Specimen-specific nonlinear finite element modeling to predict vertebrae fracture loads after vertebroplasty

Y. Matsuura, H. Giambini, Y. Ogawa, Z. Fang, A. R. Thoreson, Michael J Yaszemski, Lichun Lu, K. N. An

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

STUDY DESIGN.: Vertebral fracture load and stiffness from a metastatic vertebral defect model were predicted using nonlinear finite element models (FEM) and validated experimentally. OBJECTIVE.: The study objective was to develop and validate an FEM-based tool for predicting polymer-augmented lytic vertebral fracture load and stiffness and the influence of metastatic filling materials. SUMMARY OF BACKGROUND DATA.: Percutaneous vertebroplasty has the potential to reduce vertebral fracture risk affected with lytic metastases by providing mechanical stabilization. However, it has been shown that the mismatch in mechanical properties between poly(methyl-methacrylate) (PMMA) and bone induces secondary fractures and intervertebral disc degeneration. A biodegradable copolymer, poly(propylene fumarate-co-caprolactone) (P(PF-co-CL)), has been shown to possess the appropriate mechanical properties for bone defect repair. METHODS.: Simulated metastatic lytic defects were created in 40 cadaveric vertebral bodies, which were randomized into 4 groups: intact vertebral body (intact), simulated defect without treatment (negative), defect treated with P(PF-co-CL) (copolymer), and defect treated with PMMA (PMMA). Spines were imaged with quantitative computed tomography (QCT), and QCT/FEM-subject-specific, nonlinear models were created. Predicted fracture loads and stiffness were identified and compared with experimentally measured values using Pearson correlation analysis and paired t test. RESULTS.: There was no significant difference between the measured and predicted fracture loads and stiffness for each group. Predicted fracture loads were larger for PMMA augmentation (3960 N [1371 N]) than that for the copolymer, negative and intact groups (3484 N [1497 N], 3237 N [1744 N], and 1747 N [702 N]). A similar trend was observed in the predicted stiffness. Moreover, predicted and experimental fracture loads were strongly correlated (R = 0.78), whereas stiffness showed moderate correlation (R = 0.39). CONCLUSION.: QCT/FEM was successful for predicting fracture loads of metastatic, polymer-augmented vertebral bodies. Overall, we have demonstrated that QCT/FEM may be a useful tool for predicting in situ vertebral fracture load resulting from vertebroplasty.Level of Evidence: N/A.

Original languageEnglish (US)
Pages (from-to)E1291-E1296
JournalSpine
Volume39
Issue number22
DOIs
StatePublished - Oct 15 2014

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Vertebroplasty
Polymethyl Methacrylate
Spine
Tomography
Polymers
Intervertebral Disc Degeneration
Bone and Bones
Fumarates
Nonlinear Dynamics
Neoplasm Metastasis

Keywords

  • augmentation
  • finite element models
  • fracture risk
  • lytic metastases
  • nonlinear
  • polymer
  • specimen-specific
  • spine
  • vertebral fracture load
  • vertebroplasty

ASJC Scopus subject areas

  • Clinical Neurology
  • Orthopedics and Sports Medicine

Cite this

Specimen-specific nonlinear finite element modeling to predict vertebrae fracture loads after vertebroplasty. / Matsuura, Y.; Giambini, H.; Ogawa, Y.; Fang, Z.; Thoreson, A. R.; Yaszemski, Michael J; Lu, Lichun; An, K. N.

In: Spine, Vol. 39, No. 22, 15.10.2014, p. E1291-E1296.

Research output: Contribution to journalArticle

Matsuura, Y. ; Giambini, H. ; Ogawa, Y. ; Fang, Z. ; Thoreson, A. R. ; Yaszemski, Michael J ; Lu, Lichun ; An, K. N. / Specimen-specific nonlinear finite element modeling to predict vertebrae fracture loads after vertebroplasty. In: Spine. 2014 ; Vol. 39, No. 22. pp. E1291-E1296.
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abstract = "STUDY DESIGN.: Vertebral fracture load and stiffness from a metastatic vertebral defect model were predicted using nonlinear finite element models (FEM) and validated experimentally. OBJECTIVE.: The study objective was to develop and validate an FEM-based tool for predicting polymer-augmented lytic vertebral fracture load and stiffness and the influence of metastatic filling materials. SUMMARY OF BACKGROUND DATA.: Percutaneous vertebroplasty has the potential to reduce vertebral fracture risk affected with lytic metastases by providing mechanical stabilization. However, it has been shown that the mismatch in mechanical properties between poly(methyl-methacrylate) (PMMA) and bone induces secondary fractures and intervertebral disc degeneration. A biodegradable copolymer, poly(propylene fumarate-co-caprolactone) (P(PF-co-CL)), has been shown to possess the appropriate mechanical properties for bone defect repair. METHODS.: Simulated metastatic lytic defects were created in 40 cadaveric vertebral bodies, which were randomized into 4 groups: intact vertebral body (intact), simulated defect without treatment (negative), defect treated with P(PF-co-CL) (copolymer), and defect treated with PMMA (PMMA). Spines were imaged with quantitative computed tomography (QCT), and QCT/FEM-subject-specific, nonlinear models were created. Predicted fracture loads and stiffness were identified and compared with experimentally measured values using Pearson correlation analysis and paired t test. RESULTS.: There was no significant difference between the measured and predicted fracture loads and stiffness for each group. Predicted fracture loads were larger for PMMA augmentation (3960 N [1371 N]) than that for the copolymer, negative and intact groups (3484 N [1497 N], 3237 N [1744 N], and 1747 N [702 N]). A similar trend was observed in the predicted stiffness. Moreover, predicted and experimental fracture loads were strongly correlated (R = 0.78), whereas stiffness showed moderate correlation (R = 0.39). CONCLUSION.: QCT/FEM was successful for predicting fracture loads of metastatic, polymer-augmented vertebral bodies. Overall, we have demonstrated that QCT/FEM may be a useful tool for predicting in situ vertebral fracture load resulting from vertebroplasty.Level of Evidence: N/A.",
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AU - Matsuura, Y.

AU - Giambini, H.

AU - Ogawa, Y.

AU - Fang, Z.

AU - Thoreson, A. R.

AU - Yaszemski, Michael J

AU - Lu, Lichun

AU - An, K. N.

PY - 2014/10/15

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N2 - STUDY DESIGN.: Vertebral fracture load and stiffness from a metastatic vertebral defect model were predicted using nonlinear finite element models (FEM) and validated experimentally. OBJECTIVE.: The study objective was to develop and validate an FEM-based tool for predicting polymer-augmented lytic vertebral fracture load and stiffness and the influence of metastatic filling materials. SUMMARY OF BACKGROUND DATA.: Percutaneous vertebroplasty has the potential to reduce vertebral fracture risk affected with lytic metastases by providing mechanical stabilization. However, it has been shown that the mismatch in mechanical properties between poly(methyl-methacrylate) (PMMA) and bone induces secondary fractures and intervertebral disc degeneration. A biodegradable copolymer, poly(propylene fumarate-co-caprolactone) (P(PF-co-CL)), has been shown to possess the appropriate mechanical properties for bone defect repair. METHODS.: Simulated metastatic lytic defects were created in 40 cadaveric vertebral bodies, which were randomized into 4 groups: intact vertebral body (intact), simulated defect without treatment (negative), defect treated with P(PF-co-CL) (copolymer), and defect treated with PMMA (PMMA). Spines were imaged with quantitative computed tomography (QCT), and QCT/FEM-subject-specific, nonlinear models were created. Predicted fracture loads and stiffness were identified and compared with experimentally measured values using Pearson correlation analysis and paired t test. RESULTS.: There was no significant difference between the measured and predicted fracture loads and stiffness for each group. Predicted fracture loads were larger for PMMA augmentation (3960 N [1371 N]) than that for the copolymer, negative and intact groups (3484 N [1497 N], 3237 N [1744 N], and 1747 N [702 N]). A similar trend was observed in the predicted stiffness. Moreover, predicted and experimental fracture loads were strongly correlated (R = 0.78), whereas stiffness showed moderate correlation (R = 0.39). CONCLUSION.: QCT/FEM was successful for predicting fracture loads of metastatic, polymer-augmented vertebral bodies. Overall, we have demonstrated that QCT/FEM may be a useful tool for predicting in situ vertebral fracture load resulting from vertebroplasty.Level of Evidence: N/A.

AB - STUDY DESIGN.: Vertebral fracture load and stiffness from a metastatic vertebral defect model were predicted using nonlinear finite element models (FEM) and validated experimentally. OBJECTIVE.: The study objective was to develop and validate an FEM-based tool for predicting polymer-augmented lytic vertebral fracture load and stiffness and the influence of metastatic filling materials. SUMMARY OF BACKGROUND DATA.: Percutaneous vertebroplasty has the potential to reduce vertebral fracture risk affected with lytic metastases by providing mechanical stabilization. However, it has been shown that the mismatch in mechanical properties between poly(methyl-methacrylate) (PMMA) and bone induces secondary fractures and intervertebral disc degeneration. A biodegradable copolymer, poly(propylene fumarate-co-caprolactone) (P(PF-co-CL)), has been shown to possess the appropriate mechanical properties for bone defect repair. METHODS.: Simulated metastatic lytic defects were created in 40 cadaveric vertebral bodies, which were randomized into 4 groups: intact vertebral body (intact), simulated defect without treatment (negative), defect treated with P(PF-co-CL) (copolymer), and defect treated with PMMA (PMMA). Spines were imaged with quantitative computed tomography (QCT), and QCT/FEM-subject-specific, nonlinear models were created. Predicted fracture loads and stiffness were identified and compared with experimentally measured values using Pearson correlation analysis and paired t test. RESULTS.: There was no significant difference between the measured and predicted fracture loads and stiffness for each group. Predicted fracture loads were larger for PMMA augmentation (3960 N [1371 N]) than that for the copolymer, negative and intact groups (3484 N [1497 N], 3237 N [1744 N], and 1747 N [702 N]). A similar trend was observed in the predicted stiffness. Moreover, predicted and experimental fracture loads were strongly correlated (R = 0.78), whereas stiffness showed moderate correlation (R = 0.39). CONCLUSION.: QCT/FEM was successful for predicting fracture loads of metastatic, polymer-augmented vertebral bodies. Overall, we have demonstrated that QCT/FEM may be a useful tool for predicting in situ vertebral fracture load resulting from vertebroplasty.Level of Evidence: N/A.

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