Cervical endplate bone density distribution measured by CT osteoabsorptiometry and direct comparison with mechanical properties of the endplate

Hara, Takeshi; Ohara, Yukoh; Abe, Eiji; Takami, Kaosu; Orías, Alejandro A. Espinoza; Arai, Hajime; Inoue, Nozomu

doi:10.1007/s00586-021-06920-2

Cited by 8 publications

(9 citation statements)

References 21 publications

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“…During full-text review, study citations were examined, and 20 articles were identified and included. A total of 186 papers 29–31,33–215 were included for data extraction.…”

Section: Resultsmentioning

confidence: 99%

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Applied use of biomechanical measurements from human tissues for the development of medical skills trainers: a scoping review

Kriener,

Whiting,

Storr

et al. 2023

JBI Evidence Synthesis

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Objective: The objective of this review was to identify quantitative biomechanical measurements of human tissues, the methods for obtaining these measurements, and the primary motivations for conducting biomechanical research. Introduction: Medical skills trainers are a safe and useful tool for clinicians to use when learning or practicing medical procedures. The haptic fidelity of these devices is often poor, which may be because the synthetic materials chosen for these devices do not have the same mechanical properties as human tissues. This review investigates a heterogenous body of literature to identify which biomechanical properties are available for human tissues, the methods for obtaining these values, and the primary motivations behind conducting biomechanical tests. Inclusion criteria: Studies containing quantitative measurements of the biomechanical properties of human tissues were included. Studies that primarily focused on dynamic and fluid mechanical properties were excluded. Additionally, studies only containing animal, in silico, or synthetic materials were excluded from this review. Methods: This scoping review followed the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). Sources of evidence were extracted from CINAHL (EBSCO), IEEE Xplore, MEDLINE (PubMed), Scopus, and engineering conference proceedings. The search was limited to the English language. Two independent reviewers screened titles and abstracts as well as full-text reviews. Any conflicts that arose during screening and full-text review were mediated by a third reviewer. Data extraction was conducted by 2 independent reviewers and discrepancies were mediated through discussion. The results are presented in tabular, figure, and narrative formats. Results: Data were extracted from a total of 186 full-text publications. All of the studies, except for 1, were experimental. Included studies came from 33 different countries, with the majority of the studies coming from the United States. Human tissues samples were ex vivo, and the most commonly studied tissue type was musculoskeletal. In this study, nearly 200 unique biomechanical values were reported, and the most commonly reported value was Young’s (elastic) modulus. The most common type of mechanical test performed was tensile testing, and the most common reason for testing human tissues was to characterize biomechanical properties. Although the number of published studies on biomechanical properties of human tissues has increased over the past 20 years, there are many gaps in the literature. Of the 186 included studies, only 7 used human tissues for the design or validation of medical skills training devices. Furthermore, in studies where biomechanical values for human tissues have been obtained, a lack of standardization in engineering assumptions, methodologies, and tissue preparation may implicate the usefulness of these values. Conclusions: This review is the first of its kind to give a broad overview of the biomechanics of human tissues in the published literature. With respect to high-fidelity haptics, there is a large gap in the published literature. Even in instances where biomechanical values are available, comparing or using these values is difficult. This is likely due to the lack of standardization in engineering assumptions, testing methodology, and reporting of the results. It is recommended that journals and/or experts in engineering fields conduct further research to investigate the feasibility of implementing reporting standards. Review Registration: Open Science Framework osf.io/fgb34

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“…During full-text review, study citations were examined, and 20 articles were identified and included. A total of 186 papers 29–31,33–215 were included for data extraction.…”

Section: Resultsmentioning

confidence: 99%

“…We did not identify any studies that compared in vivo and ex vivo biomechanical studies. At least 5 studies recommended that validation research comparing in vivo and ex vivo biomechanical properties was needed 43,97,118,162,204 …”

Section: Discussionmentioning

confidence: 99%

Applied use of biomechanical measurements from human tissues for the development of medical skills trainers: a scoping review

Kriener,

Whiting,

Storr

et al. 2023

JBI Evidence Synthesis

View full text Add to dashboard Cite

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“…Moreover, a biomechanical study showed that overall mechanical strength and stiffness and HU in the superior endplate of the caudal vertebra were lower than those in the inferior endplate of the cranial in the same intervertebral disc. Because of the significant correlation between the cervical endplate HU and the mechanical properties of the endplate, a higher incidence of subsidence in the lower endplate was observed clinically [ 35 ]. We measured the HU value of the upper and lower vertebral body and endplate, included more BMD related factors, and concluded that the HU value of the lower vertebral body was an independent risk factor for TMC subsidence.…”

Section: Discussionmentioning

confidence: 99%

Low cervical vertebral CT value increased early subsidence of titanium mesh cage after anterior cervical corpectomy and fusion

et al. 2022

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Study design This study was a retrospective review. Objective To study the predictive effect of Hounsfield units (HU) value in the cervical vertebral body derived from computed tomography (CT) on the early titanium mesh cage (TMC) subsidence after anterior cervical corpectomy and fusion (ACCF). Methods This retrospective study was conducted on patients who underwent ACCF at one institution between January 2014 and December 2018. We collected date included age, gender, body mass index (BMI), disease type, surgical segment, whether merge ACDF, HU value of the vertebral body and endplate, vertebral body height loss, cervical lordosis angle, and cervical sagittal alignment. VAS, JOA, and NDI were used to assess clinical efficacy. Univariate analysis was performed to screen the influencing factors of TMC subsidence, and then logistic regression was used to find out the independent risk factors. The ROC curve and area under curve (AUC) were used to analyze the HU value to predict the TMC subsidence. Results A total of 85 patients who accepted ACCF were included in this study, and early titanium mesh cage subsidence was demonstrated in 29 patients. The subsidence rate was 34.1%. The JOA, VAS, and NDI scores significantly improved in both groups after the operation. Between the subsidence and non-subsidence groups, there were significant differences in age, intervertebral distraction height, and HU value in both upper and lower vertebral body and endplate. The logistic regression analysis proved that the HU value of the lower vertebral body was an independent risk of TMC subsidence, the AUC was 0.866, and the most appropriate threshold of the HU value was 275 (sensitivity: 87.5%, specificity: 79.3%). Conclusion Preoperative cervical CT value is an independent correlative factor for early TMC subsidence after ACCF, and patients with a low CT value of the inferior vertebral body of the operative segment have a higher risk of TMC subsidence in the early postoperative period. Trial registration: This study is undergoing retrospective registration.

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“…High mechanical strength was substantially linked with high density regions of the acetabulum and femoral head (SBP correlation coefficients ranged from 0.77 to 0.97 for FL and 0.97 to 0.96 for CF) ( Hoechel et al, 2013 ). Several researchers have discovered a link between the density distribution and mechanical strength of the talar dome ( Leumann et al, 2015 ), cervical vertebral body ( Hara et al, 2021 ), and upper and lower cervical endplate ( Orías et al, 2021 ). Yet, we are aware that, while there is a strong association between the two in this sort of research, a quantitative comparison of bone density and mechanical strength is unachievable.…”

Section: Correlation Between Bone Density and Mechanical Strengthmentioning

confidence: 99%

Computed tomography Osteoabsorptiometry: Review of bone density, mechanical strength of material and clinical application

Wang

et al. 2023

Front. Bioeng. Biotechnol.

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Computed Tomography (CT) imaging is an effective non-invasive examination. It is widely used in the diagnosis of fractures, arthritis, tumor, and some anatomical characteristics of patients. The density value (Hounsfield unit, HU) of a material in computed tomography can be the same for materials with varying elemental compositions. This value depends on the mass density of the material and the degree of X-ray attenuation. Computed Tomography Osteoabsorptiometry (CTOAM) imaging technology is developed on the basis of CT imaging technology. By applying pseudo-color image processing to the articular surface, it is used to analyze the distribution of bone mineralization under the articular cartilage, evaluate the position of prosthesis implantation, track the progression of osteoarthritis, and determine the joint injury prognosis. Furthermore, this technique was combined with indentation testing to discuss the relationship between the high bone density area of the articular surface, the mechanical strength of the bone, and the anchorage stability of the implant, in addition to the study of the relationship between mechanical strength and bone density. This narrative study discusses the pre- and postoperative evaluation of medical device implantation position, orthopedic surgery, and the clinical treatment of bone injury and degeneration. It also discusses the research status of CTOAM technology in image post-processing engineering and the relationship between bone material and mechanical strength.

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Cervical endplate bone density distribution measured by CT osteoabsorptiometry and direct comparison with mechanical properties of the endplate

Cited by 8 publications

References 21 publications

Applied use of biomechanical measurements from human tissues for the development of medical skills trainers: a scoping review

Applied use of biomechanical measurements from human tissues for the development of medical skills trainers: a scoping review

Low cervical vertebral CT value increased early subsidence of titanium mesh cage after anterior cervical corpectomy and fusion

Computed tomography Osteoabsorptiometry: Review of bone density, mechanical strength of material and clinical application

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