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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2018

Open Access 01-12-2018 | Research article

Biomechanical effects of metastasis in the osteoporotic lumbar spine: A Finite Element Analysis

Authors: Giuseppe Salvatore, Alessandra Berton, Hugo Giambini, Mauro Ciuffreda, Pino Florio, Umile Giuseppe Longo, Vincenzo Denaro, Andrew Thoreson, Kai-Nan An

Published in: BMC Musculoskeletal Disorders | Issue 1/2018

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Abstract

Background

Cancer patients are likely to undergo osteoporosis as consequence of hormone manipulation and/or chemotherapy. Little is known about possible increased risk of fracture in this population. The aim of this study was to describe the biomechanical effect of a metastatic lesion in an osteoporotic lumbar spine model.

Methods

A finite element model of two spinal motion segments (L3-L5) was extracted from a previously developed L3-Sacrum model and used to analyze the effect of metastasis size and bone mineral density (BMD) on Vertebral bulge (VB) and Vertebral height (VH). VB and VH represent respectively radial and axial displacement and they have been correlated to burst fracture. A total of 6 scenarios were evaluated combining three metastasis sizes (no metastasis, 15% and 30% of the vertebral body) and two BMD conditions (normal BMD and osteoporosis).

Results

15% metastasis increased VB and VH by 178% and 248%, respectively in normal BMD model; while VB and VH increased by 134% and 174% in osteoporotic model. 30% metastasis increased VB and VH by 88% and 109%, respectively, when compared to 15% metastasis in normal BMD model; while VB and VH increased by 59% and 74% in osteoporotic model.

Conclusion

A metastasis in the osteoporotic lumbar spine always leads to a higher risk of vertebral fracture. This risk increases with the size of the metastasis. Unexpectedly, an increment in metastasis size in the normal BMD spine produces a greater impact on vertebral stability compared to the osteoporotic spine.
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Metadata
Title
Biomechanical effects of metastasis in the osteoporotic lumbar spine: A Finite Element Analysis
Authors
Giuseppe Salvatore
Alessandra Berton
Hugo Giambini
Mauro Ciuffreda
Pino Florio
Umile Giuseppe Longo
Vincenzo Denaro
Andrew Thoreson
Kai-Nan An
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2018
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-018-1953-6

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