A cervical spine model to predict injury scenarios and clinical instability.

A complete and detailed three-dimensional finite element model of the human cervical spine (C1-C7), including soft and hard tissues, was created using a digitized geometric measurement tool. The model was validated against existing experimental studies in flexion, extension, lateral bending, and axial rotation. The aims of this study were to use the model to simulate the mechanisms of injury scenarios, such as diving and football accidents, and to correlate the external and internal responses of the spinal components to disc herniation and clinical instability. It was determined that a shear-generated flexion moment of about 10 Nm or a compression-flexion load of 450 N would generate significant stresses and strains in the discs, together with sufficient posterior-anterior displacement and rotational angulation of the vertebrae, to place the mid and lower cervical spine at risk of clinical instability or disc herniation. The results revealed that the location of the maximum stresses in the discs could not be directly correlated with the type of loads. In addition, for the loadings considered, the maximum displacement of the spine could be reduced by as much as 50% when the restraint of the cervical spine is changed from a C7-T1 to C7-T1 and C1-C2 fixed conditions.