Simulation of an anterior spine instrumentation in adolescent idiopathic scoliosis using a flexible multi-body model |
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Authors: | Geneviève Desroches Carl-Eric Aubin Daniel J Sucato Charles-Hilaire Rivard |
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Institution: | Department of Mechanical Engineering, Ecole Polytechnique de Montréal, Station Centre-Ville, PO Box 6079, Montreal, QC, Canada H3C 3A7. |
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Abstract: | Anterior spinal instrumentation is an alternative option to posterior instrumentation for surgical treatment of adolescent
idiopathic scoliosis (AIS). However, optimal instrumentation configuration and strategies are not yet clearly defined. A biomechanical
kinematic model using flexible mechanism was developed to study instrumentation strategies. Preoperative 3D reconstruction
of scoliotic patient’s spine was used to define the patient-specific geometry of the model. Mechanical properties were adjusted
to consider the discectomy and surgical manoeuvres were reproduced. Anterior spine surgeries of ten patients were simulated
and results were compared to immediate post-operative data and showed differences of <5° for the Cobb angles. The validated
model was used to find optimal instrumentation configurations for one patient prior to surgery. Six strategies were tested
out of which the optimal one was identified while two were not recommended for surgery since screw forces exceeded published
pullout forces. This study demonstrates the possibility to simulate anterior spine instrumentations. |
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Keywords: | Biomechanical model Scoliosis Spine Anterior instrumentation surgery Multi-body model Computer assisted surgery |
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