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

肋骨笼被认为对人类胸椎的稳定性和灵活性有很大的影响。人们对这种影响的大小和不同结构的相关性知之甚少。因此，对于胸椎骨折、畸形和退变的治疗，哪一种策略是最好的策略是模糊的。如果胸部骨折没有得到足够的稳定，结果可能是失去矫正。然而，尚不清楚在椎体骨折的情况下需要稳定多少胸椎节段，以及随后通过椎体置换植入物和使用椎弓根螺钉-棒系统的背部内固定重新稳定胸椎。并对连续肋骨骨折的手术治疗进行了讨论。此外，在脊柱侧弯手术中切除的肋骨和其他结构大多是凭经验选择的，这可能会导致脊柱不稳定。这些不同的切除策略对胸椎稳定性的影响还不是很清楚。胸椎标本的体外生物力学实验大多是在没有肋骨的情况下进行的，这导致数据不具代表性，难以解释结果。由于肋骨的生物力学性质未知，有限元模型或包括肋骨在内的多体模型具有严重的局限性。本项目扩展的目的是详细了解和量化胸椎和肋间所有相关结构的生物力学和重要性。这是通过对带和不带肋骨的胸椎进行几项生物力学体外研究，实施多个切除步骤来实现的。利用生成的生物力学数据和相应解剖结构的形态分析，将生成、校准和验证包括肋骨在内的人体胸椎的参数化有限元模型。随后，将在体外进行初步研究，以回答临床相关问题，并使用生成的有限元模型。

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..