Xiao-Hua Zuo1,2, Yin-Bing Chen3, Peng Xie4, Wen-Dong Zhang5, Xiang-Yun Xue6, Qian-Xi Zhang2, Ben Shan7, Xiao-Bing Zhang8, Hong-Guang Bao9, Yan-Na Si10. 1. Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China. 2. Department of Pain Management, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, Huai'an, 223002, China. 3. Department of Orthopedic Surgery, The Affiliated Haian Hospital of Nantong University, Haian, 226600, China. 4. Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, Huai'an, 223002, China. 5. Department of Orthopedics, Northern Jiangsu People's Hospital, Yangzhou, 225001, China. 6. Department of Pain Management, Yancheng No.1 People's Hospital, Yancheng, 224000, China. 7. Department of Radiology, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, Huai'an, 223002, China. 8. Department of Radiology, The Affiliated Huai'an Hospital of Xuzhou Medical University and The Second People's Hospital of Huai'an, Huai'an, 223002, China. zhangxiaobing87@163.com. 9. Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China. hongguangbaocn@sina.com. 10. Department of Anesthesiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China. siyanna@163.com.
Abstract
PURPOSE: Biomechanical comparison of wedge and biconcave deformity of different height restoration after augmentation of osteoporotic vertebral compression fractures was analyzed by three-dimensional finite element analysis (FEA). METHODS: Three-dimensional finite element model (FEM) of T11-L2 segment was constructed from CT scan of elderly osteoporosis patient. The von Mises stresses of vertebrae, intervertebral disc, facet joints, displacement, and range of motion (ROM) of wedge and biconcave deformity were compared at four different heights (Genant 0-3 grade) after T12 vertebral augmentation. RESULTS: In wedge deformity, the stress of T12 decreased as the vertebral height in neutral position, flexion, extension, and left axial rotation, whereas increased sharply in bending at Genant 0; L1 and L2 decreased in all positions excluding flexion of L2, and T11 increased in neutral position, flexion, extension, and right axial rotation at Genant 0. No significant changes in biconcave deformity. The stress of T11-T12, T12-L1, and L1-L2 intervertebral disc gradually increased or decreased under other positions in wedge fracture, whereas L1-L2 no significant change in biconcave fracture. The utmost overall facet joint stress is at Genant 3, whereas there is no significant change under the same position in biconcave fracture. The displacement and ROM of the wedge fracture had ups and downs, while a decline in all positions excluding extension in biconcave fracture. CONCLUSIONS: The vertebral restoration height after augmentation to Genant 0 affects the von Mises stress, displacement, and ROM in wedge deformity, which may increase the risk of fracture, whereas restored or not in biconcave deformity.
PURPOSE: Biomechanical comparison of wedge and biconcave deformity of different height restoration after augmentation of osteoporotic vertebral compression fractures was analyzed by three-dimensional finite element analysis (FEA). METHODS: Three-dimensional finite element model (FEM) of T11-L2 segment was constructed from CT scan of elderly osteoporosispatient. The von Mises stresses of vertebrae, intervertebral disc, facet joints, displacement, and range of motion (ROM) of wedge and biconcave deformity were compared at four different heights (Genant 0-3 grade) after T12 vertebral augmentation. RESULTS: In wedge deformity, the stress of T12 decreased as the vertebral height in neutral position, flexion, extension, and left axial rotation, whereas increased sharply in bending at Genant 0; L1 and L2 decreased in all positions excluding flexion of L2, and T11 increased in neutral position, flexion, extension, and right axial rotation at Genant 0. No significant changes in biconcave deformity. The stress of T11-T12, T12-L1, and L1-L2 intervertebral disc gradually increased or decreased under other positions in wedge fracture, whereas L1-L2 no significant change in biconcave fracture. The utmost overall facet joint stress is at Genant 3, whereas there is no significant change under the same position in biconcave fracture. The displacement and ROM of the wedge fracture had ups and downs, while a decline in all positions excluding extension in biconcave fracture. CONCLUSIONS: The vertebral restoration height after augmentation to Genant 0 affects the von Mises stress, displacement, and ROM in wedge deformity, which may increase the risk of fracture, whereas restored or not in biconcave deformity.
Authors: Jinhui Ma; Kerry Siminoski; Peiyao Wang; Nathalie Alos; Elizabeth A Cummings; Janusz Feber; Jacqueline Halton; Josephine Ho; Kristin Houghton; Bianca Lang; Paivi M Miettunen; Rosie Scuccimarri; Jacob L Jaremko; Khaldoun Koujok; Brian Lentle; Mary Ann Matzinger; Nazih Shenouda; Frank Rauch; Leanne M Ward Journal: J Bone Miner Res Date: 2019-12-17 Impact factor: 6.741
Authors: Yì Xiáng J Wáng; Daniele Diacinti; Wei Yu; Xiao-Guang Cheng; Marcello H Nogueira-Barbosa; Nazmi Che-Nordin; Giuseppe Guglielmi; Fernando Ruiz Santiago Journal: Ann Transl Med Date: 2020-03