Biomechanical effects of metastasis in the osteoporotic lumbar spine: A Finite Element Analysis

Giuseppe Salvatore, Alessandra Berton, Hugo Giambini, Mauro Ciuffreda, Pino Florio, Umile Giuseppe Longo, Vincenzo Denaro, Andrew Thoreson, Kai Nan An

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Cancer patients are likely to undergo osteoporosis as consequence of hormone manipulation and/or chemotherapy. Little is known about possible increased risk of fracture in this population. The aim of this study was to describe the biomechanical effect of a metastatic lesion in an osteoporotic lumbar spine model. Methods: A finite element model of two spinal motion segments (L3-L5) was extracted from a previously developed L3-Sacrum model and used to analyze the effect of metastasis size and bone mineral density (BMD) on Vertebral bulge (VB) and Vertebral height (VH). VB and VH represent respectively radial and axial displacement and they have been correlated to burst fracture. A total of 6 scenarios were evaluated combining three metastasis sizes (no metastasis, 15% and 30% of the vertebral body) and two BMD conditions (normal BMD and osteoporosis). Results: 15% metastasis increased VB and VH by 178% and 248%, respectively in normal BMD model; while VB and VH increased by 134% and 174% in osteoporotic model. 30% metastasis increased VB and VH by 88% and 109%, respectively, when compared to 15% metastasis in normal BMD model; while VB and VH increased by 59% and 74% in osteoporotic model. Conclusion: A metastasis in the osteoporotic lumbar spine always leads to a higher risk of vertebral fracture. This risk increases with the size of the metastasis. Unexpectedly, an increment in metastasis size in the normal BMD spine produces a greater impact on vertebral stability compared to the osteoporotic spine.

Original languageEnglish (US)
Article number38
JournalBMC Musculoskeletal Disorders
Volume19
Issue number1
DOIs
StatePublished - Feb 5 2018

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Finite Element Analysis
Spine
Neoplasm Metastasis
Bone Density
Osteoporosis
Sacrum
Hormones
Drug Therapy

Keywords

  • Finite element analysis
  • Lumbar spine
  • Metastasis
  • Osteoporosis
  • Vertebral fracture
  • Vertebroplasty

ASJC Scopus subject areas

  • Rheumatology
  • Orthopedics and Sports Medicine

Cite this

Salvatore, G., Berton, A., Giambini, H., Ciuffreda, M., Florio, P., Longo, U. G., ... An, K. N. (2018). Biomechanical effects of metastasis in the osteoporotic lumbar spine: A Finite Element Analysis. BMC Musculoskeletal Disorders, 19(1), [38]. https://doi.org/10.1186/s12891-018-1953-6

Biomechanical effects of metastasis in the osteoporotic lumbar spine : A Finite Element Analysis. / Salvatore, Giuseppe; Berton, Alessandra; Giambini, Hugo; Ciuffreda, Mauro; Florio, Pino; Longo, Umile Giuseppe; Denaro, Vincenzo; Thoreson, Andrew; An, Kai Nan.

In: BMC Musculoskeletal Disorders, Vol. 19, No. 1, 38, 05.02.2018.

Research output: Contribution to journalArticle

Salvatore, G, Berton, A, Giambini, H, Ciuffreda, M, Florio, P, Longo, UG, Denaro, V, Thoreson, A & An, KN 2018, 'Biomechanical effects of metastasis in the osteoporotic lumbar spine: A Finite Element Analysis', BMC Musculoskeletal Disorders, vol. 19, no. 1, 38. https://doi.org/10.1186/s12891-018-1953-6
Salvatore, Giuseppe ; Berton, Alessandra ; Giambini, Hugo ; Ciuffreda, Mauro ; Florio, Pino ; Longo, Umile Giuseppe ; Denaro, Vincenzo ; Thoreson, Andrew ; An, Kai Nan. / Biomechanical effects of metastasis in the osteoporotic lumbar spine : A Finite Element Analysis. In: BMC Musculoskeletal Disorders. 2018 ; Vol. 19, No. 1.
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abstract = "Background: Cancer patients are likely to undergo osteoporosis as consequence of hormone manipulation and/or chemotherapy. Little is known about possible increased risk of fracture in this population. The aim of this study was to describe the biomechanical effect of a metastatic lesion in an osteoporotic lumbar spine model. Methods: A finite element model of two spinal motion segments (L3-L5) was extracted from a previously developed L3-Sacrum model and used to analyze the effect of metastasis size and bone mineral density (BMD) on Vertebral bulge (VB) and Vertebral height (VH). VB and VH represent respectively radial and axial displacement and they have been correlated to burst fracture. A total of 6 scenarios were evaluated combining three metastasis sizes (no metastasis, 15{\%} and 30{\%} of the vertebral body) and two BMD conditions (normal BMD and osteoporosis). Results: 15{\%} metastasis increased VB and VH by 178{\%} and 248{\%}, respectively in normal BMD model; while VB and VH increased by 134{\%} and 174{\%} in osteoporotic model. 30{\%} metastasis increased VB and VH by 88{\%} and 109{\%}, respectively, when compared to 15{\%} metastasis in normal BMD model; while VB and VH increased by 59{\%} and 74{\%} in osteoporotic model. Conclusion: A metastasis in the osteoporotic lumbar spine always leads to a higher risk of vertebral fracture. This risk increases with the size of the metastasis. Unexpectedly, an increment in metastasis size in the normal BMD spine produces a greater impact on vertebral stability compared to the osteoporotic spine.",
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AU - Florio, Pino

AU - Longo, Umile Giuseppe

AU - Denaro, Vincenzo

AU - Thoreson, Andrew

AU - An, Kai Nan

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AB - Background: Cancer patients are likely to undergo osteoporosis as consequence of hormone manipulation and/or chemotherapy. Little is known about possible increased risk of fracture in this population. The aim of this study was to describe the biomechanical effect of a metastatic lesion in an osteoporotic lumbar spine model. Methods: A finite element model of two spinal motion segments (L3-L5) was extracted from a previously developed L3-Sacrum model and used to analyze the effect of metastasis size and bone mineral density (BMD) on Vertebral bulge (VB) and Vertebral height (VH). VB and VH represent respectively radial and axial displacement and they have been correlated to burst fracture. A total of 6 scenarios were evaluated combining three metastasis sizes (no metastasis, 15% and 30% of the vertebral body) and two BMD conditions (normal BMD and osteoporosis). Results: 15% metastasis increased VB and VH by 178% and 248%, respectively in normal BMD model; while VB and VH increased by 134% and 174% in osteoporotic model. 30% metastasis increased VB and VH by 88% and 109%, respectively, when compared to 15% metastasis in normal BMD model; while VB and VH increased by 59% and 74% in osteoporotic model. Conclusion: A metastasis in the osteoporotic lumbar spine always leads to a higher risk of vertebral fracture. This risk increases with the size of the metastasis. Unexpectedly, an increment in metastasis size in the normal BMD spine produces a greater impact on vertebral stability compared to the osteoporotic spine.

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KW - Vertebral fracture

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