Computational Biomechanical Modeling of Scoliotic Spine: Challenges and Opportunities.

Abstract

Biomechanical computer models of the spine have important roles in the treatment and correction of scoliosis by providing predictive information for surgeons and other clinicians. This article reviews computational models of intact and scoliotic spine and its components; vertebra, intervertebral disc, ligament, facet joints, and muscle. Several spine models, developed using multi-body modelling and finite element modelling schemes, and their pros and cons are discussed. The review reveals that scoliosis modelling is performed for 3 main applications: 1) brace simulation; 2) analysis of surgical correction technique; and 3) patient positioning before surgical instrumentation. The models provide predictive information for a priori choice of brace configurations and mechanically effective surgical correction techniques and the expected degree of correction. However, they have many shortcomings: for instance, they do not fully reproduce the active behaviour of the spine and the models' properties are not personalized.