A survey on static and quasi-static finite element models of the human cervical spine

Abstract

Finite element analyses are an important source of information on the biomechanical behaviour of the cervical spine; as well as an important tool in the design and evaluation of spinal instrumentation. This article presents a comprehensive survey of the finite element models of the cervical spine that have been used to study its pathological/nonpathological biomechanics under static/quasi-static loading conditions. Publications that met the inclusion criteria were analysed to extract parameters relative to model identification (e.g., spine segment, population, utility, limitations), model structure (e.g., loading/boundary conditions, anatomical structures, constitutive representation), simulation structure (e.g., software), verification (e.g., convergence) and validation (e.g., validated procedure/output, assumptions). Besides summarizing different modelling approaches with their associated parameters, this article outlines generalities and issues related to the obtainment of such models. The survey shows that authors often fail to report parameters that are critical for the reproducibility of results and that, even with fully reported parameters, these models are inherently difficult to replicate because they generally are patient-specific with their geometry based on data from in-house specimens/subjects. Overall, while the survey contributes to an understanding of the implications of following different modelling approaches and allows to take advantage of previously developed models, further research is required to improve the accuracy and utility of these models.