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 (microCT) 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.
The inter-lamellar connectivity of the annulus fibrosus in the intervertebral disc has been shown to affect the prediction of the overall disc behaviour in computational models. Using a combined experimental and computational approach, the inter-lamellar mechanical behaviour of the disc annulus was investigated under conditions of radial loading.Twenty-seven specimens of anterior annulus fibrosus were dissected from 12 discs taken from four frozen ovine thoracolumbar spines. Specimens were grouped depending on their radial provenance within the annulus fibrosus. Standard tensile tests were performed. In addition, micro-tensile tests under microscopy were used to observe the displacement of the lamellae and inter-lamellar connections. Finite elements models matching the experimental protocols were developed with specimen-specific geometries and boundary conditions assuming a known lamellar behaviour. An optimisation process was used to derive the interface stiffness values for each group. The assumption of a linear cohesive interface was used to model the behaviour of the inter-lamellar connectivity.The interface stiffness values derived from the optimisation process were consistently higher than the corresponding lamellar values. The interface stiffness values of the outer annulus were from 43% to 75% higher than those of the inner annulus. Tangential stiffness values for the interface were from 6% to 39% higher than normal stiffness values within each group and similar to values reported by other investigators. These results reflect the intricate fibrous nature of the inter-lamellar connectivity and provide values for the representation of the inter-lamellar behaviour at a continuum level.
Image-based continuum-level finite element models have been used for bones to evaluate fracture risk and the biomechanical effects of diseases and therapies, capturing both the geometry and tissue mechanical properties. Although models of vertebrae of various species have been developed, an inter-species comparison has not yet been investigated. The purpose of this study was to derive species-specific modelling methods and compare the accuracy of image-based finite element models of vertebrae across species. Vertebral specimens were harvested from porcine (N = 12), ovine (N = 13) and bovine (N = 14) spines. The specimens were experimentally loaded to failure and apparent stiffness values were derived. Image-based finite element models were generated reproducing the experimental protocol. A linear relationship between the element grayscale and elastic modulus was calibrated for each species matching in vitro and in silico stiffness values, and validated on independent sets of models. The accuracy of these relationships were compared across species. Experimental stiffness values were significantly different across species and specimen-specific models required species-specific linear relationship between image grayscale and elastic modulus. A good agreement between in vitro and in silico values was achieved for all species, reinforcing the generality of the developed methodology.
BackgroundVertebroplasty is increasingly used in the treatment of vertebral compression fractures. However there are concerns that this intervention may lead to further fractures in the adjacent vertebral segments. This study was designed to parametrically assess the influence of both treatment factors (cement volume and number of augmentations), and patient factors (bone and disc quality) on the biomechanical effects of vertebroplasty.MethodsSpecimen-specific finite element models of two experimentally-tested human three-vertebral-segments were developed from CT-scan data. Cement augmentation at one and two levels was represented in the respective models and good agreement in the predicted stiffness was found compared to the corresponding experimental specimens. Parametric variations of key variables associated with the procedure were then studied.FindingsThe segmental stiffness increased with disc degeneration, with increasing bone quality and to a lesser extent with increasing cement volume. Cement modulus did not have a great influence on the overall segmental stiffness and on the change in the elemental stress in the adjoining vertebrae. However, following augmentation, the stress distribution in the adjacent vertebra changed, indicating possible load redistribution effects of vertebroplasty.InterpretationThis study demonstrates the importance of patient factors in the outcomes of vertebroplasty and suggests that these may be one reason for the variation in clinical results.
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