Simulated Case Model 01: Severe Ankylosing Spondylitis & Bamboo Spine — Multi-Level Resection & Arthroplasty Simulation
In-silico structural and kinematic restoration of a fully fused thoracolumbar spine finite element model utilizing simulated touchless cold laser osteotomy, modular SLM porous titanium arthroplasty, and localized IL-17/TNF cytokine neutralization modeling.
Baseline Anatomical Model & Pathological Parameters
- Model Geometry: Simulated 44-year-old male biomechanical profile with a 22-year simulated progression of severe, HLA-B27-positive Ankylosing Spondylitis refractory to systemic biologics.
- Anatomical Auto-Fusion: 90% continuous syndesmophyte bridging across T10–L5 ("bamboo spine") finite element mesh with complete obliteration of facet joints and intervertebral disc spaces.
- Severe Fixed Deformity: Fixed thoracic kyphosis of 68° modeled with complete loss of forward visual horizon, compensatory cervical hyperextension load vectors, and calculated high-stress paraspinal fatigue.
- Restrictive Thoracic Mechanics: Costovertebral ankylosis reducing modeled chest expansion to <1.2 cm, precipitating chronic restrictive pulmonary compliance (simulated FVC 44% of predicted).
- Conventional Surgical Limitations: Conventional multi-level Smith-Petersen osteotomy models exhibit catastrophic failure modes with extreme calculated risk of acute spinal cord shear stress and aortic strain.
Pathological Disease Mechanism
Chronic autoimmune enthesitis mediated by local hyper-expression of IL-17A, TNF-α, and IL-23 triggered micro-inflammatory cascades at the modeled insertion points of the anterior longitudinal ligament and annulus fibrosus. In this pathological model, continuous unmodulated osteoblast recruitment catalyzed extensive endochondral ossification, converting flexible fibrous syndesmoses into brittle, continuous hydroxyapatite bone bridges spanning T10 through L5.