A Multiscale Finite Element Analysis of Balloon Kyphoplasty to Investigate the Risk of Bone-Cement Separation In Vivo.

Autor:	Purcell P; Bioengineering Technology Centre, Technological University Dublin, Tallaght Campus, Dublin, Ireland.; CADFEM Ireland, The Steelworks, Dublin, Ireland.; Department of Electronic and Mechanical Engineering, Dundalk Institute of Technology, Dundalk, Ireland., Tyndyk M; University College Cork, UCC Academy, Cork, Ireland., McEvoy F; Bioengineering Technology Centre, Technological University Dublin, Tallaght Campus, Dublin, Ireland., Tiernan S; Bioengineering Technology Centre, Technological University Dublin, Tallaght Campus, Dublin, Ireland., Sweeney D; CADFEM Ireland, The Steelworks, Dublin, Ireland., Morris S; Mater Misericordiae University Hospital, National Spinal Injuries Unit, Ireland.
Jazyk:	angličtina
Zdroj:	International journal of spine surgery [Int J Spine Surg] 2021 Apr; Vol. 15 (2), pp. 302-314. Date of Electronic Publication: 2021 Apr 01.
DOI:	10.14444/8040
Abstrakt:	Background: During the past decade there has been a significant increase in the number of vertebral fractures being treated with the balloon kyphoplasty procedure. Although previous investigations have found kyphoplasty to be an effective treatment for reducing patient pain and lowering cement-leakage risk, there have been reports of vertebral recollapse following the procedure. These reports have indicated evidence of in vivo bone-cement separation leading to collapse of the treated vertebra. Methods: The following study documents a multiscale analysis capable of evaluating the risk of bone-cement interface separation during lying, standing, and walking activities following balloon kyphoplasty. Results: Results from the analysis found that instances of reduced cement interlock could initiate both tensile and shear separation of the interface region at up to 7 times the failure threshold during walking or up to 1.9 times the threshold during some cases for standing. Lying prone offered the best protection from interface failure in all cases, with a minimum safety factor of 2.95. Conclusions: The results of the multiscale analysis show it is essential for kyphoplasty simulations to take account of the micromechanical behavior of the bone-cement interface to be truly representative of the in vivo situation after the treatment. The results further illustrate the importance of ensuring adequate cement infiltration into the compacted bone periphery during kyphoplasty through a combination of new techniques, tools, and biomaterials in a multifaceted approach to solve this complex challenge. (This manuscript is generously published free of charge by ISASS, the International Society for the Advancement of Spine Surgery. Copyright © 2021 ISASS.)
Databáze:	MEDLINE
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