Impact of Lumbar Degenerative Changes on Vertebral Bone Strength: A Finite Element Analysis

IF 2.3 3区 医学 Q2 ORTHOPEDICS
Soji Tani, Koji Ishikawa, Erika Chiapparelli, Gaston Camino-Willhuber, Lukas Schönnagel, Thomas Caffard, Krizia Amoroso, Ali E. Guven, Jennifer Shue, Benjamin A. Alman, John A. Carrino, Federico P. Girardi, Andrew A. Sama, Frank P. Cammisa, Alexander P. Hughes
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Abstract

Assessing the bone condition in patients with spinal disease is clinically valuable. However, evaluating bone strength in the presence of spine degenerative changes is challenging. Quantitative computed tomography (QCT) and finite element analysis (FEA) have been proposed as methods for more accurate bone quality assessment. This study investigates the relationship between bone strength predicted by FEA and other relevant biological parameters. This retrospective cross-sectional study included 127 patients with spinal disease who underwent preoperative CT scans between 2014 and 2020. Baseline patient characteristics, volumetric bone mineral density (vBMD) measured by QCT, and vertebral bone strength predicted by FEA were collected. The degree of degeneration was evaluated by classifying osteophyte formation, disc height narrowing, vertebral sclerosis, and spondylolisthesis into a grading scale ranging from 0 to 2. Multiple linear regression analysis was conducted to assess the effect of each factor on bone strength predicted by FEA. Of 127 patients, 120 patients (median age was 62 years) were included. The median vBMD and vertebral strength were 114.3 mg/cm3 and 7892.9 N, respectively. After adjusting for age, sex, body mass index, smoking status, diabetes mellitus, vBMD, and degenerative changes, multiple linear regression analysis revealed that sex, vBMD, and degree of degeneration independently increased the vertebral strength measured by FEA. This study suggests that in patients with spinal disease, vertebral bone strength is affected not only by sex and bone mineral density but also by degenerative changes. Thus, bone strength could be predicted more accurately in patients with spinal disease using FEA.

腰椎退行性改变对椎体骨强度的影响:有限元分析。
评估脊柱疾病患者的骨骼状况具有临床价值。然而,评估存在脊柱退行性改变的骨强度是具有挑战性的。定量计算机断层扫描(QCT)和有限元分析(FEA)已被提出作为更准确的骨质量评估方法。本研究探讨了有限元法预测骨强度与其他相关生物学参数的关系。这项回顾性横断面研究包括127名脊柱疾病患者,他们在2014年至2020年期间接受了术前CT扫描。收集基线患者特征、QCT测量的体积骨矿物质密度(vBMD)和FEA预测的椎体骨强度。通过将骨赘形成、椎间盘高度变窄、椎体硬化和椎体滑脱分为0 - 2级来评估退变程度。采用多元线性回归分析评价各因素对有限元预测骨强度的影响。在127例患者中,纳入了120例患者(中位年龄为62岁)。中位vBMD和椎体强度分别为114.3 mg/cm3和7892.9 N。在调整了年龄、性别、体重指数、吸烟状况、糖尿病、vBMD和退行性改变等因素后,多元线性回归分析显示,性别、vBMD和退行性改变程度独立地增加了FEA测量的椎体强度。这项研究表明,脊柱疾病患者的椎体骨强度不仅受性别和骨密度的影响,还受退行性变化的影响。因此,使用有限元分析可以更准确地预测脊柱疾病患者的骨强度。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Orthopaedic Research®
Journal of Orthopaedic Research® 医学-整形外科
CiteScore
6.10
自引率
3.60%
发文量
261
审稿时长
3-6 weeks
期刊介绍: The Journal of Orthopaedic Research is the forum for the rapid publication of high quality reports of new information on the full spectrum of orthopaedic research, including life sciences, engineering, translational, and clinical studies.
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