MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine?

Autor: Michael Dieckmeyer, Long Yu Yeung, Benedikt J. Schwaiger, Karupppasamy Subburaj, Maximilian T. Löffler, Jan S. Kirschke, Alexandra S. Gersing, Anjany Sekuboyina, Thomas Baum, Egon Burian, Nithin Manohar Rayudu, Nico Sollmann
Jazyk: angličtina
Rok vydání: 2021
Předmět:
0301 basic medicine
musculoskeletal diseases
bone mineral density
finite element analysis
functional spinal unit
incidental fracture
multi-detector computed tomography
osteoporosis
vertebral fracture
Clinical Biochemistry
Osteoporosis
030209 endocrinology & metabolism
Tomography
X-ray computed
Methods
Article
Wirbelbruch
Fractures
Bone
03 medical and health sciences
0302 clinical medicine
Functional spinal unit
Medicine
Displacement (orthopedic surgery)
ddc:610
Osteoporose
Bone mineral
lcsh:R5-920
business.industry
Knochenbruch
Thoracolumbar spine
Biomechanical strength
Spinal fractures
medicine.disease
musculoskeletal system
Finite element method
030104 developmental biology
Lumbar spine
lcsh:Medicine (General)
Bone density
Nuclear medicine
business
DDC 610 / Medicine & health
Knochendichte
Computertomografie
Zdroj: Diagnostics; Volume 11; Issue 3; Pages: 455
Diagnostics, Vol 11, Iss 455, p 455 (2021)
Diagnostics
ISSN: 2075-4418
DOI: 10.3390/diagnostics11030455
Popis: Assessment of osteoporosis-associated fracture risk during clinical routine is based on the evaluation of clinical risk factors and T-scores, as derived from measurements of areal bone mineral density (aBMD). However, these parameters are limited in their ability to identify patients at high fracture risk. Finite element models (FEMs) have shown to improve bone strength prediction beyond aBMD. This study aims to investigate whether FEM measurements at the lumbar spine can predict the biomechanical strength of functional spinal units (FSUs) with incidental osteoporotic vertebral fractures (VFs) along the thoracolumbar spine. Multi-detector computed tomography (MDCT) data of 11 patients (5 females and 6 males, median age: 67 years) who underwent MDCT twice (median interval between baseline and follow-up MDCT: 18 months) and sustained an incidental osteoporotic VF between baseline and follow-up scanning were used. Based on baseline MDCT data, two FSUs consisting of vertebral bodies and intervertebral discs (IVDs) were modeled: one standardly capturing L1-IVD–L2-IVD–L3 (FSU_L1–L3) and one modeling the incidentally fractured vertebral body at the center of the FSU (FSU_F). Furthermore, volumetric BMD (vBMD) derived from MDCT, FEM-based displacement, and FEM-based load of the single vertebrae L1 to L3 were determined. Statistically significant correlations (adjusted for a BMD ratio of fracture/L1–L3 segments) were revealed between the FSU_F and mean load of L1 to L3 (r = 0.814, p = 0.004) and the mean vBMD of L1 to L3 (r = 0.745, p = 0.013), whereas there was no statistically significant association between the FSU_F and FSU_L1–L3 or between FSU_F and the mean displacement of L1 to L3 (p > 0.05). In conclusion, FEM measurements of single vertebrae at the lumbar spine may be able to predict the biomechanical strength of incidentally fractured vertebral segments along the thoracolumbar spine, while FSUs seem to predict only segment-specific fracture risk.
publishedVersion
Databáze: OpenAIRE
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