EFFECT OF EXTREME CONDITION ON PEDICLE LUMBAR SPINE: A THREE DIMENSIONAL FINITE ELEMENT ANALYSIS

A. Zulkifli1, A.K. Ariffin, A.E. Ismail, and R. Daud Department of Mechanical & Materials Engineering, Faculty of Engineering & Built Environment, Universiti Kebangsaan Malaysia, 46300 UKM, Bangi, Selangor, Malaysia. Phone: +603-89250200, Fax: +603-89216106 E-mail: zulkola@eng.ukm.my1

ABSTRACT The objectives of this study are to determine the stress distribution on posteriorsuperior vertebrae under the hyperextension conditions are numerically investigated and subjected to different loading ratios. In this study, the model was reconstructed by using SolidWork and ANSYS finite element analysis (FEA) to solve the problems. Material properties were taken from other research that related with this study. Hyperextension condition was simulated numerically and hyperextension started to occur when the load ratio greater than 30% of total load with the corresponding Von Mises stress about 6MPa. A clinical observation revealed that a similar region of critical area of stress was obtained when compared with FEA simulation. Pedicle is the most severe damage area of spine when the loading reached hyperextension conditions. Keywords: Hyperextension, Pedicle lumbar spine, Finite element analysis (FEA), Stress INTRODUCTION Hyperextension is a straightening movement that goes beyond the normal, healthy boundaries of the joint and often results in orthopaedic injury. This movement will produce the extreme condition and create a failure on the vertebra. It occurs whether during training by the athletes and sometimes accident. Despite it, when car accident collides forward, a similar type of hyperextension occurred and called it as whiplash. Cervical and lumbar are two most critical regions on hyperextension range of motion. However, the range of flexion-extension progressively increases in the lumbar motion segments, reaching a maximum at the lumbosacral level (Victor H. Frankel et al. 1980). In this study, only lumbar segments were considered as a critical region to emphasize. Pedicle was expected as common part where most fractures were observed during trauma, experimentally and clinically (Tian-Xia Qiu et al. 2006). Furthermore, this region is susceptible to impact which can result in stress fracture (F.Nabhani et al. 2002). Most of the pedicular stress fractures have been described in young, athletic individuals. Sometimes, pedicular fracture may occur suggested a causative relationship with the patients hyperactivity (Mustafa Sirvanci et al. 2002). Bone is a difficult material to get from market and it is very valuable to do the experiment. In order to overcome this limitation, other alternative was suggested by computational analysis using the analytical methods such as finite element (FE) method (Tian-Xia Qiu et al. 2006). FE methods have become an important tool to evaluate mechanical stresses and strains in bone (Hernandez et al. 2001) and have been widely

used to investigate the mechanical behavior of bone tissue (Herrera A. et al. 2007). The analysis will become easier to determine the stress concentration without involving the real bone specimen which is taking a lot of time to do an experiment. Bones contain stress concentration features such as natural voids and defects. It also resulting from pathological conditions or created during surgery. In this approach, failure is predicted to occur if the stress exceeds a critical value (Saeid Kasiri et al. 2008). The rigid and brittle material tends to increase the stress concentration and to create high pressure zones. The purpose of this study is to determine the highest stress on the posteriorsuperior vertebra due to hyperextension condition. The hypothesis for this study is pedicle was the most critical region that affected on vertebrae when the loading subjected to the facet joints. The highest stress concentration was the critical area to fracture. METHODOLOGY Material Properties In reality, bone is a nonlinear, inhomogeneous and anisotropic material for both cortical bone and cancellous bone (Tian-Xia Qiu et al. 2006, Haisheng Yang et al. 2010, and Liang Peng et al. 2006). An anisotropic material exhibits different mechanical properties when loaded in different direction due to the structure of bone is different in the transverse and the longitudinal directions. However, most studies done in this area were based on the assumption that bone material was isotropic and inhomogeneous distribution of material properties due to its simplicity (Haisheng Yang et al. 2010, and Liang Peng et al. 2006). Therefore, this study was conducted on linear isotropic and assume that the whole vertebra considered as cortical bone properties. It is because the hypothesis shows that the highest stress concentration on posteriorsuperior vertebra without involved the vertebral body. Figure 1, shows the anatomy of the vertebra lumbar spine for different angle of view.
Superior process Facet joints Transverse process Spinous process

Spinous process Inferior process Vertebral body

(a) (b) Figure 1: Anatomy of the vertebra lumbar spine, (a) isometric view (b) top view Material properties for this model were taken by previous research from (M. Kurutz et al. 2010); Young modulus and poisson ratio are 12 GPa and 0.3 respectively.

Finite element model A three dimensional, finite element model of the human lumbar vertebra was reconstructed using the commercial software SolidWork. This reconstructed model is a simplifying based on the actual shape of vertebrae. An iges file from SolidWork software was imported in FE modeling software ANSYS. Three-dimensional meshes with tetrahedral 20 node quadratic elements (solid186) were constructed using an automatic mesh function of ANSYS. Loading and boundary conditions The inferior surface and spinous process of the vertebra were constrained in all degreesof-freedom. The load subjected to the lumbar is calculated by considering the weight supported by the 80 kg normal person with obtain only 500N comprising the head, trunk and limbs. Refer to the Figure 2, load applied to the lumbar is separated into two distinct regions; first for the superior vertebral body and second for superior facets joint using the load ratio is to represent hyperextension condition. Facet joint normally support between 10 to 40% of compression loads of vertebrae is subjected to, depending on posture of the spine (F.Nabhani et al. 2002). Therefore, the load proportion subjected to facet joint here up to 40% of total loads for comparison. Load applied

Constrained all DOF

Figure 2: Three dimensional finite element model with boundary conditions The loads have converted to pressure for uniform distributed load subjected to the area with comply the basic equation for pressure P=F/A. Modification from that equation will become; F 1 x Pbody ( x ) total (1) Abody

Pfacet ( x )

Ftotal x , x 0.1, 0.2, 0.3, 0.4 2 Afacet

(2)

Equation (1) is for pressure applied to the vertebral body whilst the facet joints are satisfied for Eq. (2). Load ratio x = 0.4 to represent 40% of load applied to the facet joints. It is maximum consideration for this study.

RESULTS AND DISCUSSION Figure 3 shows the stress distribution of the spine under hyperextension condition. It is found that the highest stress concentrations occurred at the interface between vertebral arch and pedicle segments. This is indicated that the vertebra pedicle region as the most likely areas for fracture due to the high proportion of loads subjected to the facet joints that will create the bending effects. Longer distance between the facet joints and the vertebral body will increase the bending moment. It is due to vertebral body tends to be as pivot for the vertebra.

Figure 3: the highest stress concentration on the vertebra.

Ratio Contour Von Mises

10%

20%

30%

40%

2.0255 MPa

4.0023 MPa

6.0181 MPa

8.0340 MPa

Figure 4: The stress distribution of the vertebra for different ratio From figure 4, the stress distributions for different type of ratio represent the effect of hyperextension. The comparisons between these ratios are the proportion load that subjected to the vertebral body and facet joints. For the ratio 10%, there are some stresses in the vertebral body whilst for the ratio 30%; vertebral body did not affected wholly. Hence, load ratio 30% means that hyperextension started after facet joint is sustaining exceeds 30% from total load as reported by F.Nabhani et al. (2002) and S.J. Hall (1995). Magnetic resonance imaging (MRI) in figure 5 indicates the fracture occur on the pedicle from case reported by Mustafa Sirvanci et al. (2002). This MRI results valid with the results from finite element analysis in Figure 3. The failure on the pedicle is due to the highest stress concentration located on that area. Failure or fracture on bone started on the highest stress concentration produced the weakest area on the bone. Stress concentration will reduce the mechanical integrity of the bone, making it susceptible to fracture during trauma (Saeid Kasiri et al. 2008).

Figure 5: Fracture occurs on the pedicle shows by magnetic resonance imaging (MRI). (Mustafa Sirvanci et al. 2002) On the other hand, based on energy stored in the bone, the brittle materials in cortical bone absorb relatively little energy due to liable to fracture when subjected to stress. It is convincing that cortical bone absorbs less energy to takes more load. Some studies have concluded that the cortical takes over 40% of the load (J. Homminga et al. 2001). Less energy stored in the bone, it tends to release in another form of failure such as crack, and yielding. Hence, the failure was occurred on the weakest region in bone equivalent to the highest stress concentration. In cortical bone microscopic structure, there are several capillaries inside the bone that induced the yielding bone such as Volkmanns and Haversian canal. Beside it, basic structural of bone is osteons. Osteons are concentric rings of mineralized tissue, sheath by cement layer and surrounding with Haversian canals. Yielding in bone is caused by debonding of the osteons and mineral phase as a significant role in failure progression on bone (X. Neil Dong et al. 2009). The risk of failure on bone will increased when another disease as osteoporosis presence in the diagnostic. Osteoporosis will decrease the bone quality in terms of gradual loss of bone mass in both calcium and protein components naturally (Vinayagam, 2007). Mechanical properties on bone would poor due to its porosity become bigger and induced the bone mineral density (BMD) decrease. Therefore, the probability of failure is become higher if this aspect detected in the doctor diagnostic. CONCLUSION This study has achieved the main objective that is to determine the stress concentration on the vertebra with the hyperextension condition. A clinical observation by using (MRI) suggested the similar damage area as predicted by FEA. Three major limitations of this study are acknowledged as follows: 1. The vertebra has considered as only one material which is cortical bone due to other material did not affected the results. 2. Vertebrae were assigned as linear elastic, homogeneous and isotropic material properties, when in fact bone is a nonlinear, inhomogeneous and anisotropic material. 3. In this study, attention was focused only on the mechanism of posterior elements due to critical area for this hyperextension condition; therefore anterior elements were not investigated. In the next stage, a probabilistic analysis will be used to analyze the sensitivity variables that are affected the reliability of the vertebra.

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