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Mechanical analysis of percutaneous sacroplasty using CT image based finite element models
Dennis E Anderson1, John R Cotton
1Department of Engineering Science and Mechanics, Virginia Tech-Wake Forest School of Bioengineering and Science, Virginia Tech, Blacksburg, VA 24061, United States.
Medical Engineering & Physics
|May 30, 2006
Summary
Sacroplasty, a polymethylmethacrylate cement injection, reduces strain in sacral insufficiency fractures locally. This procedure offers pain relief by minimizing fracture micromotion, with minimal impact on overall sacral stiffness.
Area of Science:
- Orthopedics
- Biomedical Engineering
- Radiology
Background:
- Sacral insufficiency fractures are a common cause of lower back pain.
- Sacroplasty, using polymethylmethacrylate (PMMA) cement, is a novel treatment for these fractures.
- The mechanism of pain relief is thought to involve reducing fracture micromotion.
Purpose of the Study:
- To investigate the mechanical effects of sacroplasty on the sacrum.
- To analyze the impact of PMMA cement on strain distribution within the sacrum.
Main Methods:
- Finite element models were created from CT images of two cadavers.
- Models simulated pre- and post-sacroplasty conditions by including or excluding PMMA cement.
- Non-homogeneous material properties were applied based on CT data.
Main Results:
- The sacrum exhibits a 3D multi-axial strain state, including significant tensile and shear strains.
- PMMA cement reduced local strains by 40-60% around the injection site.
- Overall sacral stiffness increased by only 1-4% after cement injection.
Conclusions:
- Sacroplasty's pain relief mechanism is likely due to localized strain reduction.
- The mechanical effects of sacroplasty are predominantly confined to the area surrounding the cement injection.
- Finite element analysis provides valuable insights into the biomechanics of sacroplasty.
