Patient-Specific Cervical Spine Finite Element Modelling to Advance the Understanding and Treatment of Degenerative Cervical Myelopathy

Degenerative cervical myelopathy (DCM) is a common spinal disorder caused by progressive compression of the spinal cord due to degenerative changes in the cervical spine, leading to motor and sensory deficits [1]. Finite element (FE) analysis is critical for understanding DCM progression, representing individual injuries, and optimising surgical strategies. However, existing models often lack accurate representation of spinal cord anatomy, particularly the distinction between grey and white matter [1]. Patient-specific models are essential, as anatomical variability significantly influences spinal cord loading patterns and surgical outcomes. This study presents a patient-specific FE model of the cervical spine integrating CT and MRI data, combining high-resolution bone imaging with detailed soft tissue characterisation. Vertebrae and intervertebral discs were segmented from CT using MIMICS, while grey and white matter of the spinal cord were segmented from MRI using Spinal Cord Toolbox. 3D Slicer was used for image registration. In Abaqus, vertebrae were modelled as rigid bodies, and hyperelastic material properties were assigned to IVDs and spinal cord [2]. Ligaments were modelled using axial connectors with non-linear elastic properties [2]. High-quality meshing and appropriate contact definitions were implemented. The model was subjected to 1 Nm pure moments for flexion, extension, and axial rotation, with T1 fully constrained. Predicted intersegmental range of motion showed strong agreement with previous studies but was slightly stiffer, likely due to spinal cord inclusion. Peak spinal cord strain occurred at points where the spinal cord narrows (Fig. 1). This model provides a valuable tool for understanding DCM and guiding personalised treatment.