Biomechanics of prophylactic vertebral reinforcement

Spine
Kay Sun, M A Liebschner

Abstract

The effects of bone cement placement, volume, and bone density on the degree of biomechanical reinforcement on cadaveric vertebral bodies were studied using experimentally calibrated detailed finite element models. To investigate the efficacy of prophylactic vertebroplasty on intact vertebral bodies with respect to biomechanical recovery and fracture risk reduction. Vertebroplasty is a potentially effective fracture prevention treatment, but the risk of complications due to cement leakage must be minimized. Therefore, the least amount of bone cement required to improve vertebral strengths to low fracture risk levels need to be determined. Six different polymethyl methacrylate volumes--1, 2.5, 3.5, 5, 7.5 and 9 cm--were virtually implanted into previously validated vertebral body finite element models, following bipedicular and posterolateral vertebroplasty approaches. Stiffness and fracture load of the treated and untreated vertebral body models under uniaxial compression were determined. Greater augmentation effects were observed for vertebral bodies with average quantitative computed tomography densities below 0.1 g/cm injected with polymethyl methacrylate volumes higher than 20% compared to lower injection volumes and higher...Continue Reading

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