Development of a Computer Simulation Tool for Application in Adolescent Spinal Deformity Surgery

摘要

Scoliosis is a three-dimensional spinal deformity which requires sur gical correction in progressive cases. In order to optimize correction and avoid complications following scoliosis surgery, patient-specific finite element mod els (FEM) are being developed and validated by our group. In this paper, the modeling methodology is described and two clinically relevant load cases are simulated for a single patient. Firstly, a pre-operative patient flexibility assess ment, the fulcrum bending radiograph, is simulated to assess the model's ability to represent spine flexibility. Secondly, intra-operative forces during single rod anterior correction are simulated. Clinically, the patient had an initial Cobb an gle of 44 degrees, which reduced to 26 degrees during fulcrum bending. Surgi cally, the coronal deformity corrected to 14 degrees. The simulated initial Cobb angle was 40 degrees, which reduced to 23 degrees following the fulcrum bend ing load case. The simulated surgical procedure corrected the coronal deformity to 14 degrees. The computed results for the patient-specific FEM are within the accepted clinical Cobb measuring error of 5 degrees, suggested that this model ing methodology is capable of capturing the biomechanical behaviour of a sco liotic human spine during anterior corrective surgery.