Expanded Combined Loading Injury Criterion for the Human Lumbar Spine Under Dynamic Compression.

Contemporary injury tolerance of the lumbar spine for under-body blast references axial compression and bending moments in a limited range. Since injuries often occur in a wider range of flexion and extension with increased moment contribution, this study expands a previously proposed combined loading injury criterion for the lumbar spine. Fifteen cadaveric lumbar spine failure tests with greater magnitudes of eccentric loading were incorporated into an existing injury criterion to augment its applicability and a combined loading injury risk model was proposed by means of survival analysis. A loglogistic distribution was the most representative of injury risk, resulting in optimized critical values of Fr,crit = 6011 N, and My,crit = 904 Nm for the proposed combined loading metric. The 50% probability of injury resulted in a combined loading metric value of 1, with 0.59 and 1.7 corresponding to 5 and 95% injury risk, respectively. The inclusion of eccentric loaded specimens resulted in an increased contribution of the bending moment relative to the previously investigated flexion/extension range (previous My,crit = 1155 Nm), with the contribution of the resultant sagittal force reduced by nearly 200 N (previous Fr,crit = 5824 N). The new critical values reflect an expanded flexion/extension range of applicability of the previously proposed combined loading injury criterion for the human lumbar spine during dynamic compression.

Cyclic Mechanism Affects Lumbar Spine Creep Response.

PURPOSE: This study aims to explore how cyclic loading influences creep response in the lumbar spine under combined flexion-compression loading. METHODS: Ten porcine functional spinal units (FSUs) were mechanically tested in cyclic or static combined flexion-compression loading. Creep response between loading regimes was compared using strain-time histories and linear regression. High-resolution computed tomography (µCT) visualized damage to FSUs. Statistical methods, ANCOVA and ANOVA, assessed differences in behavior between loading regimes. RESULTS: Cyclic and static loading regimes exhibited distinct creep response patterns and biphasic response. ANCOVA and ANOVA analyses revealed significant differences in slopes of creep behavior in both linear phases. Cyclic tests consistently showed endplate fractures in µCT imaging. CONCLUSION: The study reveals statistically significant differences in creep response between cyclic and static loading regimes in porcine lumbar spinal units under combined flexion-compression loading. The observed biphasic behavior suggests distinct phases of tissue response, indicating potential shifts in load transfer mechanisms. Endplate fractures in cyclic tests suggest increased injury risk compared to static loading. These findings underscore the importance of considering loading conditions in computational models and designing preventive measures for occupations involving repetitive spinal loading.

Accuracy of Instrumented Mouthguards During Direct Jaw Impacts Seen in Boxing.

PURPOSE: Measuring head kinematics data is important to understand and develop methods and standards to mitigate head injuries in contact sports. Instrumented mouthguards (iMGs) have been developed to address coupling issues with previous sensors. Although validated with anthropomorphic test devices (ATDs), there is limited post-mortem human subjects (PMHS) data which provides more accurate soft tissue responses. This study evaluated two iMGs (Prevent Biometrics (PRE) and Diversified Technical Systems (DTS) in response to direct jaw impacts. METHODS: Three unembalmed male cadaver heads were properly fitted with two different boil-and-bite iMGs and impacted with hook (4 m/s) and uppercut (3 m/s) punches. A reference sensor (REF) was rigidly attached to the base of the skull, impact kinematics were transformed to the head center of gravity and linear and angular kinematic data were compared to the iMGs including Peak Linear Acceleration, Peak Angular Acceleration, Peak Angular Velocity, Head Injury Criterion (HIC), HIC duration, and Brain Injury Criterion. RESULTS: Compared to the REF sensor, the PRE iMG underpredicted most of the kinematic data with slopes of the validation regression line between 0.72 and 1.04 and the DTS overpredicted all the kinematic data with slopes of the regression line between 1.4 and 8.7. CONCLUSION: While the PRE iMG was closer to the REF sensor compared to the DTS iMG, the results did not support the previous findings reported with use of ATDs. Hence, our study highlights the benefits of using PMHS for validating the accuracy of iMGs since they closely mimic the human body compared to any ATD's mandible.

Biofidelity and Limitations of Instrumented Mouthguard Systems for Assessment of Rigid Body Head Kinematics.

Instrumented mouthguard systems (iMGs) are commonly used to study rigid body head kinematics across a variety of athletic environments. Previous work has found good fidelity for iMGs rigidly fixed to anthropomorphic test device (ATD) headforms when compared to reference systems, but few validation studies have focused on iMG performance in human cadaver heads. Here, we examine the performance of two boil-and-bite style iMGs in helmeted cadaver heads. Three unembalmed human cadaver heads were fitted with two instrumented boil-and-bite mouthguards [Prevent Biometrics and Diversified Technical Systems (DTS)] per manufacturer instructions. Reference sensors were rigidly fixed to each specimen. Specimens were fitted with a Riddell SpeedFlex American football helmet and impacted with a rigid impactor at three velocities and locations. All impact kinematics were compared at the head center of gravity. The Prevent iMG performed comparably to the reference system up to ~ 60 g in linear acceleration, but overall had poor correlation (CCC = 0.39). Prevent iMG angular velocity and BrIC generally well correlated with the reference, while underestimating HIC and overestimating HIC duration. The DTS iMG consistently overestimated the reference across all measures, with linear acceleration error ranging from 10 to 66%, and angular acceleration errors greater than 300%. Neither iMG demonstrated consistent agreement with the reference system. While iMG validation efforts have utilized ATD testing, this study highlights the need for cadaver testing and validation of devices intended for use in-vivo, particularly when considering realistic (non-idealized) sensor-skull coupling, when accounting for interactions with the mandible and when subject-specific anatomy may affect device performance.

Human and Porcine Lumbar Endplate Injury Risk in Repeated Flexion-Compression.

Low back pain (LBP) affects 50-80% of adults at some point in their lifetime, yet the etiology of injury is not well understood. Those exposed to repeated flexion-compression are at a higher risk for LBP, such as helicopter pilots and motor vehicle operators. Animal injury models offer insight into in vivo injury mechanisms, but interspecies scaling is needed to relate animal results to human. Human (n = 16) and porcine (n = 20) lumbar functional spinal units (FSUs) were loaded in repeated flexion-compression (1 Hz) to determine endplate fracture risk over long loading exposures. Flexion oscillated from 0 to 6° and peak applied compressive stress ranged from 0.65 to 2.38 MPa for human and 0.64 to 4.68 MPa for porcine specimens. Five human and twelve porcine injuries were observed. The confidence intervals for human and porcine 50% injury risk curves in terms of stress and cycles overlapped, indicating similar failure behavior for this loading configuration. However, porcine specimens were more tolerant to the applied loading compared to human, demonstrated by a longer time-to-failure for the same applied stress. Optimization revealed that time-to-failure in human specimens was approximately 25% that of porcine specimens at a given applied stress within 0.65-2.38 MPa. This study determined human and porcine lumbar endplate fracture risks in long-duration repeated flexion-compression that can be directly used for future equipment and vehicle design, injury prediction models, and safety standards. The interspecies scale factor produced in this study can be used for previous and future porcine lumbar injury studies to scale results to relevant human injury.

Translating Cadaveric Injury Risk to Dummy Injury Risk at Iso-energy.

Injury risk assessment based on cadaver data is essential for informing safety standards. The common 'matched-pair' method matches energy-based inputs to translate human response to anthropometric test devices (ATDs). However, this method can result in less conservative human injury risk curves due to intrinsic differences between human and ATDs. Generally, dummies are stiffer than cadavers, so force and displacement cannot be matched simultaneously. Differences in fracture tolerance further influence the dummy risk curve to be less conservative under matched-pair. For example, translating a human lumbar injury risk curve to a dummy of equivalent stiffness using matched-pair resulted in a dummy injury risk over 80% greater than the cadaver at 50% fracture risk. This inevitable increase arises because the dummy continues loading without fracture to attenuate energy beyond the 'matched' cadaver input selected. Human injury response should be translated using an iso-energy approach, as strain energy is well associated with failure in biological tissues. Until cadaver failure, dummy force is related to cadaver force at iso-energy. Beyond cadaver failure, dummy force is related to cadaver force through failure energy. This method does not require perfect cadaver/dummy biofidelity and ensures that energy beyond cadaver failure does not influence the injury risk function.

The Human Lumbar Spine During High-Rate Under Seat Loading: A Combined Metric Injury Criteria.

Modern changes in warfare have shown an increased incidence of lumbar spine injuries caused by underbody blast events. The susceptibility of the lumbar spine during these scenarios could be exacerbated by coupled moments that act with the rapid compressive force depending on the occupant's seated posture. In this study, a combined loading lumbar spine vertebral body fracture injury criteria (Lic) across a range of postures was established from 75 tests performed on instrumented cadaveric lumbar spine specimens. The spines were predominantly exposed to axial compressive forces from an upward vertical thrust with 64 of the tests resulting in at least one vertebral body fracture and 11 in no vertebral body injury. The proposed Lic utilizes a recommended metric (κ), based on prismatic beam failure theory, resulting from the combination of the T12-L1 resultant sagittal force and the decorrelated bending moment with optimized critical values of Fr,crit = 5824 N and My,crit = 1155 Nm. The 50% risk of lumbar spine injury corresponded to a combined metric of 1, with the risk decreasing with the combined metric value. At 50% injury risk the Normalized Confidence Interval Size improved from 0.24 of a force-based injury reference curve to 0.17 for the combined loading metric.

Time and temperature sensitivity of the hybrid III lumbar spine.

OBJECTIVE: Researchers have found a variety of uses for the Hybrid III (HIII) dummy that fall beyond the scope of its original purpose as an automotive crash test dummy. Some of these expanded roles for the HIII introduce situations that were not envisioned in the dummy's original design parameters, such as a relatively rapid succession of tests or outdoor testing scenarios where temperature is not easily controlled. This study investigates how the axial compressive stiffness of the HIII lumbar spine component is affected by the duration of the time interval between tests. Further, it measures the effect of temperature on the compressive stiffness of the lumbar spine through a range of temperatures relevant to indoor and outdoor testing. METHODS: High-rate axial compression tests were run on a 50th percentile male HIII lumbar component in a materials testing machine. To characterize the effects of tests recovery intervals, between-test recovery was varied from 2 hours to 1 minute. To quantify temperature effects, environmental temperature conditions of 12.5°, 25°, and 37.5 °C were tested. RESULTS: During repeated compressive loading, the force levels decreased consistently across long and short rest intervals. Even after 2 hours of rest between tests, full viscoelastic recovery was not observed. Temperature effects were pronounced, resulting in compressive force differences of 261% over the range of 12.5° to 37.5 °C. Compared to the stiffness of the lumbar at 25 °C, the stiffness at 37.5 °C fell by 40%; at 12.5 °C, the stiffness more than doubled, increasing by 115%. CONCLUSIONS: A modest decrease in temperature can be sufficient to dramatically change the response and repeatability of the lumbar HIII component in compressive loading. The large magnitude of the temperature effect has severe implications in its ability to overwhelm the contributions of targeted test variables. These findings highlight the importance of controlling, monitoring and reporting temperature conditions during HIII testing, even in indoor laboratory environments.

Acoustic emissions in vertebral cortical shell failure.

Understanding the initiation of bony failure is critical in assessing the progression of bone fracture and in developing injury criteria. Detection of acoustic emissions in bone can be used to identify fractures more sensitively and at an earlier inception time compared to traditional methods. However, high rate loading conditions, complex specimen-device interaction or geometry may cause other acoustic signals. Therefore, characterization of the isolated local acoustic emission response from cortical bone fracture is essential to distinguish its characteristics from other potential acoustic sources. This work develops a technique to use acoustic emission signals to determine when cortical bone failure occurs by characterization using both a Welch power spectral density estimate and a continuous wavelet transform. Isolated cortical shell specimens from thoracic vertebral bodies with attached acoustic sensors were subjected to quasistatic loading until failure. The resulting acoustic emissions had a wideband frequency response with peaks from 20 to 900 kHz, with the spectral peaks clustered in three bands of frequencies (166 ± 52.6 kHz, 379 ± 37.2 kHz, and 668 ± 63.4 kHz). Using these frequency bands, acoustic emissions can be used as a monitoring tool in biomechanical spine testing, distinguishing bone failure from structural response. This work presents a necessary set of techniques for effectively utilizing acoustic emissions to determine the onset of cortical bone fracture in biological material testing. Acoustic signatures can be developed for other cortical bone regions of interest using the presented methods.

Time and temperature sensitivity of the Hybrid III neck.

The Hybrid III (HIII) dummy is one of the most widely used anthropomorphic test devices (ATDs) in the world, and researchers have found a variety of uses for it outside of its original purpose as an automotive crash test dummy. These expanded roles have introduced situations outside the dummy's original design parameters, where a number of tests must be run in relatively rapid succession or where it may not be possible to control the temperature of the test environment. OBJECTIVE: This study has 2 aims. The first is to determine how the duration of the time interval between tests affects the axial compression performance of the HIII neck. The second is to quantify the effect of temperature on the neck's compressive stiffness through a range of temperatures relevant to indoor or outdoor testing. METHODS: To characterize the effects of different test conditions, a series of high-rate axial compressive tests was run on a 50th percentile male HIII neck component in a materials testing machine. Between-test recovery intervals were varied from 2 h to 1 min, and temperature conditions of 0, 12.5, 25, and 37.5 °C were tested. RESULTS: Though the duration of the recovery interval had little impact on the recorded force (less than 1%), the component did exhibit considerable strain creep over the course of the test. Temperature had a strong influence on the compressive stiffness of the component. Compared to the stiffness at 25 °C (near room temperature), the stiffness of the neck at 37.5 °C fell by 15%; at 0 °C, the stiffness more than doubled. CONCLUSIONS: This study demonstrates that though the duration of the recovery interval between tests has a small influence on neck stiffness, temperature effects should not be overlooked because they influence neck compressive stiffness considerably. The relationship between recorded force and temperature is well represented by exponential decay models. These findings highlight the importance of monitoring and controlling for temperature effects during all HIII testing.