medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-061medsovet-7536Research ArticleДИССЕРТАНТDISSERTANTТопографо-анатомический анализ и конечно-элементное моделирование динамических и биомеханических закономерностей смещения мышечно-фасциальных футляров шеиTopographic and anatomical analysis and finite element modeling of dynamic and biomechanical displacement patterns of the muscular-fascial cases of the neckhttps://orcid.org/0000-0002-1079-388XМоховаЕ. С.MohovaE. S.

Мохова Екатерина Степановна, ассистент Института остеопатии 

199034, Санкт-Петербург, Университетская наб., д. 7/9

Ekaterina S. Mohova, Assistant at the Institute of Osteopathy 

7–9, Universitetskaya Emb., St Petersburg, 199034

mokhova-es@mail.ruhttps://orcid.org/0000-0002-8588-1577МоховД. Е.MohovD. E.

Мохов Дмитрий Евгеньевич, д.м.н., профессор, заведующий кафедрой остеопатии, заслуженный врач Российской Федерации, главный внештатный специалист МЗ РФ по остеопатии, президент Российской остеопатической ассоциации 

191015, Санкт-Петербург, ул. Кирочная, д. 41

Dmitriy E. Mohov, Dr. Sci. (Med.), Professor, Head of the Department of Osteopathy, Honored Doctor of the Russian Federation, Chief Freelance Specialist of the Ministry of Health of the Russian Federation on Osteopathy, President of the Russian Osteopathic Association 

41, Kirochnaya St., St Petersburg, 191015

osteopathie@mail.ruhttps://orcid.org/0000-0002-8435-7562ЯковлевЕ. В.YakovlevE. V.

Яковлев Евгений Васильевич, к.м.н., доцент, заведующий амбулаторно-поликлиническим отделением №2, врач-невролог высшей категории; заведующий кафедрой психофизиологии; доцент кафедры медицинской реабилитации и спортивной медицины 

190121, Санкт-Петербург, ул. Садовая, д. 126;199226, Санкт-Петербург, Галерный проезд, д. 3;194100, Санкт-Петербург, ул. Литовская, д. 2

Evgeny V. Yakovlev, Cand. Sci. (Med.), Associate Professor, Head of Outpatient Department No. 2, Neurologist of the Highest Category; Head of the Department of Psychophysiology; Associate Professor of the Department of Medical Rehabilitation and Sports Medicine 

126, Sadovaya St., St Petersburg, 190121;3, Galerny Passage, St Petersburg, 199226; 2, Litovskaya St., St Petersburg, 194100

 

vmeda-ev@mail.ruhttps://orcid.org/0000-0003-0363-102XЖиволуповС. А.ZhivolupovS. A.

Живолупов Сергей Анатольевич, д.м.н., профессор, профессор кафедры нервных болезней 

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Sergey A. Zhivolupov, Dr. Sci.  (Med.), Professor, Professor of  the Department of  Nervous Diseases 

6, Akademik Lebedev St., St Petersburg, 194044

peroslava@yandex.ruhttps://orcid.org/0000-0001-6284-0943БуткоД. Ю.ButkoD. Y.

Бутко Дмитрий Юрьевич, д.м.н., профессор, заведующий кафедрой медицинской реабилитации и  спортивной медицины 

194100, Санкт-Петербург, ул.  Литовская, д.  2

Dmitriy Y. Butko, Dr. Sci. (Med.), Professor, Head of the Department of Medical Rehabilitation and Sports Medicine 

2, Litovskaya St., St Petersburg, 194100

prof.butko@mail.ruhttps://orcid.org/0000-0003-0510-4936АлиевР. В.AlievR. V.

Алиев Рамиз Видадиевич, врач-рентгенолог отделения лучевой диагностики 

197022, Санкт-Петербург, ул. Профессора Попова, д. 9

Ramiz V. Aliev, Radiologist of the Radiology Department 

9, Professor Popov St., St Petersburg, 197022

alihm@mail.ruhttps://orcid.org/0000-0003-1969-2628ГасанбековИ. М.GasanbekovI. M.

Гасанбеков Имамудин Межлумович, ординатор 

117997, Москва, ул. Островитянова, д. 1

Imamudin M. Gasanbekov, Resident 

1, Ostrovityanov St., Moscow, 117997

imam_postuplenie@mail.ruhttps://orcid.org/0000-0002-8023-7803ВедяшкинаА. С.VedyashkinaA. S.

Ведяшкина Александра Сергеевна, старший преподаватель Института остеопатии, аспирант кафедры остеопатии 

191015, Санкт-Петербург, ул. Кирочная, д. 41

Aleksandra S. Vedyashkina, Senior Lecturer of Institute of Osteopathy, Postgraduate Student of the Department of Osteopathy 

41, Kirochnaya St., St Petersburg, 191015

sasha81994@mail.ruhttps://orcid.org/0000-0002-2661-3759СмирновА. А.SmirnovA. A.

Смирнов Александр Александрович, к.м.н., доцент, заведующий лабораторией биомеханического анализа 

199034, Санкт-Петербург, Университетская наб., д.  7/9

Alexander A. Smirnov, Cand. Sci. (Med.), Associate Professor, Head of the Laboratory of Biomechanical Analysis 

7–9, Universitetskaya Emb., St Petersburg, 199034

savmeda@yandex.ruСанкт-Петербургский государственный университетРоссияSt Petersburg State UniversityRussian FederationСеверо-Западный государственный медицинский университет имени И.И. МечниковаРоссияNorth-Western State Medical University named after I.I. MechnikovRussian FederationМедицинский центр «Адмиралтейские верфи»; Институт прикладного психоанализа и психологии; Санкт-Петербургский государственный педиатрический медицинский университет;РоссияAdmiralty Shipyards Medical Center; Institute of Applied Psychoanalysis and Psychology; St Petersburg State Pediatric Medical UniversityRussian FederationВоенно-медицинская академия имени С.М. КироваРоссияMilitary Medical Academy named after S.M. KirovRussian FederationСанкт-Петербургский государственный педиатрический медицинский университетРоссияSt Petersburg State Pediatric Medical UniversityRussian FederationДетский научно-клинический центр инфекционных болезней Федерального медико-биологического агентстваРоссияChildren’s Scientific and Clinical Center of Infectious Diseases of the Federal Medical and Biological AgencyRussian FederationРоссийский национальный исследовательский медицинский университет имени Н.И. ПироговаРоссияPirogov Russian National Research Medical UniversityRussian Federation20231205202306330344Copyright © Мохова Е.С., Мохов Д.Е., Яковлев Е.В., Живолупов С.А., Бутко Д.Ю., Алиев Р.В., Гасанбеков И.М., Ведяшкина А.С., Смирнов А.А., 20232023Мохова Е.С., Мохов Д.Е., Яковлев Е.В., Живолупов С.А., Бутко Д.Ю., Алиев Р.В., Гасанбеков И.М., Ведяшкина А.С., Смирнов А.А.Mohova E.S., Mohov D.E., Yakovlev E.V., Zhivolupov S.A., Butko D.Y., Aliev R.V., Gasanbekov I.M., Vedyashkina A.S., Smirnov A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7536

Введение. Вопросы динамической анатомии шеи представляют значительный практический и теоретический интерес. Это связано с особенностями смещения фасциальных слоев при изменении положения головы, описание которых затруднено. Особое значение изучение динамических явлений данной области имеет при анализе морфологических и биомеханических изменений, приводящих к развитию соматической дисфункции. Цель. На  основании топографо-анатомических исследований, а  также с  помощью конечно-элементного моделирования изучить закономерности смещения фасциальных слоев шеи при поворотах головы на 20º и 50º. Материалы и методы. При топографо-анатомическом исследовании использованы 18 МРТ-исследований, анализ которых проводили с применением Vidar Dicom Viewer. Для построения конечно-элементной модели использованы данные КТ-исследования пациента без патологических изменений шеи. При последующей обработке данных была построена антропоморфная конечно-элементная модель области шеи и выполнена серия виртуальных топографо-анатомических исследований. Результаты. 1. Величины вращательного и  углового смещения всех фасций шеи имеют нелинейный характер. 2. Фасции неравномерно смещаются вследствие различия значений углового смещения. 3. Величина углового смещения 2-й фасции на уровне С2-С3, С3-С4 и С4-С5 при повороте головы на 20º, а также на уровне С4-С5 при повороте головы на 50º превышает значение угла поворота головы. 4. Направление вращательного и  углового смещения всех фасций на  уровне С6-С7 соответствует направлению поворота головы, за исключением дорзальной части 4-й фасции шеи, которая на данном уровне смещается в противоположном относительно оси симметрии направлении. 5. Для фасций, расположенных дальше от центра межпозвонкового диска, характерны большие величины углового и вращательного смещения. 6. Скорость изменения отношения вращательного и углового смещений выше на уровне нижних сегментов. 7. Результаты измерений вращательного смещения фасций конечно-элементной модели демонстрируют положительную корреляцию с полученными данными. Выводы. Закономерности смещения фасций шеи необходимо учитывать при моделировании соматической дисфункции, в процессе диагностики и планирования остеопатических воздействий.

Introduction. The issues of dynamic and functional anatomy of the neck are of considerable practical and theoretical interest. This is due to the peculiarities of the displacement of the musculofascial layers when changing the position of the head in space, the description of which presents significant difficulties. Particular practical importance has therefore the study of dynamic phenomena of this area as well as the analysis of morphological and biomechanical changes leading to the development of somatic dysfunction of the neck. Aim. Based on the topographic and anatomical studies, as well as with the help of finite element modeling, to study the patterns of displacement of the muscular-fascial layers of the neck when turning the head by 20º and 50º. Materials and methods. The topographic and anatomical study used the results of 18 MRIs, the analysis of which was carried out using the Vidar Dicom Viewer software. To build a finite element model, data from a CT study of a patient were used, which has not any pathological changes in the organs and musculoskeletal system of the neck. As a result of the subsequent processing of the CT study data, a personalized anthropomorphic finite element model of the neck region was constructed, with the help of which a series of virtual topographic and anatomical studies were performed, repeating in general terms the topographic and anatomical part of the work. Results. 1. The values of rotational and angular displacement of all fascia of the neck are nonlinear. 2. The fascia of the neck are displaced relative to each other when turning the head due to the difference in the values of angular displacement. 3. The magnitude of the angular displacement of the 2nd fascia of the neck at the level C2-C3, C3-C4 and C4-C5 when turning the head 20º, as well as at the  level C4-C5  when turning the  head 50º exceeds the  value of  the angle of  rotation of  the head relative to the trunk. 4. The direction of rotational and angular displacement for all fasciae at the level C6-C7 corresponds to the direction of rotation of the head, with the exception of the dorsal part of the 4th fascia of the neck, which at this level, together with the esophagus, shifts in the opposite direction relative to the axis of symmetry. 5. Fasciae located at a greater distance from the  center of  the intervertebral disc are characterized by large values of  angular and rotational displacement. 6. The rate of change in the ratio of rotational and angular displacements is higher at the level of the lower segments. 7. The results of measurements of the rotational displacement of the fascial layers of the anthropomorphic finite element model demonstrate a positive correlation with the data of the topographic and anatomical study. Conclusion. The patterns of displacement of the neck musculofacial layers should be taken into account when modeling somatic dysfunction of the neck, as well as in the process of diagnosis and planning of osteopathic effects.

динамическая анатомия шеиконечно-элементный анализбиомеханика шеисоматическая дисфункциясмещение фасциальных слоевdynamic neck anatomyfinite element analysisneck biomechanicssomatic dysfunctiondisplacement of fascial layersReferencesМохов Д.Е., Беляев А.Ф., Азаренков М.Д., Аптекарь И.А., Болотов Д.А., Вяльцев А.В. и др. Остеопатическая диагностика соматических дисфункций в педиатрии: клинические рекомендации. СПб.: Невский ракурс; 2015. 60 с. Режим доступа: http://www.osteopathy-official.ru/rekomendacii_pediatria.pdf?ysclid=lgmcrgxnpr89098514.Mokhov D.E., Belyaev A.F., Azarenkov M.D., Aptekar I.A., Bolotov D.A., Vyaltsev A.V. et al. Osteopathic diagnosis of somatic dysfunctions. Clinical recommendations. St Petersburg: Nevskiy rakurs; 2015. 60 p. (In Russ.) Available at: http://www.osteopathy-official.ru/rekomendacii_pediatria.pdf?ysclid=lgmcrgxnpr89098514.Schnell H., Wagner F.M., Locher H. Segmental and somatic dysfunction: How does manual medicine work? Orthopade. 2022;51(4):253–262. https://doi.org/10.1007/s00132-022-04230-z.Schnell H., Wagner F.M., Locher H. Segmental and somatic dysfunction: How does manual medicine work? Orthopade. 2022;51(4):253–262. https://doi.org/10.1007/s00132-022-04230-z.Schnell H. From acute coronary syndrome to zoster: Differential diagnostics in segmental and somatic dysfunction of the thoracic spine and ribs. Orthopade. 2022;51(4):274–282. https://doi.org/10.1007/s00132-022-04227-8.Schnell H. From acute coronary syndrome to zoster: Differential diagnostics in segmental and somatic dysfunction of the thoracic spine and ribs. Orthopade. 2022;51(4):274–282. https://doi.org/10.1007/s00132-022-04227-8.Wagner F.M. Somatic dysfunction of the cervical spine and its complex clinical picture: The fundamentals of diagnostics of cervicobrachialgia and cervicocephalic syndrome through manual medicine. Orthopade. 2022;51(4):263–273. https://doi.org/10.1007/s00132-022-04227-8.Wagner F.M. Somatic dysfunction of the cervical spine and its complex clinical picture: The fundamentals of diagnostics of cervicobrachialgia and cervicocephalic syndrome through manual medicine. Orthopade. 2022;51(4):263–273. https://doi.org/10.1007/s00132-022-04227-8.Andrews M.A.W. Stretch Receptor and Somatic Dysfunction: A Narrative Review. J Am Osteopath Assoc. 2019;119(8):511–519. https://doi.org/10.7556/jaoa.2019.094.Andrews M.A.W. Stretch Receptor and Somatic Dysfunction: A Narrative Review. J Am Osteopath Assoc. 2019;119(8):511–519. https://doi.org/10.7556/jaoa.2019.094.Liem T.A.T. Still’s Osteopathic Lesion Theory and Evidence-Based Models Supporting the Emerged Concept of Somatic Dysfunction. J Am Osteopath Assoc. 2016;116(10):654–661. https://doi.org/10.7556/jaoa.2016.129.Liem T.A.T. Still’s Osteopathic Lesion Theory and Evidence-Based Models Supporting the Emerged Concept of Somatic Dysfunction. J Am Osteopath Assoc. 2016;116(10):654–661. https://doi.org/10.7556/jaoa.2016.129.Tramontano M., Tamburella F., Dal Farra F., Bergna A., Lunghi C., Innocenti M. et al. International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review. Healthcare (Basel). 2021;10(1):28. https://doi.org/10.3390/healthcare10010028.Tramontano M., Tamburella F., Dal Farra F., Bergna A., Lunghi C., Innocenti M. et al. International Overview of Somatic Dysfunction Assessment and Treatment in Osteopathic Research: A Scoping Review. Healthcare (Basel). 2021;10(1):28. https://doi.org/10.3390/healthcare10010028.Jung B., Bhutta B.S. Anatomy, Head and Neck, Neck Movements. StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557555/Jung B., Bhutta B.S. Anatomy, Head and Neck, Neck Movements. StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. Available at: https://www.ncbi.nlm.nih.gov/books/NBK557555/Lazennec J.Y., Laudet C.G., Guérin-Surville H., Roy-Camille R., Saillant G. Dynamic anatomy of the acetabulum: an experimental approach and surgical implications. Surg Radiol Anat. 1997;19(1):23–30. https://doi.org/10.1007/BF01627730.Lazennec J.Y., Laudet C.G., Guérin-Surville H., Roy-Camille R., Saillant G. Dynamic anatomy of the acetabulum: an experimental approach and surgical implications. Surg Radiol Anat. 1997;19(1):23–30. https://doi.org/10.1007/BF01627730.Armstrong C.G., Bahrani A.S., Gardner D.L. In vitro measurement of articular cartilage deformations in the intact human hip joint under load. JBJS. 1979;61(5):744–755. Available at: https://pubmed.ncbi.nlm.nih.gov/457718/Armstrong C.G., Bahrani A.S., Gardner D.L. In vitro measurement of articular cartilage deformations in the intact human hip joint under load. JBJS. 1979;61(5):744–755. Available at: https://pubmed.ncbi.nlm.nih.gov/457718/McMurrich J.P. Leonardo da Vinci, the anatomist. Carnegie institution of Washington, Williams & Wilkins Company, Baltimore; 1930. Available at: https://embryology.med.unsw.edu.au/embryology/images/0/0c/1930_Leonardo_da_Vinci_-_the_anatomist.pdf.McMurrich J.P. Leonardo da Vinci, the anatomist. Carnegie institution of Washington, Williams & Wilkins Company, Baltimore; 1930. Available at: https://embryology.med.unsw.edu.au/embryology/images/0/0c/1930_Leonardo_da_Vinci_-_the_anatomist.pdf.Pirogov N.I. Anatome Topographica Sectionibus Per Corpus Humanum Congelatum Triplici Directione Ductis Illustrata (Atlas): Fasciculi 1. 1A-1B. St Petersburg; 1853. Available at: https://collections.nlm.nih.gov/catalog/nlm:nlmuid-61120970RX1-mvpart.Pirogov N.I. Anatome Topographica Sectionibus Per Corpus Humanum Congelatum Triplici Directione Ductis Illustrata (Atlas): Fasciculi 1. 1A-1B. St Petersburg; 1853. Available at: https://collections.nlm.nih.gov/catalog/nlm:nlmuid-61120970RX1-mvpart.Anderson P., Chapman P.M., Ma M., Rea P. Real-time medical visualization of human head and neck anatomy and its applications for dental training and simulation. Cur Med Imag. 2013;9(4):298–308. https://doi.org/10.2174/15734056113096660004.Anderson P., Chapman P.M., Ma M., Rea P. Real-time medical visualization of human head and neck anatomy and its applications for dental training and simulation. Cur Med Imag. 2013;9(4):298–308. https://doi.org/10.2174/15734056113096660004.Nguyen N., Wilson T.D. A head in virtual reality: Development of a dynamic head and neck model. Anat Sci Educ. 2009;2(6):294–301. https://doi.org/10.1002/ase.115.Nguyen N., Wilson T.D. A head in virtual reality: Development of a dynamic head and neck model. Anat Sci Educ. 2009;2(6):294–301. https://doi.org/10.1002/ase.115.Clifton W., Damon A., Nottmeier E., Pichelmann M. Investigation of a three‐dimensional printed dynamic cervical spine model for anatomy and physiology education. Clinical Anatomy. 2021;(1):30–39. https://doi.org/10.1002/ca.23607.Clifton W., Damon A., Nottmeier E., Pichelmann M. Investigation of a three‐dimensional printed dynamic cervical spine model for anatomy and physiology education. Clinical Anatomy. 2021;(1):30–39. https://doi.org/10.1002/ca.23607.Zhao G., Jiang G., Xun Yang X., Xireayi P., Wang E. Reconstruction of the Three-dimensional Model of Cervical Vertebrae Segments Based on CT Image and 3D Printing. Zhongguo Yi Liao Qi Xie Za Zhi. 2019;43(6):451–453. https://doi.org/10.3969/j.issn.1671-7104.2019.06.016.Zhao G., Jiang G., Xun Yang X., Xireayi P., Wang E. Reconstruction of the Three-dimensional Model of Cervical Vertebrae Segments Based on CT Image and 3D Printing. Zhongguo Yi Liao Qi Xie Za Zhi. 2019;43(6):451–453. https://doi.org/10.3969/j.issn.1671-7104.2019.06.016.Zhang Y., Zhou J., Guo X. Biomechanical Effect of Different Graft Heights on Adjacent Segment and Graft Segment Following C4/C5 Anterior Cervical Discectomy and Fusion: A Finite Element Analysis. Med Sci Monit. 2019;25:4169–4175. https://doi.org/10.12659/MSM.916629.Zhang Y., Zhou J., Guo X. Biomechanical Effect of Different Graft Heights on Adjacent Segment and Graft Segment Following C4/C5 Anterior Cervical Discectomy and Fusion: A Finite Element Analysis. Med Sci Monit. 2019;25:4169–4175. https://doi.org/10.12659/MSM.916629.Ovsepyan A.L., Smirnov A.A., Pustozerov E.A., Mokhov D.E., Mokhova E.S., Trunin E.M. et al. Biomechanical analysis of the cervical spine segment as a method for studying the functional and dynamic anatomy of the human neck. Ann Anat. 2022;240:151856. https://doi.org/10.1016/j.aanat.2021.151856.Ovsepyan A.L., Smirnov A.A., Pustozerov E.A., Mokhov D.E., Mokhova E.S., Trunin E.M. et al. Biomechanical analysis of the cervical spine segment as a method for studying the functional and dynamic anatomy of the human neck. Ann Anat. 2022;240:151856. https://doi.org/10.1016/j.aanat.2021.151856.Yakovlev E.V., Ovsepyan A.L., Smirnov A.A., Safronova A.A., Starchik D.A., Zhivolupov S.A. et al. Reproducing morphological features of intervertebral disc using finite element modeling to predict the course of cervical spine dorsopathy. Rus Open Med J. 2022;11:e0118. https://doi.org/10.15275/rusomj.2022.0118.Yakovlev E.V., Ovsepyan A.L., Smirnov A.A., Safronova A.A., Starchik D.A., Zhivolupov S.A. et al. Reproducing morphological features of intervertebral disc using finite element modeling to predict the course of cervical spine dorsopathy. Rus Open Med J. 2022;11:e0118. https://doi.org/10.15275/rusomj.2022.0118.Старчик Д.А., Акопов А.Л. Атлас распилов человеческого тела. СПб.: ММЦ; 2020. 172 с.Starchik D.A., Akopov A.L. Atlas of cuts of the human body: Textbook. St Petersburg: MMC; 2020. 172 p. (In Russ.)Mitsuhashi N., Fujieda K., Tamura T., Kawamoto S., Takagi T., Okubo K. BodyParts3D: 3D structure database for anatomical concepts. Nucleic Acids Res. 2009;37(Database issue):D782–785. https://doi.org/10.18908/lsdba.nbdc00837-000.Mitsuhashi N., Fujieda K., Tamura T., Kawamoto S., Takagi T., Okubo K. BodyParts3D: 3D structure database for anatomical concepts. Nucleic Acids Res. 2009;37(Database issue):D782–785. https://doi.org/10.18908/lsdba.nbdc00837-000.Broom N., Thambyah A. Relevant Anatomy and Macro-Level Structure. In: The Soft–Hard Tissue Junction: Structure, Mechanics and Function. Cambridge: Cambridge University Press; 2018, pp. 157–177. https://doi.org/10.1017/9781316481042.007.Broom N., Thambyah A. Relevant Anatomy and Macro-Level Structure. In: The Soft–Hard Tissue Junction: Structure, Mechanics and Function. Cambridge: Cambridge University Press; 2018, pp. 157–177. https://doi.org/10.1017/9781316481042.007.Disney C.M., Eckersley A., McConnell J.C., Geng H., Bodey A.J., Hoyland J.A. et al. Synchrotron tomography of intervertebral disc deformation quantified by digital volume correlation reveals microstructural influence on strain patterns. Acta Biomaterialia. 2019;92:290–304. https://doi.org/10.1016/j.actbio.2019.05.021.Disney C.M., Eckersley A., McConnell J.C., Geng H., Bodey A.J., Hoyland J.A. et al. Synchrotron tomography of intervertebral disc deformation quantified by digital volume correlation reveals microstructural influence on strain patterns. Acta Biomaterialia. 2019;92:290–304. https://doi.org/10.1016/j.actbio.2019.05.021.Tavakoli J., Diwan A.D., Tipper J.L. Elastic fibers: The missing key to improve engineering concepts for reconstruction of the Nucleus Pulposus in the intervertebral disc. Acta Biomaterialia. 2020;113:407–416. https://doi.org/10.1016/j.actbio.2020.06.008.Tavakoli J., Diwan A.D., Tipper J.L. Elastic fibers: The missing key to improve engineering concepts for reconstruction of the Nucleus Pulposus in the intervertebral disc. Acta Biomaterialia. 2020;113:407–416. https://doi.org/10.1016/j.actbio.2020.06.008.Wade K.R., Robertson P.A., Broom N.D. On how nucleus‐endplate integration is achieved at the fibrillar level in the ovine lumbar disc. J Anat. 2012;221(1):39–46. https://doi.org/10.1111/j.1469-7580.2012.01507.x.Wade K.R., Robertson P.A., Broom N.D. On how nucleus‐endplate integration is achieved at the fibrillar level in the ovine lumbar disc. J Anat. 2012;221(1):39–46. https://doi.org/10.1111/j.1469-7580.2012.01507.x.Sharabi M., Levi-Sasson A., Wolfson R., Wade K.R., Galbusera F., Benayahu D. et al. The Mechanical Role of the Radial Fiber Network Within the Annulus Fibrosus of the Lumbar Intervertebral Disc: A Finite Elements Study. J Biomech Eng. 2019;141(2):021006. https://doi.org/10.1115/1.4041769.Sharabi M., Levi-Sasson A., Wolfson R., Wade K.R., Galbusera F., Benayahu D. et al. The Mechanical Role of the Radial Fiber Network Within the Annulus Fibrosus of the Lumbar Intervertebral Disc: A Finite Elements Study. J Biomech Eng. 2019;141(2):021006. https://doi.org/10.1115/1.4041769.Kraft R.H., Fielding R.A., Lister K., Shirley A., Marler T., Merkle A.C. et al. Modeling Skeletal Injuries in Military Scenarios. In: The Mechanobiology and Mechanophysiology of Military-Related Injuries. Springer, Cham; 2016, pp. 3–35. https://doi.org/10.1007/8415_2016_191.Kraft R.H., Fielding R.A., Lister K., Shirley A., Marler T., Merkle A.C. et al. Modeling Skeletal Injuries in Military Scenarios. In: The Mechanobiology and Mechanophysiology of Military-Related Injuries. Springer, Cham; 2016, pp. 3–35. https://doi.org/10.1007/8415_2016_191.Dreischarf M., Shirazi-Adl A., Arjmand N., Rohlmann A., Schmidt H. Estimation of loads on human lumbar spine: A review of in vivo and computational model studies. J Biomech. 2016;49(6):833–845. https://doi.org/10.1016/j.jbiomech.2015.12.038.Dreischarf M., Shirazi-Adl A., Arjmand N., Rohlmann A., Schmidt H. Estimation of loads on human lumbar spine: A review of in vivo and computational model studies. J Biomech. 2016;49(6):833–845. https://doi.org/10.1016/j.jbiomech.2015.12.038.Henninger H.B., Reese S.P., Anderson A.E., Weiss J.A. Validation of computational models in biomechanics. Proc Inst Mech Eng H. 2010;224(7):801–812. https://doi.org/10.1243/09544119JEIM649.Henninger H.B., Reese S.P., Anderson A.E., Weiss J.A. Validation of computational models in biomechanics. Proc Inst Mech Eng H. 2010;224(7):801–812. https://doi.org/10.1243/09544119JEIM649.Vasavada A.N., Peterson B.W., Delp S.L. Three-dimensional spatial tuning of neck muscle activation in humans. Exp Brain Res. 2002;147(4):437–448. https://doi.org/10.1007/s00221-002-1275-6.Vasavada A.N., Peterson B.W., Delp S.L. Three-dimensional spatial tuning of neck muscle activation in humans. Exp Brain Res. 2002;147(4):437–448. https://doi.org/10.1007/s00221-002-1275-6.

The authors declare that there are no conflicts of interest present.