• Pain physician · Nov 2015

    Effect of Augmentation Material Stiffness on Adjacent Vertebrae after Osteoporotic Vertebroplasty Using Finite Element Analysis with Different Loading Methods.

    • Ah-Reum Cho, Sang-Bong Cho, Jae-Ho Lee, and Kyung-Hoon Kim.
    • School of Mechanical Engineering, Kyungnam University, Changwon.
    • Pain Physician. 2015 Nov 1; 18 (6): E1101-10.

    BackgroundVertebroplasty is an effective treatment for osteoporotic vertebral fractures, which are one of the most common fractures associated with osteoporosis. However, clinical observation has shown that the risk of adjacent vertebral body fractures may increase after vertebroplasty. The mechanism underlying adjacent vertebral body fracture after vertebroplasty is not clear; excessive stiffness resulting from polymethyl methacrylate has been suspected as an important mechanism.ObjectivesThe aim of our study was to compare the effects of bone cement stiffness on adjacent vertebrae after osteoporotic vertebroplasty under load-controlled versus displacement-controlled conditions.Study DesignAn experimental computer study using a finite element analysis.SettingMedical research institute, university hospital, Korean.MethodsA three-dimensional digital anatomic model of L1/2 bone structure was reconstructed from human computed tomographic images. The reconstructed three-dimensional geometry was processed for finite element analysis such as meshing elements and applying material properties. Two boundary conditions, load-controlled and displacement-controlled methods, were applied to each of 5 deformation modes: compression, flexion, extension, lateral bending, and torsion.ResultsThe adjacent L1 vertebra, irrespective of augmentation, revealed nearly similar maximum von Mises stresses under the load-controlled condition. However, for the displacement-controlled condition, the maximum von Mises stresses in the cortical bone and inferior endplate of the adjacent L1 vertebra increased significantly after cement augmentation. This increase was more significant than that with stiffer bone cement under all modes, except the torsion mode.LimitationsThe finite element model was simplified, excluding muscular forces and incorporating a large volume of bone cement, to more clearly demonstrate effects of bone cement stiffness on adjacent vertebrae after vertebroplasty.ConclusionExcessive stiffness of augmented bone cement increases the risk of adjacent vertebral fractures after vertebroplasty in an osteoporotic finite element model. This result was most prominently observed using the displacement-controlled method.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…