null,"abstract":"<p><strong>Purpose: </strong>We compared adults with mitral stenosis (MS) to 8 controls (CONT) to see how pulmonary impedance and wave reflections differ at baseline and after balloon valvuloplasty.</p><p><strong>Methods: </strong>We separated the MS patients into groups according to mean pulmonary artery pressure: moderate (MOD; ≤ 26 mmHg, n = 21) and high (HIGH; > 26 mmHg, n = 33). We made baseline high-fidelity measurements in all patients, in the MS groups after vasodilation with nitroprusside, immediately and 4 months after balloon valvuloplasty.</p><p><strong>Results: </strong>Comparing MOD vs CONT, using the Kruskal-Wallis test with Bonferroni correction, reveals evidence for higher baseline input resistance (R) (489 vs 205 dyne-sec/cm<sup>5</sup>, P = 0.07); first harmonic of impedance modulus (Z<sub>1</sub>) (97.3 vs 27.6 dyne-sec/cm<sup>5</sup>, P = 0.01); first zero crossing of impedance phase angle (F<sub>0</sub>) (4.49° vs 2.19°, P = 0.02) but no difference in wave reflection index (P<sub>b</sub>/P<sub>f</sub>). Baseline HIGH vs CONT comparisons reveal stronger evidence and larger differences than MOD for R (995 vs 205, P < 0.001); Z<sub>1</sub> (151 vs 27.6, P < 0.001); F<sub>0</sub> (5.25 vs 2.19, P < 0.001); as well as P<sub>b</sub>/P<sub>f</sub> (0.69 vs 0.42, P < 0.001). Responses to nitroprusside and valvuloplasty are also greater in the HIGH than MOD, but the HIGH parameters still differ from the CONT. Four months after valvuloplasty there is evidence for reverse remodeling in both groups. Further analyses reveal that sinus rhythm and younger age are potentially important factors for remodeling.</p><p><strong>Conclusion: </strong>MS causes alterations in pulmonary hemodynamics that differ according to pressure levels. These changes are only partially reversed immediately after valvuloplasty. There is evidence for reverse remodeling 4 months afterwards.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827222","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 Novel In Silico-Ex Vivo Model for Correlating Coating Transfer to Tissue with Local Drug-Coated Balloon-Vessel Contact Pressures.","authors":"Efstathios Stratakos, Linnea Tscheuschner, Lorenzo Vincenzi, Edoardo Pedrinazzi, Fragiska Sigala, Luca D'Andrea, Dario Gastaldi, Francesca Berti, Abraham Rami Tzafriri, Giancarlo Pennati","doi":"10.1007/s10439-024-03634-6","DOIUrl":"https://doi.org/10.1007/s10439-024-03634-6","url":null,"abstract":"<p><p>Drug-coated balloons (DCBs) aim to deliver drug-loaded surface coating upon inflation at specific vascular sites, yet the role of inflation pressure remains to be defined. We implement a new approach combining ex vivo stamping experiments with in silico simulations to study acute coating transfer by commercial DCBs. This methodology comprises 3 essential pillars: (I) DCB resin inflation and slicing into cylindrical segments for subsequent stamping onto porcine-excised tissue, (II) Numerical inflation of a full DCB replica in an idealized porcine vessel to predict in vivo interfacial contact pressures (CPs) and subsequent interfacial-level numerical stamping to calculate appropriate benchtop forces that recreate these in vivo CP values, and (III) ex vivo stamping experiments and optical analysis of the stamped surfaces (DCB segment and arterial tissue), using a standard high-resolution camera to visualize coating. High-performance liquid chromatography (HPLC) was employed as a validated assay for quantifying drug in tissue samples post-stamping. HPLC analysis revealed a significant correlation with image processing, confirming the validity of the optical method as a tool to quantify DCB coating. Image and HPLC analysis revealed a statistically significant twofold rise in coating area and drug content to tissue, respectively, when the average CP roughly doubled (0.16-0.35 atm) and a non-statistically significant increase in coating area and drug content with a further rough doubling of average CP (0.35 to 0.75 atm). Imaging of DCB segments pre- and post-stamping showed transfer of partial coating thickness at low CP, contrasting with complete transfer at high CP at the same site. 3D confocal images of DCB surfaces revealed variable thickness in the transferred coating. This study introduces a comprehensive methodology for evaluating the efficacy of commercial DCB coating transfer to arterial tissue-a crucial precursor to drug elution studies-while minimizing the number of DCBs needed and improving variable control and realism.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811716","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}
Victor A Carranza, Alan Getgood, Ryan Willing, Timothy A Burkhart
{"title":"Comparing Simulation Approaches Used in Finite Element Modelling of a Medial Opening Wedge High Tibial Osteotomy.","authors":"Victor A Carranza, Alan Getgood, Ryan Willing, Timothy A Burkhart","doi":"10.1007/s10439-024-03662-2","DOIUrl":"https://doi.org/10.1007/s10439-024-03662-2","url":null,"abstract":"<p><strong>Purpose: </strong>Medial opening wedge high tibial osteotomy is a surgical procedure intended to relieve the symptoms of osteoarthritis in the medial compartment of the knee by addressing malalignment within the structures of the knee. In previous studies, the osteotomy cut and wedge opening in a Medial opening wedge high tibial osteotomy finite element model has been represented using either one of two techniques, which we define herein as wedge opening and wedge removal approaches. The purpose of this study is to determine whether the wedge removal for a medial opening wedge high tibial osteotomy finite element modelling study predicts accurate stresses and strains in the plate, screw, and throughout the proximal tibia, in comparison to the wedge opening.</p><p><strong>Methods: </strong>Seven tibia models were reconstructed from CT scans of seven cadaveric specimen. Two sets of models were created from the same set of specimens to create the wedge opening (n = 7) and wedge removal (n = 7) dataset.</p><p><strong>Results: </strong>A statistically significant difference in the mean plate stresses, screw stresses, and stresses in the tibia at the region around the apex of the osteotomy were found with the wedge removal, resulting in 4-59% greater stresses.</p><p><strong>Conclusion: </strong>The wedge removal is not an accurate representation of a medial opening wedge high tibial osteotomy with respect to the wedge opening. Selecting the appropriate modelling method that best represents the clinical scenario is the first crucial step in creating a representative finite element model.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142798948","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}
John J Bradshaw, Marcus A Brown, Yijie Jiang, Rong Z Gan
{"title":"3D Computational Modeling of Blast Transmission through the Fluid-Filled Cochlea and Hair Cells.","authors":"John J Bradshaw, Marcus A Brown, Yijie Jiang, Rong Z Gan","doi":"10.1007/s10439-024-03659-x","DOIUrl":"https://doi.org/10.1007/s10439-024-03659-x","url":null,"abstract":"<p><strong>Purpose: </strong>Veterans commonly suffer from blast-induced hearing disabilities. Injury to the sensitive organ of Corti (OC) or hair cells within the cochlea can directly lead to hearing loss, but is very difficult to measure experimentally. Computational finite element (FE) models of the human ear have been used to predict blast wave transmission through the middle ear and cochlea, but these models lack a representation of the OC. This paper reports a recently developed 3D FE model of the OC to simulate the response of hair cells to blast waves and predict possible injury locations.</p><p><strong>Methods: </strong>Components of the OC model consist of the sensory cells, membranes, and supporting cells with endolymphatic fluid surrounding them inside the scala media. Displacement of the basilar membrane induced by a 31-kPa blast overpressure derived from the macroscale model of the human ear was applied as input to the OC model. The fluid-structure interaction coupled analysis in the time domain was conducted in ANSYS.</p><p><strong>Results: </strong>Major results derived from the FE model include the strains and displacements of the outer hair cells, stereociliary hair bundles (HBs), reticular lamina, and the tectorial membrane (TcM). The highest structural strain was concentrated around the connecting region of the HBs and the TcM, potentially indicating detachment due to blast exposure. Including the interstitial fluid in the OC created a realistic environment and improved the accuracy of the results compared to the previously published OC model without fluid.</p><p><strong>Conclusion: </strong>The microscale model of OC was developed in order to simulate blast overpressure transmission through the fluid-filled cochlea and hair cells. This FE model represents a significant advancement in the study of blast wave transmission through the inner ear, and is an important step toward a comprehensive multi-scale model of the human ear that can predict blast-induced injury and hearing loss.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794326","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}
Lizzie Walker, Daniel Gordon, Alexander Chiaramonti, Shangping Wang, Zhaoxu Meng, Dane Daley, Elizabeth Slate, Hai Yao, Vincent D Pellegrini, Yongren Wu
{"title":"Morphological and Mechanical Property Differences in Trapeziometacarpal Ligaments of Healthy and Osteoarthritic Female Joints.","authors":"Lizzie Walker, Daniel Gordon, Alexander Chiaramonti, Shangping Wang, Zhaoxu Meng, Dane Daley, Elizabeth Slate, Hai Yao, Vincent D Pellegrini, Yongren Wu","doi":"10.1007/s10439-024-03660-4","DOIUrl":"https://doi.org/10.1007/s10439-024-03660-4","url":null,"abstract":"<p><strong>Purpose: </strong>To identify changes in morphological and mechanical properties in the volar ligament complex (VLC), dorsoradial ligaments (DRL), and posterior oblique ligaments (POL) in healthy and osteoarthritic female trapeziometacarpal (TMC) joints.</p><p><strong>Methods: </strong>Twenty-four fresh-frozen female cadaveric TMCs were separated into (1) younger healthy/early-stage osteoarthritic, (2) elder healthy/early-stage osteoarthritic, and (3) advanced-stage osteoarthritic groups based on age and Eaton-Littler grading. Stress relaxation and load-to-failure testing were performed to characterize mechanical tensile properties. Light imaging and scanning electron microscopy (SEM)/energy dispersive spectroscopy (EDS) were performed to further assess enthesis structural integrity.</p><p><strong>Results: </strong>The VLC in advanced-stage osteoarthritic TMCs had attenuated mechanical properties in stress relaxation experiments compared to the elder healthy/early-stage osteoarthritic specimens: Young's modulus at 20% strain (P = 0.044), instantaneous (P = 0.023), relaxed (P = 0.017) moduli. VLCs in advanced-stage osteoarthritic TMCs also had significantly lower properties in the load-to-failure experiments compared to the younger healthy/early-stage osteoarthritic specimens: stiffness (P = 0.048), ultimate load (P = 0.017), toughness (P = 0.003). Light and SEM/EDS imaging revealed partial detachment and loss of enthesis mineral gradient at VLC metacarpal insertion in advanced-stage osteoarthritic specimens. There were no mechanical or structural changes in the DRL and POL between experiment groups.</p><p><strong>Conclusion: </strong>VLC morphological and mechanical properties deteriorate across progressively severe osteoarthritis classifications while the DRL and POL remain unchanged. The attenuated mechanical properties of VLCs in advanced-stage osteoarthritic TMCs can be explained by ligament degradation as evidenced by partial detachment and loss of mineral gradient at the metacarpal insertion.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791041","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}
Ping Cai, Chen Xu, Zifan Zhang, Zhongxin Fang, Chao Deng, Gang Chen, Guoyou Wang, Jingchi Li
{"title":"An OLIF Cage Integrated with a Low-Profile Plate and Cross Screws Could Reduce the Risk of Postoperative Complications Biomechanically.","authors":"Ping Cai, Chen Xu, Zifan Zhang, Zhongxin Fang, Chao Deng, Gang Chen, Guoyou Wang, Jingchi Li","doi":"10.1007/s10439-024-03643-5","DOIUrl":"https://doi.org/10.1007/s10439-024-03643-5","url":null,"abstract":"<p><strong>Background: </strong>Stand-alone oblique lumbar interbody fusion (OLIF) cannot provide credible postoperative stability; additional fixation devices (AFDs) have been used to optimize surgical segment stability. Anterior lateral single rod (ALSR) screw fixation can be performed without intraoperative body position changes and additional surgical incisions, but its biomechanical defect may trigger complications. Inspired by the cross screw in other fixation devices, we designed an OLIF cage integrated with a low-profile plate and cross screw (LPCS).</p><p><strong>Methods: </strong>This study was designed to investigate whether the biomechanical performance of the LPCS OLIF cage is better than that of OLIF with ALSR fixation. The pullout and bending strength of the newly designed conical screw were tested by comparing it with a clinically used cylindrical screw. Different directional fixation strengths of the LPCS OLIF cage were tested by comparing the failure moment and stiffness with the ALSR fixation model. To test the fixation stability and potential risk for screw loosening in models with LPCS OLIF, we also compared the surgical segment's range of motions (ROMs) and stress distributions on OLIF models without and with different AFD fixation under physiological loading conditions.</p><p><strong>Results: </strong>The bending and pullout strength of the conical screw was better than that of the clinically used screw, and the failure moment and stiffness of the LPCS OLIF model were higher than those of the ALSR model, especially under the extension loading conditions. In which, the maximum failure moment of ALSR fixed OLIF model was 0.88 Nm and 0.76 Nm, while that of the LPCS OLIF model was 9.79 Nm and 7.48 Nm in models with normal and osteoporotic BMD, respectively. Compared to the ALSR fixed OLIF model, failure moment of LPCS models increased by 1012.5% and 884.21% in normal and osteoporotic models, respectively. Moreover, under most physiological loading conditions, the ROM and stress values of the LPCS OLIF model were lower than those of the ALSR model and even slightly lower than those of the OLIF model with bilateral pedicle screw fixation under limited loading conditions.</p><p><strong>Conclusions: </strong>Compared to OLIF with ALSR fixation, the newly developed LPCS OLIF cage demonstrates inherent biomechanical advantages in establishing immediate postoperative stability and reducing complications related to stress concentration. However, the conclusions of current research should still be validated through in vitro mechanical tests and clinical trials.</p>","PeriodicalId":7986,"journal":{"name":"Annals of Biomedical Engineering","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783891","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}