Prediction of lumbar vertebral body compressive strength of overweight and obese older adults using morphed subject-specific finite-element models to evaluate the effects of weight loss

Schoell, Samantha L.; Beavers, Kristen M.; Beavers, Daniel P.; Lenchik, Leon; Marsh, Anthony P.; Rejeski, W. Jack; Stitzel, Joel D.; Weaver, Ashley A.

doi:10.1007/s40520-018-1010-1

Cited by 10 publications

(5 citation statements)

References 63 publications

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“…The spinal functional unit was modeled between the C2 and C3 vertebrae, including the intervertebral disc, ligaments, and facets at the same level. Four different FE vertebrae models were created separately, which were formed from one, two, four, and eight layers depending on HU values ( Table 1 ) [ 22 ]. The vertebrae model comprising one layer was defined as a homogenized bone.…”

Section: Methodsmentioning

confidence: 99%

Effect of Model Parameters on the Biomechanical Behavior of the Finite Element Cervical Spine Model

Doğru

Arslan

2021

Applied Bionics and Biomechanics

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Finite element (FE) models have frequently been used to analyze spine biomechanics. Material parameters assigned to FE spine models are generally uncertain, and their effect on the characterization of the spinal components is not clear. In this study, we aimed to analyze the effect of model parameters on the range of motion, stress, and strain responses of a FE cervical spine model. To do so, we created a computed tomography-based FE model that consisted of C2-C3 vertebrae, intervertebral disc, facet joints, and ligaments. A total of 32 FE analyses were carried out for two different elastic modulus equations and four different bone layer numbers under four different loading conditions. We evaluated the effects of elastic modulus equations and layer number on the biomechanical behavior of the FE spine model by taking the range of angular motion, stress, and strain responses into account. We found that the angular motions of the one- and two-layer models had a greater variation than those in the models with four and eight layers. The angular motions obtained for the four- and eight-layer models were almost the same, indicating that the use of a four-layer model would be sufficient to achieve a stress value converging to a certain level as the number of layers increases. We also observed that the equation proposed by Gupta and Dan (2004) agreed well with the experimental angular motion data. The outcomes of this study are expected to contribute to the determination of the model parameters used in FE spine models.

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Section: Methodsmentioning

confidence: 99%

Effect of Model Parameters on the Biomechanical Behavior of the Finite Element Cervical Spine Model

Doğru

Arslan

2021

Applied Bionics and Biomechanics

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“…To evaluate bone strength and fracture risk, subject-specific finite element models of the L2 vertebra from the QCT scans will be developed at baseline and 9-month follow-up. 26 27 …”

Section: Methods and Analysismentioning

confidence: 99%

Protocol for a pilot randomised controlled trial of zoledronic acid to prevent bone loss following sleeve gastrectomy surgery

et al. 2021

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IntroductionSleeve gastrectomy (SG) is an increasingly used and effective treatment for obesity; however, the rapid weight loss associated with SG adversely affects bone metabolism predisposing patients to skeletal fragility. Bisphosphonate medications have been evaluated for safety and efficacy in combating bone loss in patients with osteoporosis, but their use in SG-induced bone loss is limited. The goal of this study is to investigate how a one-time infusion of zoledronic acid compares to placebo, in its ability to combat SG-associated bone loss.Methods and analysisThis research protocol is a 9-month, pilot randomized controlled trial (RCT) involving 30 adult SG patients randomised to receive an infusion of either 5 mg of zoledronic acid or placebo, 6 weeks following surgery. To be included participants must be <350 lbs/158.8 kg, free of bone-impacting pathologies or medications, and must have adequate serum calcium and vitamin D levels at baseline. The primary outcome is change in areal bone mineral density (aBMD) at the total hip. Secondary outcomes include change in aBMD of the femoral neck, and lumbar spine, and change in volumetric BMD at the lumbar spine. The primary aim will be tested using a linear mixed model fit with total hip aBMD at 9 months as the outcome. Treatment, participant sex and menopausal status will be considered in analysis. Groups will be compared using contrast statements at 9 months, with change over 9 months being the primary comparison.Ethics and disseminationThis study was approved by the Institutional Review Board of the University of Nebraska Medical Center (IRB820-19). Written consent will be obtained from participants at enrolment by trained staff. Careful and thorough explanation are used in obtainment of consent and voluntariness is emphasised throughout the trial. The findings of this study will be presented locally, nationally, and published in peer-reviewed journals. Additional details will be reported on ClinicalTrials.gov.Trial registration numberNCT04279392

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“…Volumetric BMD and cortical thickness estimates at the hip and femoral neck (assessed by CT scans) were significantly declined in all groups, with the most pronounced changes seen in the diet-induced weight loss group [39]. In a pooled analysis of the 3 treatment groups, bone strength estimated with subject-specific finite-element models (based on CT-derived parameters) was reduced by 6.5% at 18 months compared to baseline [46]. Although this sub-analysis was not powered to detect between-group differences, finite-element models can be used to provide better predictions of bone strength and fracture risk in future weight loss interventions.…”

Section: Interventional Studiesmentioning

confidence: 99%

Is Weight Loss Harmful for Skeletal Health in Obese Older Adults?

et al. 2019

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Purpose of Review: In view of the existing uncertainty about the implications of intentional weight loss in older obese adults, the present review (a) summarizes the available evidence from epidemiological and interventional studies concerning the effects of weight loss through lifestyle modifications on skeletal health parameters in older overweight/obese individuals, (b) proposes mechanisms that link weight loss to bone loss in this age group, and (c) identifies appropriate animal models. Main Findings and Future Directions: Based on prospective epidemiological studies, weight loss is associated with bone loss, impaired bone macro- and microstructure, and increased fracture risk in the elderly. Data from interventional studies confirm the negative effects of intentional weight loss achieved by lifestyle modifications on skeletal health outcomes in obese older individuals. These effects appear to be modest following a single weight loss attempt, but may persist in the longer term, and presumably, during subsequent weight loss efforts. Current evidence suggests that resistance exercise coupled with caloric restriction mitigates bone and muscle loss. However, alternative strategies do not exist for older individuals, especially those who are unable or unwilling to exercise. Clinical weight loss studies in obese older individuals and preclinical research in relevant animal models with obesity and osteoporosis are required. These will advance our understanding of the pathophysiology of weight-loss-associated skeletal alterations and provide evidence on how bone loss can be counteracted or prevented.

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Prediction of lumbar vertebral body compressive strength of overweight and obese older adults using morphed subject-specific finite-element models to evaluate the effects of weight loss

Abstract: Integration of CT-based measures and FE models with conventional areal BMD can improve the understanding of the effects of intentional weight loss on bone health.

Cited by 10 publications

References 63 publications

Effect of Model Parameters on the Biomechanical Behavior of the Finite Element Cervical Spine Model

Effect of Model Parameters on the Biomechanical Behavior of the Finite Element Cervical Spine Model

Protocol for a pilot randomised controlled trial of zoledronic acid to prevent bone loss following sleeve gastrectomy surgery

Is Weight Loss Harmful for Skeletal Health in Obese Older Adults?

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