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Characterization of Thoracic Spinal Development by Age and Gender and Possible Effect on Crash Occupants

University of Michigan Hospital-Michelle Caird, Carla Kohoyda-Inglis, Sven Holcombe, Stewart Wang
University of Michigan, Exponent Inc.-Chantal Parenteau
  • Technical Paper
  • 2020-01-0520
To be published on 2020-04-14 by SAE International in United States
Spine degeneration can lower injury tolerance and influence injury outcomes in vehicle crashes. To date, limited information exists on the effect of age and gender on thoracic spine 3-dimensional geometry. The purpose of this study is to quantify thoracic spinal column and canal geometry using selected geometrical measurement from a large and continuous sample of CT scans. More than 33,488 scans were obtained from the International Center for Automotive Medicine database at the University of Michigan under Institutional Review Board approval (HUM00041441). The sample consisted of CT scans obtained from 31,537 adult and 1,951 pediatric patients between the ages of 0 to 99 years old. Each scan was processed semi-automatically using custom algorithms written in MATLAB (The Math Works, Natick, MA). Five geometrical measurements were collected including: 1) maximum spinal curvature depth (D), 2) T1-to-T12 vertical height (H), 3) Kyphosis Index (KI), 4) kyphosis angle, and 5) spinal canal radius. The data were analyzed by gender and age. Maximum spinal curvature depth occurred at T6, irrespective of age and gender. It continuously increased with age.…
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Quantification of Sternum Morphomics and Injury Data

Chantal Parenteau
General Motors-Barbara Bunn, Suzanne Johannson
Published 2019-04-02 by SAE International in United States
Crash safety researchers have an increased concern regarding the decreased thoracic deflection and the contributing injury causation factors among the elderly population. Sternum fractures are categorized as moderate severity injuries, but can have long term effects depending on the fragility and frailty of the occupant. Current research has provided detail on rib morphology, but very little information on sternum morphology, sternum fracture locations, and mechanisms of injury. The objective of this study is two-fold (1) quantify sternum morphology and (2) document sternum fracture locations using computed tomography (CT) scans and crash data. Thoracic CT scans from the University of Michigan Hospital database were used to measure thoracic depth, manubriosternal joint, sternum thickness and bone density. The sternum fracture locations and descriptions were extracted from 63 International Center for Automotive Medicine (ICAM) crash cases, of which 22 cases had corresponding CT scans. The University of Michigan Internal Review Board (HUM00043599 and HUM00041441) approved the use of crash cases and CT scan data.The sternum morphomics data showed the thoracic depth increased, except for the 60-74-year-old age group.…
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A Study of Age-Related Thoracic Injury in Frontal Crashes using Analytic Morphomics

University of Michigan-Susumu Ejima, Sven Holcombe, Peng Zhang, Brian Derstine, Joel MacWilliams, Carla Kohoyda-Inglis, Stewart Wang
Published 2018-04-03 by SAE International in United States
The purpose of this study was to use detailed medical information to evaluate thoracic injuries in elderly patients in real world frontal crashes. In this study, we used analytic morphomics to predict the effect of torso geometry on rib fracture, a major source of injury for the elderly. Analytic morphomics extracts body features from computed tomography (CT) scans of patients in a semi-automated fashion. Thoracic injuries were examined in front row occupants involved in frontal crashes from the International Center for Automotive Medicine (ICAM) database. Among these occupants, two age groups (age < 60 yr. [Nonelderly] and age ≥ 60 yr. [Elderly]) who suffered severe thoracic injury were analyzed. Regression analyses were conducted to investigate injury outcomes using variables for vehicle, demographics, and morphomics. Compared to the nonelderly group, the elderly group sustained more rib fractures. Logistic regression models were fitted with different configurations of variables predictive of the Maximum Abbreviated Injury Scale of the thoracic region (MAISthx 3+). The performance of models was assessed using area under the receiver operating characteristic curve (AUC). AUC is a widely-used “rating” method to…
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The Effect of Age on Fat and Bone Properties along the Vertebral Spine

SAE International Journal of Transportation Safety

University of Michigan-Chantal Parenteau, Sven Holcombe, Peng Zhang, Carla Kohoyda-Inglis, Stewart Wang
  • Journal Article
  • 2013-01-1244
Published 2013-04-08 by SAE International in United States
The human body changes as it becomes older. The automotive safety community has been interested in understanding the effect of aging on restraint performance. Recent research has been focused on assessing the structural and material changes associated with age. In this study, structural tissue distribution was determined using the computed tomography (CT) scan data of more than 19,000 patients, aged 16 and up. The data consisted of subcutaneous fat cross-sectional area, visceral fat cross-sectional area, and trabecular bone density taken at each vertebral level. The data was quantified as a function of five age groups with the youngest group defined as 16-29 years old and the oldest group as 75 and up. An additional analysis stratified on gender was carried out.Overall, visceral fat increased with age. Compared to the 16-29 group, the visceral fat measured at the L1 level was 1.97 in the 30-44 group, 2.55 in the 45-59 group, 3.33 in the 60-74 group and 3.21 times greater in the 75+ group. Subcutaneous fat also increased with age up to the 60-74-year-old group. The…
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Safety Belt and Occupant Factors Influencing Thoracic & Upper Abdominal Injuries in Frontal Crashes

Crash Safety Consulting-Daniel Faust
General Motors Company-Huizhen Lu, Margaret Andreen, Lisa Furton, Brian Putala
Published 2011-04-12 by SAE International in United States
This paper reports on a study that examines the effect of shoulder belt load limiters and pretensioners as well as crash and occupant factors that influence upper torso harm in real-world frontal crashes. Cases from the University of Michigan International Center for Automotive Medicine (ICAM) database were analyzed. Additional information was used from other databases including the National Highway Traffic Safety Administration (NHTSA) New Car Assessment Program (NCAP), the Insurance Institute for Highway Safety (IIHS), the National Automotive Sampling System - Crashworthiness Data System (NASS-CDS), and patient data available from the University of Michigan Trauma Center. The ICAM database is comprised of information from real-world crashes in which occupants were seriously injured and required treatment at a Level 1 Trauma Center. Cases from the database were included in this study if they met the following criteria: (a) the primary collision involved a frontal type crash and; (b) case occupants were seated in front outboard positions, restrained by 3-point safety belts and deployed frontal airbags.One hundred thirty-three (133) case occupants who sustained nearly 1,800 injuries were…
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U of Michigan CIREN Side Impact Field Crashes and Injury Patterns

Univ. of Michigan-Anthony G. Melocchi, Melanie Van Horn, Daniel P. Faust, Gerald M. Fowler, Sven Holcombe, Christopher K. Horn, Kevin Joy, Adam S. Kline, Stewart Wang
Published 2010-04-12 by SAE International in United States
Side impact field crashes from the University of Michigan Crash Injury Research and Engineering Network (UM CIREN) database were studied in detail. These cases involved seriously injured occupants that spanned 1997 - 2006 model year vehicles. Specific injury risks are not presented because the database used was populated only with occupants requiring treatment at a Level 1 Trauma Center.This study analyzes side impact collisions for AIS ≥ 3 injury patterns in crash configuration, injury contact locations, gender and by age. Field crashes were also categorized into those that represent existing standard side impact laboratory test methods.Over half of the cases were identified as collisions into the passenger compartment with occupants seated on the near side of the vehicle closest to the impact, which is consistent with current standard laboratory tests. The next two largest categories involved either far-side occupants or impacts primarily centered onto the engine compartment. The most commonly injured body regions in the above categories were the head, thorax and lower extremity. Females had the highest proportion of pelvic injuries. While bone density…
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Structural and Material Changes in the Aging Thorax and Their Role in Crash Protection for Older Occupants

Toyota Motor Corp.-Fumio Matsuoka
University of Michigan-Stewart Wang, Craig S. Poster, Aaron W. Lange, Chris Brede, David Lange
Published 2005-11-09 by The Stapp Association in United States
The human body undergoes a variety of changes as it ages through adulthood. These include both morphological (structural) changes (e.g., increased thoracic kyphosis) and material changes (e.g., osteoporosis). The purpose of this study is to evaluate structural changes that occur in the aging bony thorax and to assess the importance of these changes relative to the well-established material changes. The study involved two primary components. First, full-thorax computed tomography (CT) scans of 161 patients, age 18 to 89 years, were analyzed to quantify the angle of the ribs in the sagittal plane. A significant association between the angle of the ribs and age was identified, with the ribs becoming more perpendicular to the spine as age increased (0.08 degrees/year, p=0.012). Next, a finite element model of the thorax was used to evaluate the importance of this rib angle change relative to other factors associated with aging. A three-factor, two-level factorial design was used to assess the relative importance of rib cage morphology ('young' and 'old' rib angle), thickness of the cortical shell (thick = 'young'…
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The Ciren Experience

Children's National Medical Center-Martin Eichelberger, Cathy Gotschall
George Washington Univ.-Kennerly Digges
  • Technical Paper
  • 986127
Published 1998-05-31 by National Highway Traffic Safety Administration in United States
The Crash Injury Research and Engineering Network, or CIREN, links seven trauma centers from around the country together with engineers to study the cause, kinematics, and results of real- world crashes. Each trauma center has a multidisciplinary team of physicians, medical researchers, safety engineers, crash reconstructionist, public safety professions, and others who review the crash and the patients. The network includes trauma centers in San Diego, Seattle, Newark, Baltimore, Miami, Washington and Ann Arbor. General Motors funds three of these centers. A high-speed computer network will soon link the seven centers. This state-of-the-art teleconferencing system will allow on-line multidisciplinary analyses of crashes to be performed by personnel from the trauma centers, manufacturers and government agencies.The first national conference was held last October in Ann Arbor. This research will hopefully aid the auto industry to continuously design safer cars. It is already helping the medical community, doctors and Emergency Medical Services personnel, to develop new diagnostic and treatment tools.