Sensitivity analysis of biomechanical effect in vertebral body of two different augmenters

Sun Yuewan; Wang Dongmei; Wang Wei; Sun Jingchuan; Liu Anmin; Shi Jiangang

doi:10.1016/j.clinbiomech.2020.105166

Sensitivity analysis of biomechanical effect in vertebral body of two different augmenters

Clin Biomech (Bristol, Avon). 2020 Dec:80:105166. doi: 10.1016/j.clinbiomech.2020.105166. Epub 2020 Sep 10.

Authors

Sun Yuewan¹, Wang Dongmei², Wang Wei¹, Sun Jingchuan³, Liu Anmin⁴, Shi Jiangang³

Affiliations

¹ School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai,China.
² School of Mechanical Engineering, Shanghai Jiao Tong University, Shanghai,China. Electronic address: dmwang@sjtu.edu.cn.
³ Department of Orthopedics, Shanghai Changzheng Hospital Affiliated to The Second Military Medical University, Shanghai,China.
⁴ Centre for Centre for Health Science Research, Salford University, Salford, M6 6PU, UK.

PMID: 32928587
DOI: 10.1016/j.clinbiomech.2020.105166

Abstract

Background: Transvertebral Bone Graft and Augmentation (TBGA) has achieved good clinical effects in the treatment of osteoporotic vertebral compression fractures (OVCFs). This study aimed to investigate the postoperatively biomechanical effects of TBGA and compare the biomechanical sensitivity of two different augmenters: a cylindrical enhancement device (CED) and bone cement.

Methods: Finite element models of the spine segment T11-L3 were created, including one model based on normal segment and the other three with L1 augmentation for pathological conditions. Three treatments were simulated including CED implant treatment A, CED implant treatment B, and bone cement treatment. The stress distribution and maximum displacement of the four models under different treatments were analyzed. A method of linear fitting of dummy variables was used to analyze the sensitivity of biomechanical parameters to the degree of osteoporosis (DO) and load.

Findings: The reduction of stress with increasing DO in augmented and adjacent vertebral bodies under bone cement augmentation was less than that under CED augmentation. The stress of augmented vertebral body and the adjacent vertebral body was most sensitive to extension and rotation loading conditions. As DO increasing, the bone cement augmentation significantly increased the stress level on the upper and lower endplates.

Interpretation: When the degree of osteoporosis increased, CED outperforms bone cement in terms of the stress reduction in augmented vertebral and adjacent vertebral, which could be beneficial for avoiding re-fracture. Using TBGA to treat OVCFs, especially with Plan B method, the condition of the pathological spine is closer to the original status in terms of the sensitivity to stress and the spinal range of motion. The TBGA treatment is sensitive to lateral bending and torsion, therefore patients should be advised to avoid high-risk motions like lateral bending and rotation.

Keywords: Finite element simulation; Osteoporosis OVCFs; Sensitivity analysis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Biomechanical Phenomena
Bone Cements
Calcium Phosphates
Fractures, Compression / surgery
Humans
Male
Mechanical Phenomena*
Osteoporosis / surgery
Prostheses and Implants
Spinal Fractures / surgery
Vertebral Body / physiology*
Vertebral Body / physiopathology

Substances

Bone Cements
Calcium Phosphates
beta-tricalcium phosphate