A three-dimensional finite element model of the cervical spine with spinal cord: an investigation of three injury mechanisms.

The spinal cord may be injured through various spinal column injury patterns (e.g., burst fracture, fracture dislocation); however, the relationship between column injury pattern and cord damage is not well understood. A three-dimensional finite element model of a human cervical spine and spinal cord segment was developed, verified using published experimental data, and used to investigate differences in cord strain distributions during various column injury patterns. For a transverse contusion injury, as would occur in a burst fracture, a 33% canal occlusion resulted in two peaks of strain between the indentor and opposing vertebral body and intermediate peak strain values. For a distraction injury, relevant to column distortion injuries, a 2.6 mm axial displacement to the cord resulted in more uniform strains throughout the cord and low peak strain values. For a dislocation injury, as would occur in a fracture dislocation, an anterior displacement of C5 corresponding to 30% of the sagittal dimension of the vertebral body resulted in high peak strain values adjacent to the shearing vertebrae and increased strains in the lateral columns compared to contusion. This model includes more anatomical details compared to previous studies and provides a baseline for mechanical comparisons in spinal cord injury.