The Role of the Size and Location of the Tumors and of the Vertebral Anatomy in Determining the Structural Stability of the Metastatically Involved Spine: a Finite Element Study |
| |
Authors: | Fabio Galbusera Zhihui Qian Gloria Casaroli Tito Bassani Francesco Costa Benedikt Schlager Hans-Joachim Wilke |
| |
Institution: | 2. Key Laboratory of Bionic Engineering, Jilin University, Changchun, China;3. Department of Neurosurgery, Humanitas Research Hospital, Rozzano, Italy;4. Institute of Orthopaedic Research and Biomechanics, Center for Trauma Research Ulm, Ulm University, Ulm, Germany |
| |
Abstract: | Vertebral fractures associated with the loss of structural integrity of neoplastic vertebrae are common, and determined to the deterioration of the bone quality in the lesion area. The prediction of the fracture risk in metastatically involved spines can guide in deciding if preventive solutions, such as medical prophylaxis, bracing, or surgery are indicated for the patient. In this study, finite element models of 22 thoracolumbar vertebrae were built based on CT scans of three spines, covering a wide spectrum of possible clinical scenarios in terms of age, bone quality and degenerative features, taking into account the local material properties of bone tissue. Simulations were performed in order to investigate the effect of the size and location of the tumoral lesion, the bone quality and the vertebral level in determining the structural stability of the neoplastic vertebrae. Tumors with random size and positions were added to the models, for a total of 660 simulations in which a compressive load was simulated. Results highlighted the fundamental role of the tumor size, whereas the other parameters had a lower, but non-negligible impact on the axial collapse of the vertebra, the vertebral bulge in the transverse plane and the canal narrowing under the application of the load. All the considered parameters are radiologically measurable, and can therefore be translated in a straightforward way to the clinical practice to support decisions about preventive treatment of metastatic fractures. |
| |
Keywords: | Address all correspondence to: Fabio Galbusera PhD IRCCS Istituto Ortopedico Galeazzi via Galeazzi 4 20161 Milano Italy |
本文献已被 ScienceDirect 等数据库收录! |
|