scholarly journals Effects of vertebroplasty on endplate subsidence in elderly female spines

2015 ◽  
Vol 22 (3) ◽  
pp. 273-282 ◽  
Author(s):  
Srinidhi Nagaraja ◽  
Hassan K. Awada ◽  
Maureen L. Dreher ◽  
John T. Bouck ◽  
Shikha Gupta
Keyword(s):  
Bone Cement ◽  
Trabecular Bone ◽  
Volume Fraction ◽  
Micro Ct ◽  
Control Groups ◽  
Bone Volume Fraction ◽  
Elderly Female ◽  
Maximum Subsidence ◽  
And Control ◽  
Adjacent Vertebra

OBJECT The aim in this study was to quantify the effects of vertebroplasty on endplate subsidence in treated and adjacent vertebrae and their relationship to endplate thickness and underlying trabecular bone in elderly female spines. METHODS Vertebral compression fractures were created in female cadaveric (age range 51–88 years) thoracolumbar spine segments. Specimens were placed into either the control or vertebroplasty group (n = 9/group) such that bone mineral density, trabecular microarchitecture, and age were statistically similar between groups. For the vertebroplasty group, polymethylmethacrylate bone cement was injected into the fractured vertebral body under fluoroscopy. Cyclic compression (685–1370 N sinusoid) was performed on all spine segments for 115,000 cycles. Micro-CT scans were obtained before and after cyclic loading to quantify endplate subsidence. Maximum subsidence was compared between groups in the caudal endplate of the superior adjacent vertebra (SVcau); cranial (TVcra) and caudal (TVcau) endplates of the treated vertebra; and the cranial endplate of the inferior adjacent vertebra (IVcra). In addition, micro-CT images were used to quantify average endplate thickness and trabecular bone volume fraction. These parameters were then correlated with maximum endplate subsidence for each endplate. RESULTS The maximum subsidence in SVcau endplate for the vertebroplasty group (0.34 ± 0.58 mm) was significantly (p < 0.05) greater than for the control group (−0.13 ± 0.27 mm). Maximum subsidence in the TVcra, TVcau, and IVcra endplates were greater in the vertebroplasty group, but these differences were not significant (p > 0.16). Increased subsidence in the vertebroplasty group manifested locally in the anterior region of the SVcau endplate and in the posterior region of the TVcra and TVcau endplates (p < 0.10). Increased subsidence was observed in thinner endplates with lower trabecular bone volume fraction for both vertebroplasty and control groups (R2 correlation up to 62%). In the SVcau endplate specifically, these 2 covariates aided in understanding subsidence differences between vertebroplasty and control groups. CONCLUSIONS Bone cement injected during vertebroplasty alters local biomechanics in elderly female spines, resulting in increased endplate disruption in treated and superior adjacent vertebrae. More specifically, bone cement increases subsidence in the posterior regions of the treated endplates and the anterior region of the superior caudal endplate. This increased subsidence may be the initial mechanism leading to subsequent compression fractures after vertebroplasty, particularly in vertebrae superior to the treated level.

The Effects of Bone Microstructure on Subsidence Risk for ALIF, LLIF, PLIF, and TLIF Spine Cages

2019 ◽  
Vol 141 (3) ◽  
Author(s):  
Vivek Palepu ◽  
Melvin D. Helgeson ◽  
Michael Molyneaux-Francis ◽  
Srinidhi Nagaraja
Keyword(s):  
Trabecular Bone ◽  
Bone Quality ◽  
Volume Fraction ◽  
Lumbar Fusion ◽  
Lumbar Vertebrae ◽  
Micro Ct ◽  
Cage Subsidence ◽  
Maximum Subsidence ◽  
Trabecular Bone Quality ◽  
The Impact

Several approaches (anterior, posterior, lateral, and transforaminal) are used in lumbar fusion surgery. However, it is unclear whether one of these approaches has the greatest subsidence risk as published clinical rates of cage subsidence vary widely (7–70%). Specifically, there is limited data on how a patient's endplate morphometry and trabecular bone quality influences cage subsidence risk. Therefore, this study compared subsidence (stiffness, maximum force, and work) between anterior (ALIF), lateral (LLIF), posterior (PLIF), and transforaminal (TLIF) lumbar interbody fusion cage designs to understand the impact of endplate and trabecular bone quality on subsidence. Forty-eight lumbar vertebrae were imaged with micro-ct to assess trabecular microarchitecture. micro-ct images of each vertebra were then imported into image processing software to measure endplate thickness (ET) and maximum endplate concavity depth (ECD). Generic ALIF, LLIF, PLIF, and TLIF cages made of polyether ether ketone were implanted on the superior endplates of all vertebrae and subsidence testing was performed. The results indicated that TLIF cages had significantly lower (p < 0.01) subsidence stiffness and maximum subsidence force compared to ALIF and LLIF cages. For all cage groups, trabecular bone volume fraction was better correlated with maximum subsidence force compared to ET and concavity depth. These findings highlight the importance of cage design (e.g., surface area), placement on the endplate, and trabecular bone quality on subsidence. These results may help surgeons during cage selection for lumbar fusion procedures to mitigate adverse events such as cage subsidence.

Impact of Thresholding Techniques on Micro-CT Image Based Computational Models of Trabecular Bone

2000 ◽  
Author(s):  
Mark J. Eichler ◽  
Chi Hyun Kim ◽  
Ralph Müller ◽  
X. Edward Guo
Keyword(s):  
Mechanical Properties ◽  
Trabecular Bone ◽  
Computational Models ◽  
Volume Fraction ◽  
Bone Fractures ◽  
Bone Adaptation ◽  
Bone Architecture ◽  
Micro Ct ◽  
Bone Volume Fraction ◽  
Age Related

Abstract Age-related bone fractures are mostly influenced by trabecular bone sites. Trabecular bone constantly adapts its bone volume fraction (BV/TV) and orientation, and thus its mechanical properties, to mechanical usage. Therefore, understanding the trabecular bone adaptation process and its consequences will contribute to the better understanding of the etiology of age-related fractures. Micro-computed tomography (micro-CT) is a relatively new method to quantify the complex three-dimensional (3D) trabecular bone architecture [1,2]. Finite element computational studies can be performed on these 3D microstructural images by converting each image voxel into an element [3,4,5]. Image thresholding techniques to segment bone voxels from bone marrow voxels have a major impact on the results of these models. However, the influence of different types of thresholding techniques on the mechanical properties of bone has not been examined carefully.

Effects of Thresholding Techniques on μCT-Based Finite Element Models of Trabecular Bone

2006 ◽  
Vol 129 (4) ◽  
pp. 481-486 ◽  
Author(s):  
Chi Hyun Kim ◽  
Henry Zhang ◽  
George Mikhail ◽  
Dietrich von Stechow ◽  
Ralph Müller ◽  
...  
Keyword(s):  
Mechanical Properties ◽  
Finite Element ◽  
Trabecular Bone ◽  
Volume Fraction ◽  
Ct Images ◽  
Bone Volume ◽  
Finite Element Models ◽  
Micro Ct ◽  
Bone Volume Fraction ◽  
Element Analysis

Microimaging based finite element analysis is widely used to predict the mechanical properties of trabecular bone. The choice of thresholding technique, a necessary step in converting grayscale images to finite element models, can significantly influence the predicted bone volume fraction and mechanical properties. Therefore, we investigated the effects of thresholding techniques on microcomputed tomography (micro-CT) based finite element models of trabecular bone. Three types of thresholding techniques were applied to 16-bit micro-CT images of trabecular bone to create three different models per specimen. Bone volume fractions and apparent moduli were predicted and compared to experimental results. In addition, trabecular tissue mechanical parameters and morphological parameters were compared among different models. Our findings suggest that predictions of apparent mechanical properties and structural properties agree well with experimental measurements regardless of the choice of thresholding methods or the format of micro-CT images.

scholarly journals Generation of Vertebra Micro-CT-like Image from MDCT: A Deep-Learning-Based Image Enhancement Approach

Tomography ◽  
2021 ◽  
Vol 7 (4) ◽  
pp. 767-782
Author(s):  
Dan Jin ◽  
Han Zheng ◽  
Qingqing Zhao ◽  
Chunjie Wang ◽  
Mengze Zhang ◽  
...  
Keyword(s):  
Deep Learning ◽  
Trabecular Bone ◽  
Image Enhancement ◽  
Volume Fraction ◽  
Similarity Index ◽  
Ct Images ◽  
Micro Ct ◽  
Bone Volume Fraction ◽  
Trabecular Thickness ◽  
Significant Difference

This paper proposes a deep-learning-based image enhancement approach that can generate high-resolution micro-CT-like images from multidetector computed tomography (MDCT). A total of 12,500 MDCT and micro-CT image pairs were obtained from 25 vertebral specimens. Then, a pix2pixHD model was trained and evaluated using the structural similarity index measure (SSIM) and Fréchet inception distance (FID). We performed subjective assessments of the micro-CT-like images based on five aspects. Micro-CT and micro-CT-like image-derived trabecular bone microstructures were compared, and the underlying correlations were analyzed. The results showed that the pix2pixHD method (SSIM, 0.804 ± 0.037 and FID, 43.598 ± 9.108) outperformed the two control methods (pix2pix and CRN) in enhancing MDCT images (p < 0.05). According to the subjective assessment, the pix2pixHD-derived micro-CT-like images showed no significant difference from the micro-CT images in terms of contrast and shadow (p > 0.05) but demonstrated slightly lower noise, sharpness and trabecular bone texture (p < 0.05). Compared with the trabecular microstructure parameters of micro-CT images, those of pix2pixHD-derived micro-CT-like images showed no significant differences in bone volume fraction (BV/TV) (p > 0.05) and significant correlations in trabecular thickness (Tb.Th) and trabecular spacing (Tb.Sp) (Tb.Th, R = 0.90, p < 0.05; Tb.Sp, R = 0.88, p < 0.05). The proposed method can enhance the resolution of MDCT and obtain micro-CT-like images, which may provide new diagnostic criteria and a predictive basis for osteoporosis and related fractures.

scholarly journals Bone health in spacefaring rodents and primates: systematic review and meta-analysis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Jingyan Fu ◽  
Matthew Goldsmith ◽  
Sequoia D. Crooks ◽  
Sean F. Condon ◽  
Martin Morris ◽  
...  
Keyword(s):  
Bone Formation ◽  
Trabecular Bone ◽  
Bone Health ◽  
Volume Fraction ◽  
Meta Analysis ◽  
Bone Volume ◽  
Trabecular Bone Volume ◽  
Bone Volume Fraction ◽  
Percentage Difference ◽  
Induced Changes

AbstractAnimals in space exploration studies serve both as a model for human physiology and as a means to understand the physiological effects of microgravity. To quantify the microgravity-induced changes to bone health in animals, we systematically searched Medline, Embase, Web of Science, BIOSIS, and NASA Technical reports. We selected 40 papers focusing on the bone health of 95 rats, 61 mice, and 9 rhesus monkeys from 22 space missions. The percentage difference from ground control in rodents was –24.1% [Confidence interval: −43.4, −4.9] for trabecular bone volume fraction and –5.9% [−8.0, −3.8] for the cortical area. In primates, trabecular bone volume fraction was lower by –25.2% [−35.6, −14.7] in spaceflight animals compared to GC. Bone formation indices in rodent trabecular and cortical bone were significantly lower in microgravity. In contrast, osteoclast numbers were not affected in rats and were variably affected in mice. Thus, microgravity induces bone deficits in rodents and primates likely through the suppression of bone formation.

scholarly journals Biaxial Normal Strength Behavior in the Axial-Transverse Plane for Human Trabecular Bone—Effects of Bone Volume Fraction, Microarchitecture, and Anisotropy

2013 ◽  
Vol 135 (12) ◽  
Author(s):  
Arnav Sanyal ◽  
Tony M. Keaveny
Keyword(s):  
Trabecular Bone ◽  
Volume Fraction ◽  
Elastic Anisotropy ◽  
Bone Volume ◽  
Transverse Plane ◽  
Mechanical Anisotropy ◽  
Bone Volume Fraction ◽  
Human Trabecular Bone ◽  
Strength Behavior ◽  
Normal Strength

The biaxial failure behavior of the human trabecular bone, which has potential relevance both for fall and gait loading conditions, is not well understood, particularly for low-density bone, which can display considerable mechanical anisotropy. Addressing this issue, we investigated the biaxial normal strength behavior and the underlying failure mechanisms for human trabecular bone displaying a wide range of bone volume fraction (0.06–0.34) and elastic anisotropy. Micro-computed tomography (CT)-based nonlinear finite element analysis was used to simulate biaxial failure in 15 specimens (5 mm cubes), spanning the complete biaxial normal stress failure space in the axial-transverse plane. The specimens, treated as approximately transversely isotropic, were loaded in the principal material orientation. We found that the biaxial stress yield surface was well characterized by the superposition of two ellipses—one each for yield failure in the longitudinal and transverse loading directions—and the size, shape, and orientation of which depended on bone volume fraction and elastic anisotropy. However, when normalized by the uniaxial tensile and compressive strengths in the longitudinal and transverse directions, all of which depended on bone volume fraction, microarchitecture, and mechanical anisotropy, the resulting normalized biaxial strength behavior was well described by a single pair of (longitudinal and transverse) ellipses, with little interspecimen variation. Taken together, these results indicate that the role of bone volume fraction, microarchitecture, and mechanical anisotropy is mostly accounted for in determining the uniaxial strength behavior and the effect of these parameters on the axial-transverse biaxial normal strength behavior per se is minor.

Non-Invasive Analysis of the Micro-Structural and Biomechanical Properties of Trabecular Bone in Human Femoral Head

2006 ◽  
Vol 321-323 ◽  
pp. 1070-1073
Author(s):  
Ye Yeon Won ◽  
Myong Hyun Baek ◽  
Wen Quan Cui ◽  
Kwang Kyun Kim
Keyword(s):  
Mechanical Properties ◽  
Mechanical Property ◽  
Femoral Head ◽  
Trabecular Bone ◽  
Volume Fraction ◽  
Reaction Force ◽  
Bone Volume ◽  
Fe Model ◽  
Micro Ct ◽  
Trabecular Thickness

This study investigates micro-structural and mechanical properties of trabecular bone in human femoral head with and without osteoporosis using a micro-CT and a finite element model. 15 cored trabecular bone specimens with 20 of diameter were obtained from femoral heads with osteoporosis resected for total hip arthroplasty, and 5 specimens were removed from femoral head of cadavers, which has no history of musculoskeletal diseases. A high-resolution micro-CT system was used to scan each specimen to obtain histomorphometry indexes. Based on the micro-images, a FE-model was created to determine mechanical property indexes. While the non-osteoporosis group had increases the trabecular thickness, the bone volume, the bone volume fraction, the degree of anisotropy and the trabecular number compared with those of osteoporotic group, the non-osteoporotic group showed decreases in trabecular separation and structure model index. Regarding the mechanical property indexes, the reaction force and the Young's modulus were lower in the osteoporotic group than in non-osteoporotic group. Our data shows salient deteriorations in trabecular micro-structural and mechanical properties in human femoral head with osteoporosis.

Sign in / Sign up

Export Citation Format

Share Document