Innovative Tools for In Vivo Computational Prediction of Lumbar Stresses

腰椎应力体内计算预测的创新工具

基本信息

批准号：
7491190
负责人：
RICHARD David KOMISTEK
金额：
$ 42.42万
依托单位：
UNIVERSITY OF TENNESSEE KNOXVILLE
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-09-01 至 2011-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7491190
关键词：
Absenteeism at work Accounting Age Algorithms Area Arthroplasty Back Back Pain Biomechanics Chronic Clinical Clinical Data Common Cold Communities Computer Simulation Computing Methodologies Condition Data Data Correlations Device Safety Diagnosis Disease Doctor of Philosophy Effectiveness Elderly Electromyography Elements Engineering Evaluation Facet joint structure Failure Fluoroscopy Future Goals Human body Implant Intervertebral disc structure Joints Kinetics Knowledge Laboratories Lead Leadership Ligaments Location Longevity Low Back Pain Lumbar Regions Magnetic Resonance Imaging Marketing Mechanics Medical Methodology Methods Modeling Motion Movement Muscle Muscle Fibers Musculoskeletal Operative Surgical Procedures Orthopedics Outcome Output Pain Patients Pattern Physicians Population Positioning Attribute Postoperative Period Principal Investigator Prosthesis Relative (related person)Replacement Arthroplasty Research Research Personnel Roentgen Rays Scanning Simulate Site Spinal Staging Stress Structure Surface Symptoms System Tendon force Tennessee Torque Treatment Cost United States United States National Center for Health Statistics Universities Validation Vertebral column Visit Work Workers&apos Compensation World Health Organization X-Ray Computed Tomography body system bone bone imaging cost day design disability experience improved in vivo innovation kinematics mathematical model middle age models and simulation predictive modeling programs response sacrum soft tissue tool vector vertebra body

项目摘要

DESCRIPTION (provided by applicant): The Center for Musculoskeletal Research (CMR) is a joint program between Oak Ridge National Laboratory (ORNL) and the University of Tennessee (UT). Under the leadership of Richard D. Komistek, PhD as the Principal Investigator (PI), researchers in the CMR propose to develop accurate computational models that could eventually be used to predict in vivo contact stresses at the bearing surface interface (disc and facets) of the vertebral bodies and sacrum of the lower back and assess surgical outcomes in terms of reduction of pain after fusion or disk replacement surgery. The main goal of the proposal is to develop an accurate computational methodology that involves: 1) deriving and implementing in vivo kinematics using X- ray fluoroscopy, CT scans for bone modeling and MRIs of the lumbar spine for soft-tissue evaluation as input to our mathematical models; 2) computing the forces at the spine interfaces using a mathematical model; 3) computing the deformation and stresses in the intervertebral discs under normal and degenerative disc conditions (pre-surgery stage); 4) developing an in vivo computational modeling capability for the lumbar spine structure; and 5) developing a methodology to correlate the computational and clinical data. The model could eventually be used to predict in vivo contact stresses at the bearing surface interfaces, ligament forces that provide constraint, and muscle forces (and tendons) of the vertebral bodies of the lower back. This model would allow us to assess surgical outcomes in terms of reduction of pain after fusion or disk replacement surgery, and could be used in the future design and validation of spinal prostheses. We will team with clinicians at Vanderbilt University to correlate and validate the clinical and computational data. It is estimated that 80-90% of the U.S. population will experience lower back pain at some point in their lifetime. It is the most common work-related medical problem in the United States, and the second most common reason for doctor visits behind the common cold. Lower back pain is the leading cause of disability among people ages 19-45 and is the leading cause of missed work days. People with chronic back pain account for 80% of the cost of treatment in workers compensation claims. Longer life-spans and an increasing proportion of middle aged and elderly people make lower back pain an increasingly significant problem. The cost in terms of treatments and missed work is billions of dollars annually. From an orthopedic perspective, the spine is the fastest growing segment of the market. New treatments, including total disk replacement, and facet arthroplasty, will provide alternatives to fusion, but there is a need to do more biomechanical research and develop appropriate tools to develop predictive models, assess safety of the devices, and make this knowledge and the tools available to the orthopedic community.

描述（由申请人提供）：肌肉骨骼研究中心（CMR）是橡树岭国家实验室（ORNL）和田纳西大学（UT）之间的联合计划。在Richard D. Komistek博士的领导下，CMR的研究人员提议开发准确的计算模型，这些计算模型最终可用于预测轴承表面界面（椎间盘和方面）在椎体体外的体内接触应力（椎间盘和方面），垂直造成的椎体和肉眼sack骨的痛苦中的疾病反应量后，又一次地遭受了反应的反应。该提案的主要目的是开发一种准确的计算方法，涉及：1）使用X-射线荧光镜检查得出和实施体内运动学，用于骨建模的CT扫描和腰椎的MRIS进行软组织评估，以输入我们的数学模型； 2）使用数学模型在脊柱界面上计算力； 3）计算正常和退化椎间盘条件下椎间盘的变形和应力（手术前阶段）； 4）为腰椎结构开发体内计算建模能力； 5）开发一种将计算和临床数据关联的方法。该模型最终可用于预测轴承表面界面的体内接触应力，提供约束的韧带和下背部椎体的肌肉力（和肌腱）。该模型将使我们能够通过减少融合或椎间盘置换手术后的疼痛来评估手术结局，并可以在未来的设计和脊柱假体验证中使用。我们将与范德比尔特大学的临床医生合作，以关联和验证临床和计算数据。据估计，美国80-90％的人口将在其一生中的某个时候遭受下背痛。它是美国最常见的与工作有关的医疗问题，也是公共感冒之后医生探访的第二个最常见原因。下背部疼痛是19-45岁人口残疾的主要原因，是失踪日期的主要原因。患有慢性背痛的人占工人赔偿索赔中治疗费用的80％。更长的寿命以及越来越多的中年和老年人的比例使下背部疼痛成为越来越重大的问题。在治疗和失业方面的费用是每年数十亿美元。从骨科的角度来看，脊柱是市场增长最快的细分市场。包括全盘置换术和刻面关节置换术在内的新疗法将为融合提供替代方案，但是有必要进行更多的生物力学研究，并开发适当的工具来开发预测模型，评估设备的安全性，并使这些知识和该工具可用于正常皮质社区。