GTR 7 Informal Working Group December 5, 2011 Geneva Preliminary PMHS Injury Risk Curves & Potential IARVs in Rear Impact ____________________________.

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Presentation transcript:

GTR 7 Informal Working Group December 5, 2011 Geneva Preliminary PMHS Injury Risk Curves & Potential IARVs in Rear Impact ____________________________ Preliminary PMHS Injury Risk Curves & Potential IARVs in Rear Impact ____________________________ Kevin Moorhouse, Ph.D. NHTSA Yun-Seok Kang, Ph.D. Ohio State University Kevin Moorhouse, Ph.D. NHTSA Yun-Seok Kang, Ph.D. Ohio State University

Rear Impact Research Objectives Evaluate biofidelity of available RIDs (BioRID, RID3D, HyIII) Choose biofidelity test condition Develop experimental seat for rear impact sled testing Conduct sled tests PMHS (Post-Mortem Human Subjects) Dummies (BioRID II, RID3D, Hybrid III) Assess biofidelity and repeatability of dummies Investigate the mechanism of injury Develop and validate 3-D cervical spine kinematic instrumentation Identify injurious kinematics Choose appropriate injury criterion Assess efficacy of various ICs Evaluate biofidelity of available RIDs (BioRID, RID3D, HyIII) Choose biofidelity test condition Develop experimental seat for rear impact sled testing Conduct sled tests PMHS (Post-Mortem Human Subjects) Dummies (BioRID II, RID3D, Hybrid III) Assess biofidelity and repeatability of dummies Investigate the mechanism of injury Develop and validate 3-D cervical spine kinematic instrumentation Identify injurious kinematics Choose appropriate injury criterion Assess efficacy of various ICs

Rear Impact Injury Mechanism

Documentation of Injuries

C7/T1 C3/C4 C4/C5 C7/T1 Injury Examples (Post-test CT)

C1 C2 C3 C4 C5 C6 C7 T1 C7 T1 C6 C5 C2 anterior longitudinal ligament ligamentum flavum facet joint capsule interspinous ligament C4 C3 : disc rupture : subluxation : laceration (tear) PMHS03 PMHS04 PMHS05 PMHS06 PMHS07 PMHS08 Documentation of Injuries

PMHS#1#2#3#4#5#6#7#8 C2/C3 No injury Subluxation FJ (AIS3) No injury C3/C4 No injury Subluxation FJ (AIS3) No injury Subluxation FJ (AIS3) and ligametum flavum (AIS1) No injury C4/C5 No injury Subluxation FJ (AIS3) No injury Subluxation FJ (AIS3) and ligametum flavum/interspinous lig(AIS1) No injury C5/C6 No injury Subluxation FJ (AIS3) and ligametum flavum/interspinous lig(AIS1) Facet joint capsule tear on right side/ degeneration disc-mild subluxation (AIS1) No injury C6/C7 No injury Subluxation ligamentum flavum (AIS1) & interspinous lig (AIS1) Interspinous lig (AIS1) No injury Anterior longitudinal lig tear (posterior intact), Severe FJ on both sides, ligamentum flavum tear, Disc injury w ruptured (AIS3), Interspinous lig tear (AIS1) Seperation of degenerative disc, ligamentum flavum right side close to spinous process, facet joint capsule tear on the right side (AIS1) C7/T1 No injury Anterior longitudinal lig. tear (posterior intact), FJ capsule tear on both sides, ligamentum flavum tear on left side, Disc rupture w fracture (AIS3), Interspinous lig. tear (AIS1) Seperation of degenerative disc No injury Documentation of Injuries

Injury Criteria Analysis

Injury Analysis Injury Risk Curves – Intervertebral Kinematics C1 C2 C3 C4 C5 C6 C7 T1 intervertebral levels Intervertebral kinematics Injury Risk Curves C2/C3 – C6/C7: 5 levels C2/C3 – C6/C7: 5 levels 5 data points per test 5 data points per test Two speeds Two speeds n ~ 10 per subject n ~ 10 per subject

Injury Analysis Injury Risk Curves – Intervertebral Kinematics Peudo R 2 > 0.2, Nagelkerke R 2 > 0.4, P-value 0.6 Best correlation and prediction Intervertebral kinematicsPseudo R 2 Nagelkerke R 2 Log-LikelihoodP-value Goodman-Kruskal Gamma Acceleration x (+) (-) Max Acceleration z (+) (-) Max Velocity x (+) (-) Max Velocity z (+) (-) Max Angular velocity y (+) (-) Max Displacement xMax Displacement zMax Rotation yMax (+) : positive peak, (-): negative peak, Max: maximum peak

Injury Analysis Injury Risk Curves – Intervertebral Kinematics Peudo R 2 > 0.2, Nagelkerke R 2 > 0.4, P-value 0.6 Best correlation and prediction Intervertebral kinematicsPseudo R 2 Nagelkerke R 2 Log-LikelihoodP-value Goodman-Kruskal Gamma Acceleration x (+) (-) Max Acceleration z (+) (-) Max Velocity x (+) (-) Max Velocity z (+) (-) Max Angular velocity y (+) (-) Max Displacement xMax Displacement zMax Rotation yMax Facet JT SlideMax Facet JT Slide RateMax Facet JT AxialMax Facet JT Axial RateMax (+) : positive peak, (-): negative peak, Max: maximum peak

Injury Analysis Injury Risk Curves – Intervertebral Kinematics Peudo R 2 > 0.2, Nagelkerke R 2 > 0.4, P-value 0.6 Best correlation and prediction Intervertebral kinematics Pseudo R 2 Nagelkerke R 2 Log- Likelihood P-value Goodman- Kruskal Gamma Rotation yMax Angular velocity y (+) Facet JT Slide Max (+) : positive peak, (-): negative peak, Max: maximum peak

Injury Analysis Injury Risk Curves – Intervertebral Kinematics Facet Slide Intervertebral Angular Velocity Intervertebral Rotation Each intervertebral level may have different threshold Each intervertebral level may have different threshold Normalization using physiological range of motion Normalization using physiological range of motion IV-NIC [Panjabi et al., 1999] IV-NIC [Panjabi et al., 1999]

IV-NIC (Rotation) PMHS03PMHS04PMHS05PMHS06PMHS07PMHS08 LowModerateLowModerateLowModerateLowModerateLowModerateLowModerate C2/C ** C3/C ** C4/C C5/C C6/C C7/T Qualitative Correlation - IV-NIC and Injuries Qualitative Correlation - IV-NIC and Injuries

Qualitative Correlation - IV-NIC and Injuries Qualitative Correlation - IV-NIC and Injuries Injury Documentation PMHS03PMHS04PMHS05PMHS06PMHS07PMHS08 C2/C3 No injury Subluxation FJ (AIS3)No injury C3/C4 Subluxation FJ (AIS3) No injury Subluxation FJ (AIS3) and ligametum flavum No injury C4/C5 Subluxation FJ (AIS3) No injury Subluxation FJ (AIS3) and ligametum flavum/interspinous lig. No injury C5/C6 No injury Subluxation FJ (AIS3) and ligametum flavum/interspinous lig. Facet joint capsule tear on right side/ degeneration disc- mild subluxation No injury C6/C7 No injury Subluxation ligamentum flavum & interspinous lig. Interspinous ligNo injury Anterior longitudinal lig. tear (posterior intact), Severe FJ on both sides, ligamentum flavum tear, Disc injury w ruptured (AIS3), Interspinous lig. tear (AIS1) Seperation of degenerative disc, ligamentum flavum right side close to spinous process, facet joint capsule tear on the right side C7/T1 Anterior longitudinal lig. tear (posterior intact), FJ capsule tear on both sides, ligamentum flavum tear on left side, Disc injury w ruptured (AIS3), Interspinous lig. tear (AIS1) Seperation of degenerative disc No injury

IV-NIC (Rotation) PMHS03PMHS04PMHS05PMHS06PMHS07PMHS08 LowModerateLowModerateLowModerateLowModerateLowModerateLowModerate C2/C ** C3/C ** C4/C C5/C C6/C C7/T Qualitative Correlation - IV-NIC and Injuries Qualitative Correlation - IV-NIC and Injuries

Qualitative Correlation - IV-NIC and Injuries Qualitative Correlation - IV-NIC and Injuries Injury Documentation PMHS03PMHS04PMHS05PMHS06PMHS07PMHS08 C2/C3 No injury Subluxation FJ (AIS3)No injury C3/C4 Subluxation FJ (AIS3) No injury Subluxation FJ (AIS3) and ligametum flavum No injury C4/C5 Subluxation FJ (AIS3) No injury Subluxation FJ (AIS3) and ligametum flavum/interspinous lig. No injury C5/C6 No injury Subluxation FJ (AIS3) and ligametum flavum/interspinous lig. Facet joint capsule tear on right side/ degeneration disc- mild subluxation No injury C6/C7 No injury Subluxation ligamentum flavum & interspinous lig. Interspinous ligNo injury Anterior longitudinal lig. tear (posterior intact), Severe FJ on both sides, ligamentum flavum tear, Disc injury w ruptured (AIS3), Interspinous lig. tear (AIS1) Seperation of degenerative disc, ligamentum flavum right side close to spinous process, facet joint capsule tear on the right side C7/T1 Anterior longitudinal lig. tear (posterior intact), FJ capsule tear on both sides, ligamentum flavum tear on left side, Disc injury w ruptured (AIS3), Interspinous lig. tear (AIS1) Seperation of degenerative disc No injury

Injury Analysis Injury Risk Curves – IV-NIC parameters Peudo R 2 > 0.2, Nagelkerke R 2 > 0.4, P-value 0.6 Best correlation and prediction Intervertebral kinematicsPseudo R 2 Nagelkerke R 2 Log-LikelihoodP-value Goodman- Kruskal Gamma IV-NICs (slide)Max IV-NICs rateMax IV-NICs productMax IV-NICa (axial)Max IV-NICa rateMax IV-NICa productMax IV-NICuMax IV-NICu rateMax IV-NICu productMax (+) : positive peak, (-): negative peak, Max: maximum peak

Injury Analysis Injury Risk Curves – IV-NIC parameters Each intervertebral level was normalized by physiological range of motions Each intervertebral level was normalized by physiological range of motions IV-NICu : best correlation to injuries IV-NICu : best correlation to injuries IV-NICu product: also shows correlation IV-NICu product: also shows correlation 50 % chance of AIS 1+ injuries 50 % chance of AIS 1+ injuries IV-NICu : 1.12 IV-NICu : 1.12 IV-NICu product : IV-NICu product :

Current/Potential Injury Criteria Correlation between IV-NIC values and existing injury criteria Correlation? Yes NDC, Nij Head-to-T1 Rotation Upper/Lower Fx, Fz, My T1G Rebound V Any physical parameters Potential PMHS IARVs

Current/Potential Injury Criteria x z x z RelativeOC-to-T1 velocity 1 IV-NIC and IV-NIC product Correlation? Occipital Condyle (OC) 1 st thoracic vertebra (T1)

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria IV-NICuIV-NICu product R - valueP - valueR - valueP - value NIC Nte Ntf Nce Ncf Nae Naf Npe Npf LNL NDCx NDCx rate NDCx product NDCz NDCz rate NDCz product NDCr NDCr rate NDCr product Nij Nkm NDC

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NDCr

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria IV-NICuIV-NICu product R - valueP - valueR - valueP - value NIC Nte Ntf Nce Ncf Nae Naf Npe Npf LNL NDCx NDCx rate NDCx product NDCz NDCz rate NDCz product NDCr NDCr rate NDCr product Nij Nkm NDC

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NDCr

Injury Analysis Summary Best injury predictor IV-NIC Rotation more correlated than displacements IV-NIC product Current Injury Criteria NIC, NDC NDCr more correlated than NDCx or NDCz Potential Injury Criteria NDCr rate and product; NDCx rate and product Best injury predictor IV-NIC Rotation more correlated than displacements IV-NIC product Current Injury Criteria NIC, NDC NDCr more correlated than NDCx or NDCz Potential Injury Criteria NDCr rate and product; NDCx rate and product

Injury Criteria Analysis Plan PMHS and BioRID II in identical test conditions Scaling technique for IARV(s) Transfer function for IARV(s)

Injury Criteria Analysis Plan Plan for next meeting Calculate intervertebral strain and strain rate Develop corresponding injury risk curves Detailed discussion and collaboration with Japan Develop most appropriate IARVs for PMHS Develop most appropriate IARVs for BioRID II Plan for next meeting Calculate intervertebral strain and strain rate Develop corresponding injury risk curves Detailed discussion and collaboration with Japan Develop most appropriate IARVs for PMHS Develop most appropriate IARVs for BioRID II

Thanks for your attention Questions?

FBD for Lower Neck Loads

Intervertebral facet sliding rate (maximum peak) Additional Injury Risk Curves

Intervertebral facet axial rate (maximum peak) Additional Injury Risk Curves

Intervertebral acceleration (positive peak x) Additional Injury Risk Curves

Intervertebral acceleration (negative peak x) Additional Injury Risk Curves

Intervertebral acceleration (maximum peak x) Additional Injury Risk Curves

Intervertebral acceleration (positive peak z) Additional Injury Risk Curves

Intervertebral acceleration (negative peak z) Additional Injury Risk Curves

Intervertebral acceleration (maximum peak z) Additional Injury Risk Curves

Intervertebral velocity (positive peak x) Additional Injury Risk Curves

Intervertebral velocity (negative peak x) Additional Injury Risk Curves

Intervertebral velocity (maximum peak x) Additional Injury Risk Curves

Intervertebral velocity (positive peak z) Additional Injury Risk Curves

Intervertebral velocity (negative peak z) Additional Injury Risk Curves

Intervertebral velocity (maximum peak z) Additional Injury Risk Curves

Intervertebral angular velocity (positive peak y) Additional Injury Risk Curves

Intervertebral angular velocity (negative peak y) Additional Injury Risk Curves

Intervertebral angular velocity (maximum peak y) Additional Injury Risk Curves

Detailed cervical model Sagittal View from CT PMHS01 PMHS04 PMHS05 PMHS07 PMHS08 Cervical Kinematics (detailed geometry)

Detailed cervical model able to calculate strain and strain rate between vertebrae Detailed cervical model able to calculate strain and strain rate between vertebrae correlation between strain/strain rate and injuries at each level PMHS07 Cervical Kinematics (detailed geometry)

Detailed cervical model able to calculate strain and strain rate between vertebrae Detailed cervical model able to calculate strain and strain rate between vertebrae correlation between strain/strain rate and injuries at each level PMHS07 Cervical Kinematics (detailed geometry)

Physiological Relative Rotation (Panjabi, 2005) Physiological Flexion(-)/Extension(+) Max values Flexion/Extension C2/C3-5.4(2.3)/+3.6(1.8)-7.7/+5.4 C3/C4-5.7(2.7)/+4.2(1.9)-8.4/+6.1 C4/C5-7.6(2.7)/+6.7(2.9)-10.3/+9.6 C5/C6-7.7(4.5)/+6.5(3.5)-12.2/+10.0 C6/C7-8.0(1.6)/+7.1(2.2)-9.6/+9.3 C7/T1-3.7(1.6)/+3.1(1.1)-5.3/+4.2 IV-NIC Calculation

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NIC

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NDCx

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NDCx rate

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NDCx product

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NDCz

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NDCz rate

Injury Analysis IV-NIC vs. Current/Potential Injury Criteria NDCz product