Development of a finite element model of the upper cervical spine and a parameter study of ligament characteristics

Study Design. Numeric techniques were used to study the upper cervical spine. Objectives. To develop and validate an anatomic detailed finite element model of the ligamentous upper cervical spine and to analyze the effect of material properties of the ligaments on spinal kinematics. Summary of Background Data. Cervical spinal injuries may be prevented with an increased knowledge of spinal behavior and injury mechanisms. The finite element method is tempting to use because stresses and strains in the different tissues can be studied during the course of loading. The authors know of no published results so far of validated finite element models that implement the complex geometry of the upper cervical spine. Methods. The finite element model was developed with anatomic detail from computed tomographic images of the occiput to the C3. The ligaments were modeled with nonlinear spring elements. The model was validated for axial rotation, flexion, extension, lateral bending, and tension for 1.5 Nm, 10 Nm, and 1500 N. A material property sensitivity study was conducted for the ligaments. Results. The model correlated with experimental data for all load cases. Moments of 1.5 Nm produced joint rotations of 3degrees to 23degrees depending on loading direction. The parameter study confirmed that the mechanical properties of the upper cervical ligaments play an important role in spinal kinematics. The capsular ligaments had the largest impact on spinal kinematics (40% change). Conclusions. The anatomic detailed finite element model of the upper cervical spine realistically simulates the complex kinematics of the craniocervical region. An injury that changes the material characteristics of any spinal ligament will influence the structural behavior of the upper cervical spine.