Computational modeling of long-term effects of prophylactic vertebroplasty on bone adaptation

Badilatti, Sandro D.; Christen, Patrik; Ferguson, Stephen J.; Müller, Ralph

doi:10.1177/0954411916683222

Cited by 8 publications

(10 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Case E aimed at investigating an extreme case where the bone tissue was so deteriorated that it could be neglected. The long-term behaviour of the bone present in the augmented region is unclear, 24 so results obtained with method E are a representation of one of the worst possible cases. It is also worth noticing the similarity between approaches E (bone tissue is neglected) and B (pure porous PMMA).…”

Section: Figure 8 Distribution Of Bone Cement Volume (Relative Frequementioning

confidence: 99%

“…Consequently, one research question is whether considering the PMMA porosity for the augmented bone has a statistically important impact when predicting the optimal volume of bone cement required to achieve a specific level of bone augmentation. Furthermore, a second research task is to identify the correlation between level of osteoporosis and optimum volume of bone cement, as the latter is proven to be an important factor both for the biomechanical properties of the bone after an augmentation procedure and the long‐term behaviour of bone after augmentation . Lastly, a third research question is to quantify the sensitivity of the optimum volume of bone cement on essential design variables of the examined problem, namely the grade of porosity of PMMA, as well as the frontal and the transverse direction of the external load, resembling a fall on the greater trochanter.…”

Section: Introductionmentioning

confidence: 99%

“…Furthermore, a second research task is to identify the correlation between level of osteoporosis and optimum volume of bone cement, as the latter is proven to be an important factor both for the biomechanical properties of the bone after an augmentation procedure 18,23 and the long-term behaviour of bone after augmentation. 24 Lastly, a third research question is to quantify the sensitivity of the optimum volume of bone cement on essential design variables of the examined problem, namely the grade of porosity of PMMA, as well as the frontal and the transverse direction of the external load, resembling a fall on the greater trochanter. Changes in the direction of the applied load concern variations of the fall direction on the greater trochanter.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Numerical investigation of the effect of bone cement porosity on osteoporotic femoral augmentation

Artiles

Venetsanos

2018

Numer Methods Biomed Eng

View full text Add to dashboard Cite

Femoroplasty is the injection of bone cement into the proximal femur, enhances the bone load capacity, and is typically applied to osteoporotic femora. To minimize the required injected volume of bone cement and maximize the load capacity enhancement, an optimization problem must be solved, where the modulus of elasticity of the augmented bone is a key element. This paper, through the numerical investigation of a fall on the greater trochanter of an osteoporotic femur, compares different ways to calculate this modulus and introduces an approach, based on the concept of bone cement porosity, which provides results statistically similar to those obtained with other considerations. Based on this approach, the present paper quantifies the correlation between degree of osteoporosis and optimum volume of bone cement. It concludes with an exhaustive search that reveals the effect of the bone cement porosity on the optimum volume of PMMA, for various combinations of the frontal and transverse angles of the fall on the greater trochanter.

show abstract

Section: Figure 8 Distribution Of Bone Cement Volume (Relative Frequementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Numerical investigation of the effect of bone cement porosity on osteoporotic femoral augmentation

Artiles

Venetsanos

2018

Numer Methods Biomed Eng

View full text Add to dashboard Cite

show abstract

“…Biomechanical tests of PKP have confirmed that cement augmentation improved vertebral fracture stability, and there were no significant differences in VH restoration in in vitro studies [ 10 , 11 ]. The results of restoration of mechanical stability through VA have been also confirmed by finite element analysis (FEA), which can predict the long-term stability of a bone after cement augmentation through reliable models [ 8 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Biomechanical effects of different vertebral heights after augmentation of osteoporotic vertebral compression fracture: a three-dimensional finite element analysis

et al. 2018

View full text Add to dashboard Cite

BackgroundClinical results have shown that different vertebral heights have been restored post-augmentation of osteoporotic vertebral compression fractures (OVCFs) and the treatment results are consistent. However, no significant results regarding biomechanical effects post-augmentation have been found with different types of vertebral deformity or vertebral heights by biomechanical analysis. Therefore, the present study aimed to investigate the biomechanical effects between different vertebral heights of OVCFs before and after augmentation using three-dimensional finite element analysis.MethodsFour patients with OVCFs of T12 underwent computed tomography (CT) of the T11-L1 levels. The CT images were reconstructed as simulated three-dimensional finite-element models of the T11-L1 levels (before and after the T12 vertebra was augmented with cement). Four different kinds of vertebral height models included Genant semi-quantitative grades 0, 1, 2, and 3, which simulated unilateral augmentation. These models were assumed to represent vertical compression and flexion, left flexion, and right flexion loads, and the von Mises stresses of the T12 vertebral body were assessed under different vertebral heights before and after bone cement augmentation.ResultsData showed that the von Mises stresses significantly increased under four loads of OVCFs of the T12 vertebral body before the operation from grade 0 to grade 3 vertebral heights. The maximum stress of grade 3 vertebral height pre-augmentation was produced at approximately 200%, and at more than 200% for grade 0. The von Mises stresses were significantly different between different vertebral heights preoperatively. The von Mises stresses of the T12 vertebral body significantly decreased in four different loads and at different vertebral body heights (grades 0–3) after augmentation. There was no significant difference between the von Mises stresses of grade 0, 1, and 3 vertebral heights postoperatively. The von Mises stress significantly decreased between pre-augmentation and post-augmentation in T12 OVCF models of grade 0–3 vertebral heights.ConclusionVertebral augmentation can sufficiently reduce von Mises stresses at different heights of OVCFs of the vertebral body, although this technique does not completely restore vertebral height to the anatomical criteria.

show abstract

“…With the deepening understanding of PVP surgery and the advances in biomechanical experiments, others believed that the new vertebral fractures after PVP were not caused by increased stiffness of the vertebral body. They indicated that it was the injected bone cement that caused vertebral body stiffness and slightly increased end-plate pressure-but not enough to lead to adjacent vertebral fractures [20,21]. Although the strength of the vertebral body was greater after PVP than before fracture, and the stiffness was partially restored, it was still less than that before the fracture [22].…”

Section: Discussionmentioning

confidence: 99%

How the clinical dosage of bone cement biomechanically affects adjacent vertebrae

et al. 2020

View full text Add to dashboard Cite

Objective: This study evaluated the biomechanical changes in the adjacent vertebrae under a physiological load (500 N) when the clinically relevant amount of bone cement was injected into fractured cadaver vertebral bodies. Methods: The embalmed cadaver thoracolumbar specimens in which each vertebral body (T12-L2) had a BMD of < 0.75 g/cm 2 were used for the experiment. For establishing a fracture model, the upper one third of the L1 vertebra was performed wedge osteotomy and the superior endplate was kept complete. Stiffness of specimens was measured in different states. Strain of the adjacent vertebral body and intervertebral disc were measured in pre-fracture, post-fracture, and after augmentation by non-contact optical strain measurement system. Results: The average amount of bone cement was 4.4 ml (3.8-5.0 ml). The stiffness of after augmentation was significantly higher than the stiffness of post-fracture (p < 0.05), but still lower than pre-fracture stiffness (p < 0.05). After augmentation, the adjacent upper vertebral strain showed no significant difference (p > 0.05) with prefracture, while the strain of adjacent lower vertebral body was significantly higher than that before fracture (p < 0.05). In flexion, T12/L1 intervertebral disc strain was significantly greater after augmentation than after the fracture (p < 0.05), but there was no significant difference from that before the fracture (p > 0.05); L1/2 vertebral strain after augmentation was significantly less than that after the fracture (p < 0.05), but there was no significant difference from that before the fracture (p > 0.05). Conclusions: PVP may therefore have partially reversed the abnormal strain state of adjacent vertebral bodies which was caused by fracture.

show abstract

Computational modeling of long-term effects of prophylactic vertebroplasty on bone adaptation

Cited by 8 publications

References 35 publications

Numerical investigation of the effect of bone cement porosity on osteoporotic femoral augmentation

Numerical investigation of the effect of bone cement porosity on osteoporotic femoral augmentation

Biomechanical effects of different vertebral heights after augmentation of osteoporotic vertebral compression fracture: a three-dimensional finite element analysis

How the clinical dosage of bone cement biomechanically affects adjacent vertebrae

Contact Info

Product

Resources

About