Injury, instrumentation, or surgery may change the functional biomechanics of the spine. Spinal fusion, the current surgical treatment of choice, stabilizes the spine by rigid fixation, reducing spinal mobility at the cost of increased stress at adjacent levels. Recently, alternatives to spinal fusion have been investigated. One such alternative is total disc replacements. The current generation of total disc replacements (TDRs) focuses on restoring the quantity of motion. Recent studies indicate that the moment-rotation response and axis of rotation, or quality of motion (QOM), may have important implications in the health of adjacent segments as well as the health of the surrounding tissue of the operative level. This dissertation examines the use of compliant mechanism design theory in the design and analysis of spinal arthroplasty devices. Particularly, compliant mechanism design techniques were used to develop a total disc replacement capable of replicating the normal moment-rotation response and location and path of the helical axis of motion. Closed-form solutions for the device's performance are proposed and a physical prototype was created and evaluated under a modified F1717 and a single-level cadaveric experiment. The results show that the prototype's QOMclosely matched the selected force-deflection response of the specified QOM profile. The use of pseudo-rigid-body modeling to evaluate the effects of various changes on motion at adjacent segments is also investigated. The ability to model biomechanical changes in the spine has traditionally been based on animal models, in vitro testing, and finite element analysis. These techniques, although effective, are costly. As a result, their use is often limited to late in the design process. The pseudo-rigid-body model (PRBM) developed accurately predicted the moment-rotation response of the entire specimen and the relative contribution of each level. Additionally, the PRBM was able to predict changes in relative motion patterns of the specimen due to instrumentation.
| Identifer | oai:union.ndltd.org:BGMYU2/oai:scholarsarchive.byu.edu:etd-3167 |
| Date | 08 July 2010 |
| Creators | Halverson, Peter Andrew |
| Publisher | BYU ScholarsArchive |
| Source Sets | Brigham Young University |
| Detected Language | English |
| Type | text |
| Format | application/pdf |
| Source | Theses and Dissertations |
| Rights | http://lib.byu.edu/about/copyright/ |
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