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3D computerized model for measuring strain and displacement of the brachial plexus following placement of reverse shoulder prosthesis

Tom Van Hoof (UGent) , Germano Gomes (UGent) , Emmanuel Audenaert (UGent) , Koenraad Verstraete (UGent) , Ingrid Kerckaert (UGent) and Katharina D'Herde (UGent)
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Abstract
The aim of the present study was to develop a method for three-dimensional (3D) reconstruction of the brachial plexus to study its morphology and to calculate strain and displacement in relation to changed nerve position. The brachial plexus was finely dissected and injected with contrast medium and leaden markers were implanted into the nerves at predefined places. A reverse shoulder prosthesis was inserted in a cadaveric specimen what induced positional change in the upper limb nerves. Computed tomography (CT) was performed before and after this surgical intervention. The computer assisted image processing package Mimics (R) was used to reconstruct the pre- and postoperative brachial plexus in 3D. The results show that the current interactive model is a realistic and detailed representation of the specimen used, which allows 3D study of the brachial plexus in different configurations. The model estimated strains up to 15.3% and 19.3% for the lateral and the medial root of the median nerve as a consequence of placing a reverse shoulder prosthesis. Furthermore, the model succeeded in calculating the displacement of the brachial plexus by tracking each implanted lead marker. The presented brachial plexus 3D model currently can be used in vitro for cadaver biomechanical analyses of nerve movement to improve diagnosis and treatment of peripheral neuropathies. The model can also be applied to study the exact location of the plexus in unusual upper limb positions like during axillary radiation therapy and it is a potential tool to optimize the approaches of brachial plexus anesthetic blocks.
Keywords
brachial plexus, anatomic models, biomechanics, computer assisted image processing

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Chicago
Van Hoof, Tom, Germano Gomes, Emmanuel Audenaert, Koenraad Verstraete, Ingrid Kerckaert, and Katharina D’Herde. 2008. “3D Computerized Model for Measuring Strain and Displacement of the Brachial Plexus Following Placement of Reverse Shoulder Prosthesis.” Anatomical Record-advances in Integrative Anatomy and Evolutionary Biology 291 (9): 1173–1185.
APA
Van Hoof, T., Gomes, G., Audenaert, E., Verstraete, K., Kerckaert, I., & D’Herde, K. (2008). 3D computerized model for measuring strain and displacement of the brachial plexus following placement of reverse shoulder prosthesis. ANATOMICAL RECORD-ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY, 291(9), 1173–1185. Presented at the 37th International Sun Valley Workshop on Skeletal Tissue Biology.
Vancouver
1.
Van Hoof T, Gomes G, Audenaert E, Verstraete K, Kerckaert I, D’Herde K. 3D computerized model for measuring strain and displacement of the brachial plexus following placement of reverse shoulder prosthesis. ANATOMICAL RECORD-ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY. 111 RIVER ST, HOBOKEN, NJ 07030 USA: WILEY-LISS, DIV JOHN WILEY & SONS INC; 2008;291(9):1173–85.
MLA
Van Hoof, Tom et al. “3D Computerized Model for Measuring Strain and Displacement of the Brachial Plexus Following Placement of Reverse Shoulder Prosthesis.” ANATOMICAL RECORD-ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY 291.9 (2008): 1173–1185. Print.
@article{597247,
  abstract     = {The aim of the present study was to develop a method for three-dimensional (3D) reconstruction of the brachial plexus to study its morphology and to calculate strain and displacement in relation to changed nerve position. The brachial plexus was finely dissected and injected with contrast medium and leaden markers were implanted into the nerves at predefined places. A reverse shoulder prosthesis was inserted in a cadaveric specimen what induced positional change in the upper limb nerves. Computed tomography (CT) was performed before and after this surgical intervention. The computer assisted image processing package Mimics (R) was used to reconstruct the pre- and postoperative brachial plexus in 3D. The results show that the current interactive model is a realistic and detailed representation of the specimen used, which allows 3D study of the brachial plexus in different configurations. The model estimated strains up to 15.3% and 19.3% for the lateral and the medial root of the median nerve as a consequence of placing a reverse shoulder prosthesis. Furthermore, the model succeeded in calculating the displacement of the brachial plexus by tracking each implanted lead marker. The presented brachial plexus 3D model currently can be used in vitro for cadaver biomechanical analyses of nerve movement to improve diagnosis and treatment of peripheral neuropathies. The model can also be applied to study the exact location of the plexus in unusual upper limb positions like during axillary radiation therapy and it is a potential tool to optimize the approaches of brachial plexus anesthetic blocks.},
  author       = {Van Hoof, Tom and Gomes, Germano and Audenaert, Emmanuel and Verstraete, Koenraad and Kerckaert, Ingrid and D'Herde, Katharina},
  issn         = {1932-8486},
  journal      = {ANATOMICAL RECORD-ADVANCES IN INTEGRATIVE ANATOMY AND EVOLUTIONARY BIOLOGY},
  keywords     = {brachial plexus,anatomic models,biomechanics,computer assisted image processing},
  language     = {eng},
  location     = {Sun Valley, ID},
  number       = {9},
  pages        = {1173--1185},
  publisher    = {WILEY-LISS, DIV JOHN WILEY & SONS INC},
  title        = {3D computerized model for measuring strain and displacement of the brachial plexus following placement of reverse shoulder prosthesis},
  url          = {http://dx.doi.org/10.1002/ar.20735},
  volume       = {291},
  year         = {2008},
}

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