On prediction of the strength levels and failure patterns of human vertebrae using quantitative computed tomography...

This paper presents an effective patient-specific approach for prediction of failure initiation and growth in human vertebra using the general framework of the quantitative computed tomography (QCT)-based finite element method (FEM). The studies were carried out on 13 vertebrae (lumbar and thoracic), excised from 3 cadavers with the average age of 42 years old. Initially, 4 samples were QCT scanned and the images were directly converted into voxel-based 3D finite element models for linear and nonlinear analyses. The equivalent plastic strains obtained from the nonlinear analyses were used to predict the occurrence of local failures and development of the failure patterns. In the linear analyses, the strain energy density measure was used to identify the critical elements and predict the failure patterns. Subsequently, the samples were destructively tested in uniaxial compression and the experimental load-displacement diagrams were obtained. The plain radiographic images of the tested samples were also examined for observation of the failure patterns. In continuation, the presence of osteolytic defects in vertebrae was simulated by creation of artificial cavities within 9 remaining samples using a computer numerical control (CNC) milling machine. The same protocol was followed for scanning, modeling, and destructive testing of these samples. A strong correlation was found between the predicted and measured strengths. Finally, a typical vertebroplasty treatment was simulated by injection of low-viscosity bone cement within 3 compressed samples. The failure patterns and the associated load levels for these samples were also predicted using the QCT voxel-based FEM.