Projects in paediatrics


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Projects

1.Patient-specific biomechanical modelling for improved treatment of spinal deformity.

Spinal deformities are debilitating and disfiguring conditions which strike the young and otherwise healthy, especially girls. In Australia there are over 50,000 adolescents with idiopathic scoliosis, a deformity for which neither cause nor cure has been discovered. Modern spinal implants apply targeted corrective forces, however excessive force can overload spinal joints and vertebrae leading to tissue damage, implant breakage and loss of correction after surgery. Predicting the limits of correction achievable in a particular patient requires biomechanical models of spinal tissues and implants. This project will develop new modelling techniques to optimise deformity correction and avoid implant- related complications.

Single anterior rod scoliosis correction

Finite element simulation of intraoperative curve correction

2. Combined finite/discrete element simulation for prediction of micro-crack formation in trabecular bone.
Trabecular bone plays an important load-bearing role in the spine. High loads or insertion of implants can damage trabecular bone, causing micro-cracking of individual trabeculae. Micro-crack formation is important since small cracks cannot be detected on medical images yet they play a key role in inducing either bone repair or resorption (bone loss). The Paediatric Spine Research group has recently applied a new technique (the combined finite/discrete element method) to successfully predict micro-cracking of trabeculae. This project will further develop the technique, leading to a powerful new technique for prediction of trabecular bone response to applied loads in the spine.

3. Investigating the effect of axial compression on vertebral rotation in spinal deformity patients.
Axial rotation of vertebrae is a defining feature of scoliotic spine deformity. Axial rotation of vertebrae causes deformation of the ribcage, manifest as a noticeable "rib hump". Aside from the undesirable cosmetic appearance, deformation of the ribcage can cause respiratory problems in severe cases. Correction of axial rotation and associated reduction in rib hump is a goal of spine deformity surgery, but this goal is rarely achieved, especially with single rod instrumentation which has limited ability to apply torsional corrective forces to the spine.
This study will investigate the relationship between axial compression and vertebral rotation in pre-operative spine deformity patients by applying an axial compressive force to subjects as they undergo magnetic resonance (MR) imaging. We hypothesize that axial compressive force significantly affects both the curvature and vertebral rotation of the spine and ribcage. This relationship has implications for both pre-operative medical imaging and surgical planning.