Mechanisms of initial endplate failure in the human vertebral body |
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| Authors: | Aaron J Fields Gideon L Lee Tony M Keaveny |
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| Institution: | 1. School of Mechanical Engineering, The Fleischman Faculty of Engineering, Tel Aviv University, Tel Aviv 69978, Israel;2. Institute of Orthopaedic Research and Biomechanics, University of Ulm, Helmholtzstrasse 14, 89081 Ulm, Germany;3. IRCCS Galeazzi Orthopaedic Institute, via Galeazzi 4, 20161 Milan, Italy;4. Department of Internal Medicine II, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany;5. Core Facility Small Animal MRI, Medical Faculty, Ulm University, Albert-Einstein-Allee 11, 89081 Ulm, Germany;1. Department of Orthopedics, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China;2. Department of Ophthalmology, Southwest Hospital, Third Military Medical University, Chongqing 400038, China;3. Department of Orthopedics, General Hospital of Chinese PLA, Beijing 100853, China;4. Institute of Pathology and Southwest Cancer Center, Southwest Hospital, Third Military Medical University, Chongqing 400038, China;5. Key Laboratory of Tumor Immunopathology of Ministry of Education of China, Third Military Medical University, Chongqing 400038, China;1. Department of Orthopaedic Surgery and Traumatology, CHU, Poitiers, France;2. Spine & Neuromodulation Functional Unit, Department of Neurosurgery, CHU Poitiers, PRISMATICS Lab, Poitiers, France;3. Institut Pprime UPR 3346, CNRS – Université de Poitiers – ISAE-ENSMA, France;4. ABS Lab, Université de Poitiers, France |
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| Abstract: | Endplate failure occurs frequently in osteoporotic vertebral fractures and may be related to the development of high tensile strain. To determine whether the highest tensile strains in the vertebra occur in the endplates, and whether such high tensile strains are associated with the material behavior of the intervertebral disc, we used micro-CT-based finite element analysis to assess tissue-level strains in 22 elderly human vertebrae (81.5±9.6 years) that were compressed through simulated intervertebral discs. In each vertebra, we compared the highest tensile and compressive strains across the different compartments: endplates, cortical shell, and trabecular bone. The influence of Poisson-type expansion of the disc on the results was determined by compressing the vertebrae a second time in which we suppressed the Poisson expansion. We found that the highest tensile strains occurred within the endplates whereas the highest compressive strains occurred within the trabecular bone. The ratio of strain to assumed tissue-level yield strain was the highest for the endplates, indicating that the endplates had the greatest risk of initial failure. Suppressing the Poisson expansion of the disc decreased the amount of highly tensile-strained tissue in the endplates by 79.4±11.3%. These results indicate that the endplates are at the greatest risk of initial failure due to the development of high tensile strains, and that such high tensile strains are associated with the Poisson expansion of the disc. We conclude that initial failure of the vertebra is associated with high tensile strains in the endplates, which in turn are influenced by the material behavior of the disc. |
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