Brian Stemper - Academia.edu (original) (raw)

Papers by Brian Stemper

Seminars in Spine Surgery, 2013

ABSTRACT Whiplash-associated disorders constitute a large proportion of cervical injuries. The po... more ABSTRACT Whiplash-associated disorders constitute a large proportion of cervical injuries. The posteroanterior acceleration loading from rear-end motor vehicle crashes results in motions of the head–neck complex. This manuscript describes the various mechanisms of injury, including hyperextension kinematics, hydrodynamic forces (pressure gradient in the spinal canal), eccentric contraction (muscle focus), and combined axial and shear loading (local variations in the kinetics of different segments of the cervical spinal column). The anatomic components of the cervical spine that may be involved in functional alterations and that result in acute and chronic symptoms are discussed along with demographic and vehicular factors.

PloS one, 2015

Alcoholism is a frequent comorbidity following mild traumatic brain injury (mTBI), even in patien... more Alcoholism is a frequent comorbidity following mild traumatic brain injury (mTBI), even in patients without a previous history of alcohol dependence. Despite this correlational relationship, the extent to which the neurological effects of mTBI contribute to the development of alcoholism is unknown. In this study, we used a rodent blast exposure model to investigate the relationship between mTBI and voluntary alcohol drinking in alcohol naïve rats. We have previously demonstrated in Sprague Dawley rats that blast exposure leads to microstructural abnormalities in the medial prefrontal cortex (mPFC) and other brain regions that progress from four to thirty days. The mPFC is a brain region implicated in alcoholism and drug addiction, although the impact of mTBI on drug reward and addiction using controlled models remains largely unexplored. Alcohol naïve Sprague Dawley rats were subjected to a blast model of mTBI (or sham conditions) and then tested in several common measures of volunt...

Diffuse brain injury (DBI) severity can be clinically diagnosed as concussion or diffuse axonal i... more Diffuse brain injury (DBI) severity can be clinically diagnosed as concussion or diffuse axonal injury (DAI). Concussion the least severe DBI, is associated with neurological deficit limited to disorientation and unconsciousness lasting minutes to hours [1–4]. In contrast, DAI, a severe injury, commonly results in death or permanent vegetation [1]. It is generally accepted that injury severity is modulated by increased mechanical measures such as rotational acceleration and velocity [5–11].

Stapp car crash journal, 2000

The objective of this study was to subject small female and large male cadavers to simulated rear... more The objective of this study was to subject small female and large male cadavers to simulated rear impact, document soft-tissue injuries to the neck, determine the kinematics, forces and moments at the occipital condyles, and evaluate neck injury risks using peak force, peak tension and normalized tension-extension criteria. Five unembalmed intact human cadavers (four small females and one large male) were prepared using accelerometers and targets at the head, T1, iliac crest, and sacrum. The specimens were placed on a custom-designed seat without head restraint and subjected to rear impact using sled equipment. High-speed cameras were used for kinematic coverage. After the test, x-rays were obtained, computed tomography scans were taken, and anatomical sections were obtained using a cryomicrotome. Two female specimens were tested at 4.3 m/s (mean) and the other two were tested at 6.8 m/s (mean), and one large male specimen was subjected to 6.6 m/s velocity. One female specimen teste...

Journal of neurosurgery. Spine, 2014

Segmental instability in the lumbar spine can result from a number of mechanisms including interv... more Segmental instability in the lumbar spine can result from a number of mechanisms including intervertebral disc degeneration and facet joint degradation. Under traumatic circumstances, elevated loading may lead to mechanical yield of the annular fibers, which can decrease load-carrying capacity and contribute to instability. The purpose of this study was to quantify the biomechanics of intervertebral annular yield during tensile loading with respect to spinal level and anatomical region within the intervertebral disc. This laboratory-based study incorporated isolated lumbar spine annular specimens from younger and normal or mildly degenerated intervertebral discs. Specimens were quasi-statically distracted to failure in an environmentally controlled chamber. Stress and strain associated with yield and ultimate failure were quantified, as was stiffness in the elastic and postyield regions. Analysis of variance was used to determine statistically significant differences based on lumbar...

Annals of advances in automotive medicine / Annual Scientific Conference ... Association for the Advancement of Automotive Medicine. Association for the Advancement of Automotive Medicine. Scientific Conference, 2013

Recent studies suggest that dorsal spine injuries occur in motor vehicle crashes to restrained oc... more Recent studies suggest that dorsal spine injuries occur in motor vehicle crashes to restrained occupants. Compression/compression-flexion injuries occur in frontal crashes due to seat pan and vertical loading. While injuries, mechanisms and tolerances for neck injuries have been determined, thoraco-lumbar spine data are very limited. The objective of the study was to determine the biomechanical characteristics associated with such spinal injuries due to vertical loading. Upper thoracic (T2-T6), lower thoracic (T7-T11) and lumbar (T12-L5) columns from post mortem human surrogates were procured, fixed at the ends and dropped from three heights: the first two impacts designed as non-failure tests and the final was the failure test. Intermittent evaluations consisted of palpations and x-rays. Injuries were assessed using posttest x-rays and computed tomography scans. The age, stature, total body mass and body mass index of three PMHS were: 50 years, 164 cm, 66.9 kg, and 24.7 kg/m(2). Th...

Biomedical sciences instrumentation, 2012

Shock tubes can be used to study traumatic brain injuries due to blast waves in a laboratory sett... more Shock tubes can be used to study traumatic brain injuries due to blast waves in a laboratory setting without the use of explosives. A literature review shows that several shock tubes used in these type of studies are large in size and have a high cost of conducting tests and maintaining the device. The purpose of this study was to design and characterize small shock tubes to simulate open field blast waves, which can be used in a laboratory with limited space and has low cost of operation. In addition, the shock tube can be used to induce localized blast in a small region to study the injury mechanisms in the desired region. Furthermore, the animal is placed outside of the shock tube, which provides the ability to expose the animal to a pure primary blast wave. A helium-driven shock tube with driven length of 3.04 m and driver length of 0.30 m was used in the present study. Transducers were placed at multiple locations and distances to characterize the blast wave outside the shock t...

The objective of the study was to determine differences between the United States-based NASS and ... more The objective of the study was to determine differences between the United States-based NASS and CIREN and Australia-based ANCIS databases in occupant-, crash-, and vehicle-related parameters for AIS 4+ head injuries in motor vehicle crashes. Logistic regression analysis was performed to examine roles of the change in velocity (DV), crash type (frontal, far-side, nearside, rear impact), seatbelt use, and occupant position, gender, age, stature, and body mass in cranial traumas. Belted and unbelted non-ejected occupant (age >16 years) data from 1997-2006 were used for the NASS and CIREN datasets, and 2000-2010 for ANCIS. Vehicle model year, and occupant position and demographics including body mass index (BMI) data were obtained. Injuries were coded using AIS 1990-1998 update. Similarities were apparent across all databases: mean demographics were close to the mid-size anthropometry, mean BMI was in the normal to overweight range, and representations of extreme variations were unc...

The spine journal : official journal of the North American Spine Society, 2011

Anteroposterior width of prevertebral soft tissues (PVSTs) in the cervical spine has long been co... more Anteroposterior width of prevertebral soft tissues (PVSTs) in the cervical spine has long been considered a valuable radiographic measurement for evaluation of occult cervical spine pathology. These measurements, generally obtained from lateral radiographs of the cervical spine, have been used clinically as references for the evaluation of patients with traumatic, neoplastic, or other cervical spine disorders. Magnetic resonance imaging (MRI) offers a subtle delineation of the soft-tissue structures anterior to the vertebral column, with the potential for more accurate and sensitive determination of PVST width. Upright magnetic resonance images permit comparison with and validation of previously reported upright lateral radiographic measurements of PVST width. To our knowledge, evaluation of cervical spine PVST width using upright MRI has not been previously published in the English literature. The purposes of this study were to validate lateral radiographic measurements of PVST wid...

Biomedical sciences instrumentation, 2009

The objective was to examine significant differences in the bony structure of cervical spine vert... more The objective was to examine significant differences in the bony structure of cervical spine vertebrae based on gender and spinal level that may influence injury risk in women following automotive rear impact. Male and female subjects were recruited for a separate study and data from two subsets were selected for inclusion in this study. Subjects were size-matched based on sitting height (17 males, 11 females) and head circumference (9 males, 18 females). Axial CT scans were obtained of the cervical spine from the C1 through C6. Bony boundaries of cervical vertebrae were defined using image-analysis software and biomechanically-relevant dimensions were derived at spinal levels C2 through C6. Six of seven vertebral dimensions were significantly dependent upon gender and spinal level in both subgroups. Male vertebrae had larger dimensions for each metric. Depth dimensions were greatest at caudal and cranial extents, whereas width dimensions were smallest at C2 and increased caudally. ...

Stapp car crash journal, 2007

Injury to the far side occupant has been demonstrated as a significant portion of the total traum... more Injury to the far side occupant has been demonstrated as a significant portion of the total trauma in side impacts. The objective of the study was to determine the response of PMHS in far side impact configurations, with and without generic countermeasures, and compare responses to the WorldSID and THOR dummies. A far side impact buck was designed for a sled test system that included a center console and three-point belt system. The buck allowed for additional options of generic countermeasures including shoulder or thorax plates or an inboard shoulder belt. The entire buck could be mounted on the sled in either a 90-degree (3-o'clock PDOF) or a 60-degree (2-o'clock PDOF) orientation. A total of 18 tests on six PMHS were done to characterize the far side impact environment at both low (11 km/h) and high (30 km/h) velocities. WorldSID and THOR-NT tests were completed in the same configurations to conduct matched-pair comparisons. For high-speed tests, center console pelvic fo...

Biomedical sciences instrumentation, 2007

The relationship between diffuse brain injury (DBI) occurrence and impact biomechanics is well do... more The relationship between diffuse brain injury (DBI) occurrence and impact biomechanics is well documented. Previous studies attempted to develop injury thresholds based on various biomechanical parameters and have demonstrated inconsistent results. The spectral nature of DBI requires robust metrics capable of predicting injury occurrence and severity. In the present study impact biomechanics reported previously were correlated to rat unconsciousness time. Significant correlation was identified in three parameters including square angular velocity, change in rotational velocity, and Head Impact Power. Results suggest rotational loading of the rat head has similar correlates to the human condition. In addition, certain biomechanical parameters demonstrate capacity for predicting DBI severity.

Biomedical sciences instrumentation, 2006

Commonly considered a continuum of injuries, diffuse brain injury (DBI) ranges from mild concussi... more Commonly considered a continuum of injuries, diffuse brain injury (DBI) ranges from mild concussion to severe diffuse axonal injury. The lower end of the spectrum is generally referred to as mild traumatic brain injury (MTBI). More severe forms of DBI have garnered extensive experimentation while these milder cases are considerably less explored. Recently, a new device was designed to generate DBI in the rodent using impact-induced angular acceleration. This device is modifiable so the entire spectrum of DBI can be investigated. Severity of DBI is critically dependent on magnitude of angular acceleration. A small animal surrogate like a rodent has a relatively small brain mass. This constraint poses a unique problem because the angular acceleration necessary for DBI is inversely related to brain mass. Prior experimentation estimated an angular acceleration of approximately 350 krad/s2 is necessary for the induction of mild traumatic brain injury (MTBI) in the rodent. To induce these...

Annals of biomedical engineering, Jan 25, 2014

A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments a... more A majority of traumatic brain injuries (TBI) in motor vehicle crashes and sporting environments are mild and caused by high-rate acceleration of the head. For injuries caused by rotational acceleration, both magnitude and duration of the acceleration pulse were shown to influence injury outcomes. This study incorporated a unique rodent model of rotational acceleration-induced mild TBI (mTBI) to quantify independent effects of magnitude and duration on behavioral and neuroimaging outcomes. Ninety-two Sprague-Dawley rats were exposed to head rotational acceleration at peak magnitudes of 214 or 350 krad/s(2) and acceleration pulse durations of 1.6 or 3.4 ms in a full factorial design. Rats underwent a series of behavioral tests including the Composite Neuroscore (CN), Elevated Plus Maze (EPM), and Morris Water Maze (MWM). Ex vivo diffusion tensor imaging (DTI) of the fixed brains was conducted to assess the effects of rotational injury on brain microstructure as revealed by the paramet...

Frontiers in neurology, 2015

Due to recent involvement in military conflicts, and an increase in the use of explosives, there ... more Due to recent involvement in military conflicts, and an increase in the use of explosives, there has been an escalation in the incidence of blast-induced traumatic brain injury (bTBI) among US military personnel. Having a better understanding of the cellular and molecular cascade of events in bTBI is prerequisite for the development of an effective therapy that currently is unavailable. The present study utilized organotypic hippocampal slice cultures (OHCs) exposed to blast overpressures of 150 kPa (low) and 280 kPa (high) as an in vitro bTBI model. Using this model, we further characterized the cellular effects of the blast injury. Blast-evoked cell death was visualized by a propidium iodide (PI) uptake assay as early as 2 h post-injury. Quantification of PI staining in the cornu Ammonis 1 and 3 (CA1 and CA3) and the dentate gyrus regions of the hippocampus at 2, 24, 48, and 72 h following blast exposure revealed significant time dependent effects. OHCs exposed to 150 kPa demonstr...

ASME 2007 Summer Bioengineering Conference, 2007

ABSTRACT Gender differences have been identified in a variety of spine-related disorders includin... more ABSTRACT Gender differences have been identified in a variety of spine-related disorders including rates of thoracic sagittal plane scoliosis and rates of whiplash associated disorder following automotive rear impacts. For example, female gender was identified as a main risk factor for thoracic curve progression in adolescent idiopathic scoliosis [1]. Clinical and epidemiological studies have identified females to be more susceptible to whiplash injury [2]. However, biomechanical evidence for these discrepancies has been limited. Experimental investigations using human volunteers and post mortem human head-neck specimens have identified dynamic gender differences in overall head kinematics relative to T1 [3] and segmental and localized spinal kinematics [4, 5] following simulated automotive rear impacts. However, it remains unclear whether dynamic gender differences resulted from anthropometry, or geometrical or structural differences in the head-neck complex and/or cervical spine. Structural gender differences identified in anterior cruciate ligaments of the knee [6] and histological differences identified in the ligamentum flavum of the lumbar spine may indicate possible structural or material gender differences in spinal ligaments [7]. Therefore, the present investigation was conducted to experimentally identify soft tissue structural differences in spinal biomechanics.

Annual proceedings / Association for the Advancement of Automotive Medicine. Association for the Advancement of Automotive Medicine, 2006

Far side impact trauma has been demonstrated as a significant portion of the total trauma in side... more Far side impact trauma has been demonstrated as a significant portion of the total trauma in side impacts. The objective of the study was to assess the potential usefulness of countermeasures and assess the trade-offs associated with generic countermeasure design. Because the WorldSID dummy has demonstrated promise as a potential far side impact dummy, it was chosen to assess countermeasures in this mode. A unique far side impact buck was designed for a sled test system that included, as a standard configuration, a center console and outboard three-point belt system. This configuration assumed a left side driver with a right side impact. The buck allowed for additional options of generic restraints including shoulder or thorax plates or an inboard shoulder belt. The entire buck could be mounted on the sled in either a 90-degree (3-o'clock PDOF) or a 60-degree (2-o'clock PDOF) orientation. A total of 19 WorldSID tests were completed. The inboard shoulder belt configuration pr...

Volume 2: Biomedical and Biotechnology Engineering; Nanoengineering for Medicine and Biology, 2011

ABSTRACT The purpose of the study was to quantify attenuation of open field shockwaves passing th... more ABSTRACT The purpose of the study was to quantify attenuation of open field shockwaves passing through the PMHS (Post Mortem Human Subject) cranium. A better understanding of the relationship between shockwave characteristics external to the cranium and insults experienced by the brain is essential for understanding injury mechanisms, validation of finite element models, and development of military safety devices for soldiers in the field. These relationships are being developed using experimental PMHS techniques. Our existing shock tube produced open field shockwaves by increasing input pressure behind a Mylar membrane using compressed nitrogen until the membrane burst. Increasing membrane thickness resulted in greater bursting pressure and peak shockwave pressure. Peak pressure decreased predictably with greater distance from the shock tube outlet. Input pressures between 1.6 and 3.2 MPa resulted in peak shockwave pressures between 45 kPa and 90 kPa measured between 40 and 60 cm from the shock tube exit. The experimental protocol consisted of obtaining a PMHS head, filling the voided cranium with Sylgard gel, and securing the head in front of the shock tube using a Hybrid III dummy neck. Pressure transducers were mounted on the external cranium surface on the ipsilateral side and on the internal cranium surface on the ipsilateral and contralateral sides. Because the specimen was tested in multiple orientations, the ipsilateral side referred to the frontal or temporal sides. Transducers were mounted prior to adding the Sylgard gel. Data from all tests indicated shockwave rise times less than 10 μs external to the skull and internal to the skull on the ipsilateral side. Therefore, the sampling rate was 10 MHz using a digital oscilloscope. Shockwave characteristics were quantified including peak overpressure, peak underpressure, and duration of positive phase. The results show peak overpressure attenuations between 14 and 26% from the external ipsilateral transducer to the contralateral transducers in frontal and lateral orientation. In addition, there was a 93–96% reduction in the rate of onset between those transducers. Each characteristic may affect injury type/severity. This setup can be used to understand injury mechanisms for blast-induced mTBI, to quantify effects of interventions (e.g., helmets) on attenuation of open field blast waves, and for validation of finite element models.

Biomechanics in Ergonomics, Second Edition, 2007