Possibilities of personalized finite element segmental analysis of the cervical spine for predicting the course of dorsopathy

Abstract

Introduction. The use of mathematical modeling methods in clinical practice will make it possible to identify the pathogenetic forms of dorsopathies and thus reasonably use the concept of targeted treatment in the management of patients of this category.Aim. To evaluate the possibilities of finite element segmental analysis of the cervical spine for personalized treatment and prediction of the course of dorsopathies.Material and methods. Based on the combined data of computed and magnetic resonance imaging of the patient (female, born in 1951), a model of the C5 – C7 segment was generated, including: vertebrae C5, C6, C7, IVD, anterior and posterior longitudinal ligaments, two pairs of facet joints, spinal cord, nuchal ligament. Computer modeling and finite element method were used to  analyze the stress-strain state of the cervical spine of a patient with degenerative-dystrophic changes in the C2 – C7 segments. In the Abaqus/CAE 6.14 software, finite element analysis of the C5 – C7 stress-strain state was carried out in the state of flexion, rotation and compression. The data obtained during compression were compared with previous experiments in silico and in vitro for the norm.Results. For each state, stress and displacement diagrams, load-displacement curves, stress profiles in the MPD were obtained. The axial mobility of the segment under compressive load is two times lower compared to the norm under the same boundary conditions and material models. The degree of involvement of the spinal cord in conflicts with the surrounding anatomical structures was studied. When the model was rotated to the right, conflicts were observed between the spinal cord roots and the bone structures of the vertebrae in the foraminal zones, as well as at the level of the C5 – C6 and C6 – C7 discs with the left posterolateral surfaces of the fibrous rings. When the model was turned to the left, conflicts of the spinal cord were observed in all foraminal zones, as well as at the level of the C6 – C7 disc with the left posterolateral surface of the fibrous rings. Based on the data on stresses in the studied segment, further development of dorsopathies and degenerative changes in the cervical spine was predicted.Conclusions. The use of finite element segmental analysis of the cervical spine creates objective prerequisites for the formation of a combined personalized treatment and prediction of the course of dorsopathies.