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      FEM Simulation of Non-Progressive Growth from Asymmetric Loading and Vicious Cycle Theory: Scoliosis Study Proof of Concept

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          Abstract

          Scoliosis affects about 1-3% of the adolescent population, with 80% of cases being idiopathic. There is currently a lack of understanding regarding the biomechanics of scoliosis, current treatment methods can be further improved with a greater understanding of scoliosis growth patterns. The objective of this study is to develop a finite element model that can respond to loads in a similar fashion as current spine biomechanics models and apply it to scoliosis growth. Using CT images of a non-scoliotic individual, a finite element model of the L3-L4 vertebra was created. By applying asymmetric loading in accordance to the ‘vicious cycle’ theory and through the use of a growth modulation equation it is possible to determine the amount of growth each region of the vertebra will undergo; therefore predict scoliosis growth over a period of time. This study seeks to demonstrate how improved anatomy can expand researchers current knowledge of scoliosis.

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          Most cited references41

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          Adolescent idiopathic scoliosis: natural history and long term treatment effects

          Adolescent idiopathic scoliosis is a lifetime, probably systemic condition of unknown cause, resulting in a spinal curve or curves of ten degrees or more in about 2.5% of most populations. However, in only about 0.25% does the curve progress to the point that treatment is warranted. Untreated, adolescent idiopathic scoliosis does not increase mortality rate, even though on rare occasions it can progress to the >100° range and cause premature death. The rate of shortness of breath is not increased, although patients with 50° curves at maturity or 80° curves during adulthood are at increased risk of developing shortness of breath. Compared to non-scoliotic controls, most patients with untreated adolescent idiopathic scoliosis function at or near normal levels. They do have increased pain prevalence and may or may not have increased pain severity. Self-image is often decreased. Mental health is usually not affected. Social function, including marriage and childbearing may be affected, but only at the threshold of relatively larger curves. Non-operative treatment consists of bracing for curves of 25° to 35° or 40° in patients with one to two years or more of growth remaining. Curve progression of ≥ 6° is 20 to 40% more likely with observation than with bracing. Operative treatment consists of instrumentation and arthrodesis to realign and stabilize the most affected portion of the spine. Lasting curve improvement of approximately 40% is usually achieved. In the most completely studied series to date, at 20 to 28 years follow-up both braced and operated patients had similar, significant, and clinically meaningful reduced function and increased pain compared to non-scoliotic controls. However, their function and pain scores were much closer to normal than patient groups with other, more serious conditions. Risks associated with treatment include temporary decrease in self-image in braced patients. Operated patients face the usual risks of major surgery, a 6 to 29% chance of requiring re-operation, and the remote possibility of developing a pain management problem. Knowledge of adolescent idiopathic scoliosis natural history and long-term treatment effects is and will always remain somewhat incomplete. However, enough is know to provide patients and parents the information needed to make informed decisions about management options.
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            Application of a new calibration method for a three-dimensional finite element model of a human lumbar annulus fibrosus.

            Major deficits of many finite element models of the lumbar spine are the oversimplification, assumed constellation of the material properties or the insufficiently performed calibration using experimental in vitro data. The aim of this study was, to develop a method for calibrating the two-composite structure of the annulus fibrosus, the ground substance and collagen fibers.
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              The load on lumbar disks in different positions of the body.

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                Author and article information

                Journal
                Open Biomed Eng J
                TOBEJ
                The Open Biomedical Engineering Journal
                Bentham Open
                1874-1207
                17 August 2010
                2010
                : 4
                : 162-169
                Affiliations
                [1 ]Mechanical Engineering, University of Alberta, Edmonton, Canada
                [2 ]Civil Engineering, University of Alberta, Edmonton, Canada
                Author notes
                [* ]Address correspondence to this author at the 4-9 Mechanical Engineering, University of Alberta, Edmonton, AB, T6G 2G8, Canada; Tel: 780-492-7168; Fax: 780-492-2200; E-mail: jason.carey@ 123456ualberta.ca
                Article
                TOBEJ-4-162
                10.2174/1874120701004010162
                3044893
                21379393
                9b52b4b3-79c4-494c-b38e-accb8ed96541
                © Fok et al.; Licensee Bentham Open.

                This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited

                History
                : 1 June 2010
                : 16 July 2010
                : 18 July 2010
                Categories
                Article

                Biomedical engineering
                biomechanics,growth,finite element analysis,non-progressive.,scoliosis
                Biomedical engineering
                biomechanics, growth, finite element analysis, non-progressive., scoliosis

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