Biomechanical assessment of vertebrae with lytic metastases with subject-specific finite element models

Costa, Maria Cristiana; Éltes, Péter Endre; Varga, Péter Pál; Viceconti, Marco; Dall’Ara, Enrico

doi:10.1016/j.jmbbm.2019.06.027

Cited by 33 publications

(34 citation statements)

References 35 publications

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“…CT scans are one of the sources of imaging data, given their high resolution, although magnetic resonance imaging (MRI) is more accurate for IVD degeneration detection. X-ray scans are more limited due to their 2D nature, but they are also employed as they permit less radiation exposure than CT equipment when considering in vivo evaluations [44,[61][62][63]. Table 1 lists the most common constitutive models and data sources for different FSU tissues.…”

Section: Tissue Levelmentioning

confidence: 99%

“…A different trend of FE-based studies is to emphasise on the modelling of specific FSU tissues, namely the cortical/trabecular layers of the VB [62,66,80,81], the layered organisation of the AF [58,65,82,83] or the fluid exchange and osmotic swelling properties of the NP [84][85][86][87]. These (and other) studies are contributing to identifying the complexity of FSU tissues and to understanding their interaction, ranging from vertebroplasty support to the importance of the AF criss-cross angles in the herniation process, despite the frequent simplifications on the modelling of surrounding tissues (i.e., the FSU components that are not the focus of such study).…”

Section: Tissue Levelmentioning

confidence: 99%

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Computational Challenges in Tissue Engineering for the Spine

Castro

2021

Bioengineering

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This paper deals with a brief review of the recent developments in computational modelling applied to innovative treatments of spine diseases. Additionally, it provides a perspective on the research directions expected for the forthcoming years. The spine is composed of distinct and complex tissues that require specific modelling approaches. With the advent of additive manufacturing and increasing computational power, patient-specific treatments have moved from being a research trend to a reality in clinical practice, but there are many issues to be addressed before such approaches become universal. Here, it is identified that the major setback resides in validation of these computational techniques prior to approval by regulatory agencies. Nevertheless, there are very promising indicators in terms of optimised scaffold modelling for both disc arthroplasty and vertebroplasty, powered by a decisive contribution from imaging methods.

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Section: Tissue Levelmentioning

confidence: 99%

Section: Tissue Levelmentioning

confidence: 99%

Computational Challenges in Tissue Engineering for the Spine

Castro

2021

Bioengineering

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“…endplate. An axial compressive preload of 500N was set, and a torsional moment of 10 N•M was dictated to imitate the motions of neutral position (NP), exion (FLEX), extension (EXT), left lateral bending (LLB), right lateral bending (RLB), left axial rotation (LAR) and right axial rotation (RAR) [18,[27][28][29]. The overall displacement and ROM of T11-L2 segment in four heights were investigated and compared with the two types of fracture.…”

Section: Loading and Boundary Conditionsmentioning

confidence: 99%

Finite element analysis of wedge and biconcave deformity in four different height restoration after augmentation of osteoporotic vertebral compression fracture

Zuo¹,

Chen

Xie³

et al. 2020

Preprint

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Purpose Biomechanical comparison of wedge and biconcave deformity of different height restoration after augmentation of osteoporotic vertebral compression fractures was analyzed by three-dimensional finite element analysis (FEA). Methods Three-dimensional finite element model (FEM) of T11-L2 segment was constructed from CT scan of elderly osteoporosis patient. The von Mises stresses of vertebrae, intervertebral disc, facet joints, displacement, and range of motion (ROM) of wedge and biconcave deformity were compared at four different heights (Genant 0–3 grade) after T12 vertebral augmentation. Results In wedge deformity, the stress of T12 decreased as the vertebral height in neutral position, flexion, extension and left axial rotation, whereas increased sharply in bending at Genant 0; L1 and L2 decreased in all positions excluding flexion of L2, and T11 increased in neutral position, flexion, extension, and right axial rotation at Genant 0. No significant changes in biconcave deformity. The stress of T11-T12, T12-L1, and L1-L2 intervertebral disc gradually increased or decreased under other positions in wedge fracture, whereas L1-L2 no significant change in biconcave fracture. The utmost overall facet joint stress is at Genant 3, whereas there is no significant change under the same position in biconcave fracture. The displacement and ROM of the wedge fracture had ups and downs, while a decline in all positions excluding extension in biconcave fracture. Conclusions The vertebral restoration height after augmentation to Genant 0 affects the von Mises stress, displacement, and ROM in wedge deformity, which may increase the risk of fracture; Whereas restored or not in biconcave deformity.

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“…The SINS score has proved to be an excellent tool for non-surgeons to identify the patients that should be referred to a spine surgeon, with an excellent inter-observer and intra-observer agreement [6,7]. However the SINS score is only partially helpful for surgeon as a treatment guide [8]: there is a large grey zone of "potentially unstable" (SINS 7 to 12), were spine surgeons currently must rely on their own experience to determine whether instability is present in the setting of spinal neoplasia and surgery is urgently indicated. A recent review [9] confirmed that the recommendations for treating the primary bone tumors are based on moderate quality evidence and expert opinions.…”

Section: Introductionmentioning

confidence: 99%

Assessing the Mechanical Weakness of Vertebrae Affected by Primary Tumors: A Feasibility Study

et al. 2020

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Patients spend months between the primary spinal tumor diagnosis and the surgical treatment, due to the need for performing chemotherapy and/or radiotherapy. During this period, they are exposed to an unknown risk of fracture. The aim of this study was to assess if it is possible to measure the mechanical strain in vertebrae affected by primary tumors, so as to open the way to an evidence-based scoring or prediction tool. We performed biomechanical tests on three vertebrae with bone tumor removed from patients. The tests were designed so as not to compromise the standard surgical and diagnostic procedures. Non-destructive mechanical tests in combination with state-of-the-art digital image correlation allowed to measure the distribution of strain on the surface of the vertebra. Our study has shown that the strains in the tumor region is circa 3 times higher than in the healthy bones, with principal strain peaks of 40,000/−20,000 microstrain, indicating a stress concentration potentially triggering vertebral fracture. This study has proven it is possible to analyze the mechanical behavior of primary tumor vertebrae as part of the clinical treatment protocol. This will allow building a tool for quantifying the risk of fracture and improving decision making in spine tumors.

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Biomechanical assessment of vertebrae with lytic metastases with subject-specific finite element models

Cited by 33 publications

References 35 publications

Computational Challenges in Tissue Engineering for the Spine

Computational Challenges in Tissue Engineering for the Spine

Finite element analysis of wedge and biconcave deformity in four different height restoration after augmentation of osteoporotic vertebral compression fracture

Assessing the Mechanical Weakness of Vertebrae Affected by Primary Tumors: A Feasibility Study

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