Biomechanics of the thoracic spine and the influence of the chest.

胸腔被认为对人类胸椎的稳定性和灵活性有很大的影响。人们对这种影响的程度和不同结构的相关性知之甚少。因此，对于胸椎骨折、变形和退行性变的最佳治疗策略是模糊的。如果胸椎骨折没有得到充分稳定，可能会导致无法矫正。然而，目前尚不清楚在椎体骨折的情况下，需要稳定多少胸椎节段，并随后通过椎体置换植入物和椎弓根螺钉-棒系统的背侧内固定进行再稳定。本文还讨论了连环肋骨骨折的手术治疗。此外，脊柱侧凸手术中切除的肋骨和其他结构大多是凭经验选择的，这可能导致脊柱不稳定。这些不同的切除策略对胸椎稳定性的影响尚不清楚。胸椎标本的体外生物力学实验大多是在没有胸腔的情况下进行的，这导致了数据的不代表性和结果的难以解释。由于未知的胸腔生物力学特性，包括胸腔在内的有限元模型或多体模型具有严重的局限性。该项目扩展的目的是详细了解和量化胸椎和胸腔所有相关结构的生物力学和重要性。这是通过对有或没有胸腔的胸椎进行多次体外生物力学研究，实施多个切除步骤来完成的。利用生成的生物力学数据和相应解剖结构的形态学分析，将生成、校准和验证包括胸腔在内的人类胸椎的参数化有限元模型。随后，将在体外并使用生成的有限元模型进行初步调查，以回答临床相关问题。

The rib cage is assumed to have a strong influence on the stability and flexibility of the human thoracic spine. The magnitude of this influence and the relevance of the different structures are poorly understood. Therefore it is vague as to which is the best strategy for the treatment of fractures, deformations, and degenerations in the thoracic spine. If thoracic fractures are not stabilized sufficiently, the consequence may be loss of correction. However, it is not known how many segments of the thoracic spine are needed to be stabilized in case of vertebral body fractures and subsequent restabilisation by vertebral replacement implants and dorsal instrumentation using pedicle screw-rod systems. The operative treatment of serial rib fractures is also discussed. Moreover, the ribs and other structures resected during scoliosis surgery are mostly chosen empirically, potentially leading to instabilities of the spine. The influence of these different resection strategies on the stability of the thoracic spine is not understood well enough. Biomechanical in vitro experiments with thoracic spine specimens were mostly performed without the rib cage, which lead to unrepresentative data and difficulties interpreting the results. Finite element models or multi-body models including the rib cage have critical limitations due to the unknown biomechanical properties of the ribcage.The purpose of the extension of this project is to understand and quantify, in detail, the biomechanics and importance of all relevant structures of the thoracic spine and rib cage. This is accomplished by performing several biomechanical in vitro studies on thoracic spines with and without the rib cage, implementing multiple resection steps. Using this generated biomechanical data and morphological analyses of the corresponding anatomical structures, a parameterized finite element model of the human thoracic spine including the rib cage will be generated, calibrated, and validated. Subsequently preliminary investigations to answer clinically relevant questions will be performed in vitro and using the generated finite element model..