Finite element analysis of wedge and biconcave deformity in four different height restoration after augmentation of osteoporotic vertebral compression fractures

Abstract

Purpose Biomechanical comparison of wedge and biconcave deformity of different height restoration after augmentation of osteoporotic vertebral compression fractures was analyzed by three-dimensional finite element analysis (FEA). Methods Three-dimensional finite element model (FEM) of T11-L2 segment was constructed from CT scan of elderly osteoporosis patient. The von Mises stresses of vertebrae, intervertebral disc, facet joints, displacement, and range of motion (ROM) of wedge and biconcave deformity were compared at four different heights (Genant 0–3 grade) after T12 vertebral augmentation. Results In wedge deformity, the stress of T12 decreased as the vertebral height in neutral position, flexion, extension, and left axial rotation, whereas increased sharply in bending at Genant 0; L1 and L2 decreased in all positions excluding flexion of L2, and T11 increased in neutral position, flexion, extension, and right axial rotation at Genant 0. No significant changes in biconcave deformity. The stress of T11-T12, T12-L1, and L1-L2 intervertebral disc gradually increased or decreased under other positions in wedge fracture, whereas L1-L2 no significant change in biconcave fracture. The utmost overall facet joint stress is at Genant 3, whereas there is no significant change under the same position in biconcave fracture. The displacement and ROM of the wedge fracture had ups and downs, while a decline in all positions excluding extension in biconcave fracture. Conclusions The vertebral restoration height after augmentation to Genant 0 affects the von Mises stress, displacement, and ROM in wedge deformity, which may increase the risk of fracture, whereas restored or not in biconcave deformity.

Biomechanical comparison between unilateral and bilateral percutaneous vertebroplasty for osteoporotic vertebral compression fractures: A finite element analysis

“…Spinal ligaments [the anterior longitudinal ligament (ALL), posterior longitudinal ligament (PLL), capsular ligament (CL), intertransverse ligament (ITL), ligamentum flavum (LF), interspinous ligament (ISL), and supraspinous ligament (SSL)] were included in the model. These ligaments were modeled with two-node 1D spring elements applied only to the tension force in seven groups ( Figures 1D,E ) ( Tan et al, 2021 ; Zuo X. et al, 2021 ; Elmasry et al, 2017 ). All material properties and element types of the above tissues are listed in Table 2 .…”

“…At 75 years or older, the incidence increases to 19.6/1000 person-years in females and 5.2–9.3/1000 person-years in males ( Liu et al, 2021 ). Nowadays, the increasing incidence of OVCF has imposed an economic burden on society and families and has been a major global health problem ( Zuo X. H. et al, 2021 ; Badilatti et al, 2015 ). The quality of life can be deteriorated by OVCF, which is associated with acute or chronic back pain, functional limitations of the spine, vertebral height (VH) loss, and kyphotic deformity ( Zhao et al, 2018 ; Distefano et al, 2021 ).…”

Analysis of Clinical Outcomes of Percutaneous Kyphoplasty and Vertebroplasty in the Treatment of Osteoporosis-Induced Vertebral Compression Fracture

“…In addition, it was discovered that patients with osteoporotic compression fractures had a lower death rate after spinal augmentation as opposed to nonsurgical care [7]. Nevertheless, elderly patients with various comorbidities and VCF frequently encounter risks and contraindications to vertebral augmentation, which can result in worse outcomes like higher rates of morbidity and mortality and problems following surgery [8][9][10].…”

Static study and numerical simulation of the influence of cement distribution in the upper and lower adjacent vertebrae on sandwich vertebrae in osteoporotic patients: Finite element analysis

“…Osteoporotic vertebral compression fracture (OVCF) is a common fracture type that can lead to persistent pain, kyphotic deformity, and limited mobility, adversely affecting the quality of patients' lives 1,2 . With the aging population, the incidence and disability rates of OVCF are increasing with about 1.4 million cases every year, resulting in an increase in incidence rate, mortality and medical‐related costs burdening society and families and becoming a major global health problem 3–6 . Percutaneous vertebroplasty (PVP) is the percutaneous injection of bone cement into the fractured vertebral body, which can quickly stabilize the fractured vertebral body, strengthen the anterior column, and relieve pain.…”

“… 1 , 2 With the aging population, the incidence and disability rates of OVCF are increasing with about 1.4 million cases every year, resulting in an increase in incidence rate, mortality and medical‐related costs burdening society and families and becoming a major global health problem. 3 , 4 , 5 , 6 Percutaneous vertebroplasty (PVP) is the percutaneous injection of bone cement into the fractured vertebral body, which can quickly stabilize the fractured vertebral body, strengthen the anterior column, and relieve pain. It is currently the most common minimally invasive method for treating OVCF.…”