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Biomechanical effect of vertebroplasty on the adjacent intervertebral levels using a three-dimensional finite element
Sheng Lu1, Yong-Qing Xu, Mei-Chao Zhang
1Department of Orthopedics, Kunming General Hospital of Chengdu Military Region, Kunming 650032, China.
Objective:
To investigate the biomechanical effect of different volume, distribution and leakage to adjacent disc of bone cement on the adjacent vertebral body by three-dimensional osteoporosis finite element model of lumbar.
Methods:
L(4)-L(5) motion segment data of the cadaver of an old man who had no abnormal findings on roentgenograms were obtained from computed tomography (CT) scans. Three-dimensional model of L(4)-L(5) was established with Mimics software, and finite element model of L(4)-L(5) functional spinal unit (FSU) was established by Ansys 7.0 software. The effect of different loading conditions and distribution of bone cement after vertebroplasty on the adjacent vertebral body was investigated.
Results:
This study presented a validated finite element model of L(4)-L(5) FSU with a simulated vertebroplasty augmentation to predict stresses and strains of adjacent untreated vertebral bodies. The findings from this FSU study suggested the endplate and disc stress of the adjacent vertebral body was not influenced by filling volume of bone cement but unipedicle injection and leakage to the disc of bone cement could concentrate the stress of adjacent endplate.
Conclusions:
Asymmetric distributions and leakage of cement into intervertebral disc can improve the stress of endplate in adjacent vertebral body. These results suggest that optimal biomechanical configuration should have symmetric placement and avoid leakage of cement in operation.