Development of specimen-specific finite element models of human vertebrae for the analysis of vertebroplasty

Abstract The aim of this study was to determine the accuracy of specimen-specific finite element models of untreated and cement-augmented vertebrae by direct comparison with experimental results. Eleven single cadaveric vertebrae were imaged using micro computed tomography (mCT) and tested to failure in axial compression in the laboratory. Four of the specimens were first augmented with PMMA cement to simulate a prophylactic vertebroplasty. Specimen-specific finite element models were then generated using semi-automated methods. An initial set of three untreated models was used to determine the optimum conversion factors from the image data to the bone material properties. Using these factors, the predicted stiffness and strength were determined for the remaining specimens (four untreated, four augmented). The model predictions were compared with the corresponding experimental data. Good agreement was found with the non-augmented specimens in terms of stiffness (root-mean-square (r.m.s.) error 12.9 per cent) and strength (r.m.s. error 14.4 per cent). With the augmented specimens, the models consistently overestimated both stiffness and strength (r.m.s. errors 65 and 68 per cent). The results indicate that this method has the potential to provide accurate predictions of vertebral behaviour prior to augmentation. However, modelling the augmented bone with bulk material properties is inadequate, and more detailed modelling of the cement region is required to capture the bone—cement interactions if the models are to be used to predict the behaviour following vertebroplasty.

[1]  J. Ahn,et al.  Risk factors of new compression fractures in adjacent vertebrae after percutaneous vertebroplasty , 2004, Acta radiologica.

[2]  L. Nolte,et al.  The Effect of Cement Augmentation on the Load Transfer in an Osteoporotic Functional Spinal Unit: Finite-Element Analysis , 2003, Spine.

[3]  S. Belkoff,et al.  Material properties of various cements for use with vertebroplasty , 2002, Journal of materials science. Materials in medicine.

[4]  Amos Race,et al.  Mechanics of bone/PMMA composite structures: an in vitro study of human vertebrae. , 2007, Journal of biomechanics.

[5]  T. Keaveny,et al.  Quantitative computed tomography estimates of the mechanical properties of human vertebral trabecular bone , 2002, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[6]  A. Evans,et al.  An Investigation of the Inelastic Deformation of Cortical Bone , 2005 .

[7]  S. Kurtz,et al.  The Biomechanical Effects of Kyphoplasty on Treated and Adjacent Nontreated Vertebral Bodies , 2005, Journal of spinal disorders & techniques.

[8]  P. Prendergast,et al.  Fatigue of cemented hip replacements under torsional loads , 1999 .

[9]  Alison C Jones,et al.  Assessment of factors influencing finite element vertebral model predictions. , 2007, Journal of biomechanical engineering.

[10]  Ruth K Wilcox The influence of material property and morphological parameters on specimen-specific finite element models of porcine vertebral bodies. , 2007, Journal of biomechanics.

[11]  Michael A. K. Liebschner,et al.  Evolution of Vertebroplasty: A Biomechanical Perspective , 2004, Annals of Biomedical Engineering.

[12]  C. Cooper,et al.  Perspective how many women have osteoporosis? , 1992, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[13]  R. Martin,et al.  Determinants of the mechanical properties of bones. , 1991, Journal of biomechanics.

[14]  I. Lieberman,et al.  Vertebroplasty and Kyphoplasty Affect Vertebral Motion Segment Stiffness and Stress Distributions: A Microstructural Finite-Element Study , 2005, Spine.

[15]  D. Kallmes,et al.  New fractures after vertebroplasty: adjacent fractures occur significantly sooner. , 2006, AJNR. American journal of neuroradiology.

[16]  P Geusens,et al.  Risk of new vertebral fracture in the year following a fracture. , 2001, JAMA.

[17]  J S Thomsen,et al.  Lumbar vertebral body compressive strength evaluated by dual-energy X-ray absorptiometry, quantitative computed tomography, and ashing. , 1999, Bone.

[18]  Joshua A Hirsch,et al.  Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis. , 2003, Radiology.

[19]  W. Hayes,et al.  An evidence-based evaluation of percutaneous vertebroplasty. , 2000, Managed care.

[20]  Cari M Whyne,et al.  Biomechanical assessment of stability in the metastatic spine following percutaneous vertebroplasty: effects of cement distribution patterns and volume. , 2005, Journal of biomechanics.

[21]  R. Wilcox,et al.  The Biomechanical Effect of Vertebroplasty on the Adjacent Vertebral Body: A Finite Element Study , 2006, Proceedings of the Institution of Mechanical Engineers. Part H, Journal of engineering in medicine.

[22]  J. Nemes,et al.  Load shift of the intervertebral disc after a vertebroplasty: a finite-element study , 2003, European Spine Journal.