Traumatic Injury Biomechanics
CDC-RFA-CD08-002
Biomechanics Applications to the Reduction of Traumatic Injuries and Their Severity
Susan Margulies, Ph.D.
University of Pennsylvania
210 S. 33rd Street
Philadelphia, PA 19104
Phone: 215-898-0882
FAX: 215-573-2071
E mail: margulie@seas.upenn.edu
Grant Number: CE001445
Project Title: Development and Validation of a Diagnostic Tool for Infant Head Injuries from Falls
Project Period: 08/01/2008 – 07/31/2011
Abstract:
Traumatic brain injury (TBI) is the most common cause of death in childhood. The
predominant etiologies of TBI in young children are motor vehicle accidents, firearm
incidents, falls, and child abuse. Unfortunately, falls are the leading cause of non inflicted
head injury in infants less than a year old, and are also the most common history provided
by caretakers suspected of child abuse. Some cases are easy to diagnose, but in cases of
uncertainty accurate diagnosis of inflicted trauma is hindered by a lack of clarity regarding
specific head injury mechanisms for young infants. The objective of this research proposal
is to provide clinicians with a biomechanics based tool to aide in the diagnosis of inflicted
or non inflicted trauma with a history of a low height fall. In Aim 1, biomechanical
tolerances of extra axial hemorrhage (subdural and subarachnoid hemorrhage) are
determined by using a porcine computational model to simulate non impact rapid head
rotation experiments in 3 5 day old piglets. Mechanical responses from the model (cortical
displacement relative to skull and peak cortical tissue strain) are statistically correlated
with the actual occurrence of extra axial hemorrhage (EAH) on the piglets' cortex to
identify biomechanical tolerances associated with 10, 50 and 90 percent probability of
EAH. To validate this tolerance and determine probability thresholds with the greatest
specificity and sensitivity to predicting EAH in cases of well witnessed falls, a human
infant computational model is developed in Aim 2 to predict the brain and skull response
to impact. Simulating well witnessed cases of falls in infants, the biomechanical tolerance
for EAH in Aim 1 and a biomechanical tolerance for skull fracture previously published from
our lab are used to determine the robability of skull fracture and EAH most predictive of
the injuries in each of the case simulations. To measure loads in common household fall
settings, a 1 1/2 month old human infant biofidelic surrogate is used in Aim 3 to recreate
falls from 1, 2, and 3 feet onto carpet, concrete, hardwood, tile, and linoleum to simulate
common household fall settings. Impact force and angular accelerations for ten repetitions
of each height, surface, and primary head impact location (parietal or occipital) are
obtained, creating a load corridor for each fall scenario. Combining the biomechanical
loads from the surrogate experiments, existing pediatric large animal TBI data, and a new
biofidelic computational model of the brain and skull of a human infant, a predictive tool
is to be created in Aim 4 to determine the plausibility of skull fracture and extra axial
hemorrhages (EAH) in infants following low height falls. Validated with real world clinical
data, this biomechanical data will advance the understanding of injury thresholds in
common non inflicted scenarios that will ultimately improve the accuracy in detection of
inflicted and non inflicted head trauma. National objectives from Healthy People 2010
calls for a reduction in child maltreatment, a reduction in fatalities caused by child
maltreatment, a reduction in unintentional injury and a reduction in deaths from falls.
Developing a clinical tool that is biomechanically sound and informs clinical practice will
directly contribute to the fulfillment of these national health and welfare priorities.
Mark D Grabiner, Ph.D.
University of Illinois at Chicago
1919 West Taylor Street
Chicago, IL 60612
Phone: 312-996-2757
FAX: 312-413-0319
E mail: grabiner@uic.edu
Grant Number: CE001430
Project Title: Reducing Falls in the Elderly: Beyond the Laboratory to the Community
Project Period: 08/01/2008 – 07/31/2011
Abstract:
The long term objective of our work is to reduce the premature death and disability due to
fall related injuries to older adults. The proposed randomized prospective study will
determine the effectiveness of a novel exercise based fall prevention intervention. To
date, our work with the exercise based intervention has demonstrated its efficacy for
reducing laboratory induced trip related falls by older women. The basis of the fall
prevention intervention is task specific training focused on improving performance of
compensatory stepping responses (CSR). The intervention specifically improves CSR
necessary to avoid falling following postural disturbances that serve as a biomechanical
surrogate for a trip. The proposed randomized 12 month prospective study will be
conducted over a period of three years. One specific aim will be addressed and one
primary hypothesis will be tested. Older women who do not participate in the CSR
intervention will be compared to those of older women who complete the 2 week 4 session
CSR intervention. The specific aim is to quantify the influence of a CSR intervention on
the incidence of all cause falls during the 12 months following completion of the
intervention. We hypothesize that women who participate in the CSR intervention will
have significantly fewer all cause falls. Secondary hypotheses include expectations that
compared to the control group, the women who complete the CSR training will have a
significantly longer period of time to the first fall and significantly fewer fall related
injuries that require medical attention.
CDC-RFA-CD07-006
Grants for Traumatic Injury Biomechanics
Research
Paul C. Ivancic,
Ph.D.
Yale University
330 Cedar Street,
FMB 526A
P.O. Box 208071
New Haven, CT
06520‑8071
Phone: 203‑785‑4052
FAX: 203‑785‑5079
E‑mail:
paul.ivancic@yale.edu
Grant Number: CE001257
Project Title:
Prevention of neck injuries in older adults during rear motor vehicle
collisions
Project Period:
09/01/2007 ‑ 08/31/2010
Abstract:
Importance: A neck injury rate up to 30% has been reported for older adult occupants of rear motor vehicle collisions (RMVCs) and older adults experience longer recovery times, as compared to younger RMVC occupants. Females experience higher neck injury risk and longer recovery times, as compared to males. Some epidemiological studies have found head restraints to be ineffective, while others have reported an effectiveness rate reaching only 20% for neck injury reduction. Objectives, Study Design, Setting, and Specimens. The specific hypotheses are: (1) for each spinal level, prevention of neck injuries in older adult (biomechanical instability, and ligamentous, neural and/or vascular injuries) depends upon the specific neck injury prevention system, and (2) for each neck injury prevention system, the potential neck injury severity depends upon the occupant gender and peak RMVC acceleration. There are three specific aims. Aim 1: to advance our biomechanical understanding of traumatic neck injuries by developing a Human Model of the Neck (HUMON) and RMVC simulation apparatus in our experimental laboratory. HUMON will consist of a fresh‑frozen human cadaveric specimen (entire head and neck through to T1 vertebra) stabilized with muscle force replication, mounted to the torso of an anthropometric test dummy. All specimens will be obtained from older adult donors, above 65 years of age, with an equal number of males and females. The RMVC simulation apparatus will include an automobile seat (with HUMON in it) rigidly attached to a sled on linear bearings, impacting mass and its power system, and a braking system. Aim 2: to determine the human neck injury tolerance due to RMVC. HUMON, without a head restraint, will be used to obtain baseline data (n=20; 10 males and 10 females) during simulated RMVC, to determine the human neck injury tolerance, differences among gender, and to validate its dynamic biofidelity against in vivo data. Neck injuries (biomechanical instability) will be quantified using flexibility testing before and after each RMVC. During the RMVCs, ligament strains, spinal canal and intervertebral foramen narrowing, and vertebral artery elongation (potential injuries to neural and ligamentous tissues and vertebral artery) will be determined using custom transducers and a high speed digital camera. Intact and post‑RMVC imaging (CT and MRI) will document clinical injuries. Outcome Measures. Neck injuries and their prevention will be documented by measuring dynamic intervertebral motions and spinal loads. All neck injury criteria (IV‑NIC, NDC, NIC, Nij, Nkm) will be compared. Interventions. Aim 3: to evaluate the effectiveness of the active head restraint and energy absorbing seat for neck injury prevention. The protocol of Aim 2 will be repeated to evaluate the role of two newly developed active injury prevention systems in reducing neck injury severity in older adults during RMVCs: active head restraint (n=20; 10 males and 10 females), and energy absorbing seat (n=20; 10 males and 10 females). Outcome Measures: Differences in neck injury severity among gender will be determined.
Thomas McAllister,
M.D.
Trustees of
Dartmouth College
Dartmouth‑Hitchcock
Medical Center
One Medical Center
Drive
Lebanon, NH 03756
Phone: 603‑650‑5824
FAX: 603‑650‑5842
E‑mail:
tom.mcallister@dartmouth.edu
Grant Number: E001254
Project Title: Effect of Biomechanical Force Exposure on Cognition and Brain
Activation in Student Athletes
Project Period:
09/01/2007 ‑ 08/31/2010
Abstract:
300,000 individuals sustain sports concussions each year in the U.S. The majority of at risk athletes are at the high school level. High school football players represent a particularly high‑risk group, accounting for about two‑thirds of all concussions in high school athletes. The short and long‑term effects of sports concussions and perhaps more importantly repetitive sub‑concussive impacts are not known, nor are the cumulative effects of repeated injuries understood. There is enormous variability in outcome, although the reasons for this variability are not understood. The overarching theme of this proposal is that a youth’s exposure to biomechanical forces is a critical factor influencing cognitive outcome. This has two broad components: the characteristics of a single impact (e.g. linear acceleration, rotational acceleration, direction etc.), and the history of exposure to biomechanical forces over time (e.g. measures of frequency and intensity of impacts over the preceding days and weeks). We propose to use technological advances in on‑field head impact monitoring, cognitive testing, and functional brain imaging to learn for the first time what types of head impacts, under what circumstances, in which individuals, cause what effects in brain function. Exposure to biomechanical forces acutely (post‑concussive), sub‑acutely (preto one‑month post‑season), and cumulatively (exposure over multiple seasons of play) are of interest and will be monitored. Two groups of high school student athletes (football players and non‑impact sport athletes) will be studied at three time points (preseason, after a single season of play, and after multiple seasons of play) using a standardized cognitive battery and functional MRI (fMRI). A subgroup of students who sustain concussion, and matched controls from their team and from the non‑impact athlete group will also be studied within one week of the concussion. Impact parameters will be directly measured using helmet‑based accelerometer units. This proposal will help to determine the short and long term effects of repetitive biomechanical force exposure on the developing adolescent brain, provide important information on the biomechanics of sports‑related traumatic brain injury, and lead to more informed return‑to‑play guidelines.
Traumatic
Injury Biomechanics Research
Grantee
Abstracts
John Cavanaugh, MD
Wayne State University
818 West Hancock
Detroit, MI 48202
Phone: 313-577-3916
Fax: 313-577-8333
E-mail:
cavanau@rrb.eng.wayne.edu
Project Title: Neurophysiology of Whiplash Pain: Phase 1
Project Period: 9/30/01–9/29/04
Description: Whiplash-associated disorders are a major problem related to motor vehicle crashes, particularly those involving rear-end impact. The cervical facet joints, small synovial joints between the vertebrae, may be subject to excessive strain during whiplash. The aim of this study is to determine if the cervical facet joint capsules are a likely source of whiplash pain. The study investigates the distribution of nerve endings in human and goat cervical facet joint capsules and determines the amount of strain necessary to cause pain fibers to fire in cervical facet joint capsules of
the goat. Researchers use neurophysiology, immunocytochemistry, and biomechanical techniques.
Project Title: Neurophysiology of Whiplash Pain: Phase 2
Project Period: 8/1/04–7/31/07
Description: This project builds on previous studies, which
implicate the facet joints as perhaps the major source of pain after
whiplash. Researchers will use histological, neurophysiological, and
biomechanical techniques to determine if nociceptors (pain
receptors) in the cervical facet joints can be a source of whiplash
pain. The specific aims of this second-phase study are to determine
(1) the response of cervical facet nociceptors and mechanoreceptors
to low- versus high-rate loading; (2) the response of paraspinal
muscles to low-rate facet capsule stain; (3) the morphology of the
human cervical facet joint capsules, including the ventral aspect of
the joint and synovial folds; and (4) the distribution of nerves and
nerve endings in the human facet joint capsule, with focus on
anterior aspects and synovial folds. Immunocytochemistry will be
used to identify nerves containing substance P (SP) and calcitonin
gene-related peptide (CGRP), neuropeptides associated with pain, and
beta amyloid precursor protein (BAPP).
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Li-Shan Chou, PhD
University of Oregon
Department of Exercise & Movement Science
1240 University of Oregon
Eugene, OR 97403
Phone: 541-346-3391
Fax: 541-346-2841
E-mail:
chou@uoregon.edu
Project Title: Biomechanical and Sensory Motor Functions
After Concussion
Project Period: 09/30/03–09/29/06
Description: Approximately 5.3 million Americans, a little more than
2% of the U.S. population, currently live with disabilities from
traumatic brain injuries (TBI). Sports and physical activity provide
significant exposures to TBI, with some 300,000 sports-related
concussions or mild TBIs (MTBI) occurring each year in the United
States. It has been reported that motor functions may recover more
slowly than cognitive function or may not be closely related to
standard neuropsychological assessments. Also, approximately one
third of TBI patients complain of poor balance and poor
coordination.
The overall goal of this project is to longitudinally quantify
deficits in the maintenance of dynamic stability during locomotion
and in sensory motor functions of individuals following a concussion
and to establish recovery curves of these measurements from the time
of injury. Sixty college men and women participating in
intercollegiate, intramural, and club sport athletic activities at
the University of Oregon will be recruited (30 concussion subjects
and 30 controls). A biomechanical motion analysis will assess whole
body dynamic stability during walking with various terrain and
attention conditions, and a battery of sensory motor tests will
examine the ability of several selected sensory motor functions and
their contribution to the deficits during dynamic motor tasks.
Concussion subjects will be tested at four times post-injury: within
48 hours, after 5 days, after 14 days, and after 28 days. The same
number of testing times and durations will also be applied to
control subjects. The specific aims of this project follow:
- Develop a biomechanical measuring system to quantitatively evaluate the dynamic balance control of concussion patients during gait;
- Understand the association between the cognitive function of concussion patients and their abilities to negotiate obstacles and maintain sideways stability;
- Characterize how specific visual, oculomotor, and attentional functions contribute to deficits in dynamic balance control during gait of concussion patients;
- Establish recovery curves based on measures of dynamic stability, sensory motor control, and neuropsychological function, and investigate the functional relations among these measures. The knowledge gained from this research will provide an objective and quantitative measurement of the residual impairment on dynamic motor functions following a concussion, which may enhance the development of TBI assessment and rehabilitation programs.
Jeff Crandall, PhD
University of Virginia
Department of Mechanical and Aerospace Engineering
122 Engineers Way
P.O. Box 400746
Charlottesville, VA 22904-4746
Phone: 434-296-7288 ext. 131
Fax: 434-296-3453
E-mail: Jrc2h@virginia.edu
Project Title: Benefits of Rear-Facing Restraints for Older Children
Project Period: 8/1/04–7/31/07
Description: Current recommendations from the National Highway Traffic Safety Administration advise that children should switch from rear-facing (RFCR) to forward-facing child restraints (FFCR) when they reach 1 year of age and 20 pounds. Preliminary data from Scandinavian countries with an older transition age, however, show a marked benefit for rear-facing restraints for children up to 4 years old. This project will evaluate the discrepancy between U.S. policy and foreign field experience and, if justified, develop guidelines and recommendations for a revised U.S. policy on the transition from RFCR to FFCR.
This project involves three mutually supportive research approaches. First, U.S. field data will be used to assess injury risk and define the crash and injury experience of children restrained by RFCR and FFCR. This analysis will provide guidelines for the subsequent proposed tasks. Second, a series of full-scale sled tests will be used to compare and contrast RFCR and FFCR over a range of the most important test conditions. Finally, computational modeling will be used to expand the research matrix to include the range of restraint, crash, and occupant conditions that cannot be assessed experimentally. At each stage of this research plan, an external advisory panel will assess the findings and the direction of the research. Once the field, experimental, and computational data are collected, compiled, and evaluated, a formal policy recommendation regarding automobile restraint use for children age 1 to 3 will be developed and disseminated.
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This research should provide definitive data about the influence of
cerebral blood vessels and the pia-arachnoid complex on brain tissue
deformation and failure. If proven to be important, as anticipated,
the inclusion of these structures in a more clinically relevant
finite element model could lead to better injury protection systems
and pave the way for improved prevention and outcome of traumatic
brain injury.
Edith D. Gurewitsch, MD
The Johns Hopkins Hospital
Phipps 217
600 North Wolfe Street
Baltimore, MD 21287
Phone: 410-955-8297
Fax: 410-614-8305
E-mail:
egurewi@jhmi.edu
Project Title: Preventing Unintentional Mechanical Birth Injuries
Project Period: 8/1/04–7/31/07
Description: The objective of this project is to elucidate
mechanisms involved in mechanical birth injuries that occur
following an obstetric emergency known as shoulder dystocia and to
develop practical interventions to control or prevent such injuries,
some of which can lead to lifelong disability. Affecting up to 15%
of vaginal deliveries, shoulder dystocia is a naturally occurring
mechanical obstruction in which, after the head delivers, the fetal
shoulders become impacted behind the mother’s pubic bone and the
trunk cannot deliver without specific intervention by the clinician
who must act quickly to prevent asphyxia while simultaneously
avoiding undue stretch on the fetal neck. The latter can result in
skeletal fractures and brachial plexus nerve injury—unintended
outcomes of up to nearly 30% of shoulder dystocias. Standard
obstetric maneuvers used to resolve shoulder dystocia involve
manipulation of either the mother or the fetus. Although the
superiority of one maneuver over another has not been proven,
biomechanical considerations support the hypothesis that fetal
manipulation requires 20% to 30% less force to deliver the infant
than maternal manipulation and, if prioritized, could reduce the
incidence of injury. However, most clinicians are less familiar with
fetal maneuvers and defer their use in favor of repeating maternal
ones.
The goals of this research are to demonstrate the mechanical
advantage of fetal manipulation over maternal manipulation in
accomplishing atraumatic resolution of shoulder dystocia and to
familiarize clinicians with fetal maneuvers as a public health
measure to reduce and prevent neonatal injury. To achieve these
objectives, biomedical engineering will be integrated with clinical
obstetrics through five specific aims:
Geoffrey T. Manley, MD, PhD
University of California San Francisco
Department of Neurological Surgery
Neurosurgery Research Administration
2211 Post Street, Suite 404
San Francisco, CA 94143-1631
Phone: 415-206-4536
Fax: 415-2064466
E-mail:
manleyg@neurosurg.ucsf.edu
Project Title: Vascular Biomechanics in Traumatic Brain Injury
Project Period: 8/1/04–7/31/07
Description: Traumatic brain injury, a major cause of death and
disability, is frequently associated with the failure of cerebral
blood vessels. However, little is known about the biomechanics of
these vessels. The long-term goal of this research is to determine
the contribution of cerebral blood vessels to the mechanical
response of the brain and to develop more effective tools and
strategies for preventing traumatic brain injury. Recent work by
this group has defined the longitudinal mechanical properties of
human cerebral arteries and veins. A preliminary finite element
model incorporating these data suggests that the cerebral blood
vessels constrain brain deformations. The central hypothesis of this
project is that the cerebral blood vessels and the surrounding
pia-arachnoid complex significantly contribute to brain tissue
deformation and failure.
Three aims will test this hypothesis:
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Mark Grabiner, PhD
Dept. of Movement Sciences (MC994)
808 S Wood Street, 690 CME
Chicago, Il 60612
Email: grabiner@uic.edu
Project Title: Reducing Falls Using Task-Specific Training
Project Period: 9/30/05-9/29/08
Description: Fall-related injuries and deaths among older adults are a considerable societal problem and the present focus of this research. Trips account for up to and greater than 50 percent of fall-related hip and upper extremity fractures, respectively among older adults. This research uses a within- and between-subject experimental design to determine the effectiveness of task-specific training to decrease the incidence of trip-related falls.
Controlling the motion of the trunk is crucial for avoiding a fall after tripping. Researchers propose task-specific training that will involve stepping responses to avoid falling. They anticipate that increased skill level will be associated with significantly smaller trunk flexion angle and trunk flexion acceleration, thus lowering the incidence of falls. The global hypothesis is that fall incidence will be smaller in subjects who have participated in task-specific training compared to controls. To test this, 215 older women will be recruited over a three-year period to address two
specific aims and three primary hypotheses. In Specific Aim 1, the extent to which motor skill learning occurs will be characterized over a four-week period and the extent to which the motor skill is retained after training is withheld. The hypothesis is that increased skill level will be associated with significantly smaller trunk flexion angle and trunk flexion acceleration after the treadmill disturbance. Also, the hypothesis is that skill level will not degrade significantly after four weeks during which training is withheld. In Specific Aim 2, the extent to which the learned motor
skill reduces the incidence of falls after inducing forward-directed trip will be quantified. It is hypothesized that subjects who participated in the skill specific training protocol will have a significantly lower incidence of falls compared to the untrained control group.
Support of the hypotheses will provide evidence that task-specific exercise can contribute meaningfully and efficiently to fall prevention programs. It also provides a springboard for further study of graded, task-specific exercise as a component that can target older adults with a fear of falling, and those with physical impairments and disabilities.
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Roger Haut, PhD
Michigan State University
College of Osteopathic Medicine
A414 East Fee Hall
East Lansing, MI 48824 1316
Email: haut@msu.edu
Project Title: Addressing Injury to Cartilage by Forces Generated during Knee Ligament Trauma
Project Period: 9/30/05-9/29/08
Description: The knee is the most frequently treated joint by orthopedic surgeons. Those suffering from knee ligament injuries have a significantly increased risk of generating a long-term, chronic disease such as osteoarthritis (OA). Each year, 80,000 knees suffer acute tears of the anterior cruciate ligament (ACL) in the United States, with health care costs totaling nearly one billion dollars. Yet, surgically reconstructing a torn ACL has not proven to significantly reduce the incidence of OA. Occult microcracks are diagnosed via magnetic resonance imaging of the traumatized joint in
more than 80 percent of ACL trauma cases. Relatively few studies have investigated the long term consequences of the documented acute injury to cartilage overlying these occult microcracks.
For this study, researchers will propose that these occult microcracks result from excessive compressive overloading of the joint, which causes the ACL to rupture in the human cadaver model; that this level of acute mechanical trauma may cause gross surface lesions and damage to articular cartilage with associated death of tissue cells, which leads to joint OA in an animal model; and that early pharmacological intervention for the traumatized joint, repairing damaged cell membranes, will help delay or mitigate the development of a post-traumatic OA in the joint. The results of this
research can show that surgical reconstruction of ruptured knee ligaments, such as the ACL, can stabilize the traumatized joint and lead to a satisfactory long-term outcome.
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Beth Ann Winkelstein, PhD
University of Pennsylvania
3320 Smith Walk
Suite 120 Hayden Hall
Philadelphia, PA 19104
Email: winkelst@seas.upenn.edu
Project Title: Biomechanical Mechanisms of Facet-Mediated Whiplash Injury & Pain
Project Period: 8/30/05-8/29/08
Description: Whiplash and its associated syndromes continue to be ranked among the most common and debilitating nonfatal injuries. During whiplash, the neck’s fact joint can undergo subfailure mechanical injury, which due to its neurophysiologic anatomy, can generate pain from this extreme loading.
Researchers will define the mechanical conditions for dynamic facet joint loading that cause persistent pain symptoms and will develop guidelines for reducing the incidence of painful whiplash injuries in the general population. They will also guide modifications to the automobile and occupant use habits to reduce risk for such injuries. Researchers will integrate biomechanics, behavioral test instruments, and biochemical assays to link pain pathways with mechanical loading of the cervical fact joint. Investigators will apply controlled distraction(s) and compression(s) of the facet
joint and study the onset of a graded persistent pain response in a rat, using a new micromechanical device developed in this laboratory. This research will directly link the initial mechanical conditions of the facet joint to pain pathways in the central nervous system; define mechanical thresholds for painful facet injuries and investigate the biomechanical risk factors; recommend future design interventions and behavioral modifications to prevent these injuries; and guide the future development of neck pain prevention and treatment.
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Timothy Ovaert, PhD
University of Notre Dame
Aerospace and Mechanical Engineering
374 Fitzpatrick Hall
Notre Dame, IN 46556
Email: tovaert@nd.edu
Project Title: Computer Modeling and Etiological Investigation of Acute Injury Risk
Project Period: 8/01/05-7/31/06
Description: Acute injuries to the spine and other extremities are both a health risk and a major contributor to total health care costs in the U.S. To reduce the severity and cost of these injuries, researchers will study injury biomechanics through the development of advanced computer modeling and risk assessment-based etiological methods.
Researchers will develop computational models of spinal fusion to determine the relative importance of fusion mass, location, fusion mass size, bone density of the fusion, and trabecular bone density within the vertebral body on the load carrying capacity of a lumbar interbody fusion. They will also develop a damage-specific contrast agent with greater x-ray attenuation than bone, for micro-computed tomography (micro-CT) of microdamage. This project will include developing a nonlinear hybrid cellular automata approach for designing automotive structural topologies that are tailored for
energy-absorbing capability.
As a result of this study, diagnostic aids can be developed to evaluate interbody fusions, allowing clinicians to quantitatively assess the procedure and to set limits on physical activity to prevent spine re-injury for those with active lifestyles. Further, non-destructive techniques can be developed for detecting microdamage in bone that could eventually translate into new in vivo and clinical diagnostic techniques for fracture susceptibility, thus reducing the potential for injury among older adults.
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