Highlights
- •A finite element model was built to assess the performance of a novel transpedicular implant.
- •The model is based on a 3D scan of a patient composed of three vertebrae, discs and ligaments.
- •A heterogeneous bone material properties was assigned to the vertebrae using the grey scale level.
- •Upper vertebra is loaded by applying a compressive loading of 1 MPa on the upper surface of the model.
- •The implant restored the spine stiffness and reduced the stress applied to the vertebrae.
Abstract
Background
A finite element study was performed to investigate the biomechanical performance
of a novel transpedicular implant (V-STRUT©, Hyprevention, France) made of PEEK (polyetheretherketone)
material in terms of strengthening the osteoporotic vertebra and the thoraco-lumbar
spine.
The objective was to assess numerically the efficacy of the implant to reduce the
stress distribution within bone and absorb part of the stress by the implant thanks
to its optimized material selection close to that of normal bone.
Methods
A numerical model was generated based on a scan of an osteoporotic patient. The model
is composed of three consecutive vertebrae and intervertebral discs. A heterogeneous
distribution of bone material properties was assigned to the bone.
In order to investigate the rationale of the device material selection, three FE models
were developed (i) without the device to serve a reference model, (ii) with device
made in Titanium material and (iii) with device made in PEEK material.
Stiffness and stress distribution within the spine segment were computed and compared
in order to assess the implants' performances.
Findings
The results obtained by the simulations indicated that the novel transpedicular implant
made of PEEK material provided support to the superior vertebral endplate, restored
the thoraco-lumbar spine segment stiffness and reduced the stress applied to the vertebrae
under the compressive load.
Interpretation
Implant geometry in combination with its material properties are very important factors
to restore vertebral strength and stiffness and limiting the risk of fracture at the
same vertebra or adjacent ones.
Keywords
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References
- Comparative biomechanical study of a new transpedicular vertebral device and vertebroplasty for the treatment or prevention of vertebral compression fractures.Clin. Biomech. 2018; 56: 40-45
- Risk of subsequent fracture after prior fracture among older women.Osteoporos. Int. 2019; 30: 79-92
- Stent screw-assisted internal fixation (SAIF) of severe lytic spinal metastases: a comparative finite element analysis of the SAIF technique.World Neurosurg. 2019; 128: e370-e377
- Ethnic difference of clinical vertebral fracture risk.Osteoporos. Int. 2012; 23: 879-885
- Comparison of quantitative computed tomography-based measures in predicting vertebral compressive strength.Bone. 2007; 40: 767-774
- Osteoporotic hip and spine fractures: a current review.Geriatr. Orthop. Surg. Rehabil. 2014; 5: 207-212
- Biomechanical investigation of pedicle screw-ver tebrae complex: a finite element approach using bonded and contact interface conditions.Med. Eng. Phys. 2003; 25: 275-282
- A patientspecific finite element methodology to predict damage accumulation in vertebral bodies under axial compression, sagittal flexion and combined loads.Comput. Meth. Biomech. Biomed. Eng. 2008; 11: 477-487
- Effect of augmentation material stiffness on adjacent vertebrae after osteoporotic vertebroplasty using finite element analysis with different loading methods.Pain Physician. 2015; 18: E1101-E1110
- Stent-screw-assisted internal fixation: the SAIF technique to augment severe osteoporotic and neoplastic vertebral body fractures.J. Neurointerv. Surg. 2019; 11: 603-609
- Percutaneous transpedicular fixation by PEEK polymer implants combined with cementoplasty for vertebral compression fractures: a pilot study.Cardiovasc. Intervent. Radiol. 2021; 44: 642-646
- QCT-based finite element models predict human vertebral strength in vitro significantly better than simulated DEXA.Osteoporos. Int. 2012; 23: 563-572
- Comparison of eight published static finite element models of the intact lumbar spine: predictive power of models improves when combined together.J. Biomech. 2014; 47: 1757-1766
- Premature adjacent vertebral fracture after vertebroplasty: a biomechanical study.Neurosurgery. 2011; 69: 733-744
- Acute and long-term management of patients with vertebral fractures.QJM. 2004; 97: 63-74
- Case-specific non-linear finite element models to predict failure behavior in two functional spinal units.J. Orthop. Res. 2018; 36: 3208-3218
- 2018, analysis of adjacent fractures after two-level percutaneous vertebroplasty: is the intervening vertebral body prone to te-fracture?.Asian Spine J. 2018; 12: 524-532
- Nonlinear finite element model predicts vertebral bone strength and fracture site.Spine (Phila Pa 1976). 2006; 31: 1789-1794
- Numerical comparison of restored vertebral body height after incomplete burst fracture of the lumbar spine.J. Pers. Med. 2022; 12 (10): 253
- Balloon kyphoplasty versus KIVA vertebral augmentation--comparison of 2 techniques for osteoporotic vertebral body fractures: prospective randomized study.Spine (Phila Pa 1976). 2013; 38 (15): 292-299
- Finite element modeling of the human thoracolumbar spine.Spine (Phila Pa 1976). 2003; 28: 559-565
- Risk of new vertebral fracture in the year following a fracture.JAMA. 2001; 285: 320-323
- Poly-Ether-Ether-Ketone (PEEK) in orthopaedic practice- a current concept review.. 2022; 1: 3-7
- Epidemiology of spinal osteoporosis.Spine. 1997; 22: 2S-11S
- Trabecular bone modulus-density relationships depend on anatomic site.J. Biomech. 2003 Jul; 36: 897-904
- Effect of strain rate and bone mineral on the structural properties of the human anterior longitudinal ligament.Spine. 1994; 19: 205-211
- Clinical performance and safety of 108 SpineJack implantations: 1-year results of a prospective multicentre single-arm registry study.Biomed. Res. Int. 2015; 173872
- Adverse prognostic factors and optimal intervention time for kyphoplasty/vertebroplasty in osteoporotic fractures.Biomed. Res. Int. 2014; 2014925683
- Biomechanical properties of human lumbar spine ligaments.J. Biomech. 1992; 25: 1351-1356
- The effect of cement augmentation on the load transfer in an osteoporotic functional spinal unit: finite-element analysis.Spine. 2003; 28: 991-996
- Application of a calibration method provides more realistic results for a finite element model of a lumbar spinal segment.Clin. Biomech. 2007; 22: 377-384
- A study on the relationship between the rate of vertebral body height loss before balloon kyphoplasty and early adjacent vertebral fracture.J. Back Musculoskelet. Rehabil. 2021; 34: 649-656
- Influence of occupant collision state parameters on the lumbar spinal injury during frontal crash.J. Adv. Res. 2021; 28: 17-26
- KAST study: the Kiva system as a vertebral augmentation treatment-A safety and effectiveness trial: A randomized, noninferiority trial comparing the Kiva system with balloon Kyphoplasty in treatment of osteoporotic vertebral compression fractures.Spine (Phila Pa 1976). 2015; 40 (15): 865-875
- Finite element analysis of trabecular bone structure: a comparison of image-based P. meshing techniques.J. Biomech. 1998; 31: 1187-1192
- Occurrence of new vertebral body fracture after percutaneous vertebroplasty in patients with osteoporosis.Radiology. 2003; 226: 119-124
- Armed Kyphoplasty: an indirect Central Canal decompression technique in burst fractures.AJNR Am. J. Neuroradiol. 2019 Nov; 40: 1965-1972
- The reduction of endplate fractures during balloon vertebroplasty: a detailed adiological analysis of the treatment of burst fractures using pedicle screws, balloon vertebroplasty, and calcium phosphate cement.Spine. 2005; 30: 1840-1845
- Balloon kyphoplasty is effective in deformity correction of osteoporotic vertebral compression fractures.Spine. 2005; 30: 2806-2812
- Finite element analysis of the influence of loading rate on a model of the full lumbar spine under dynamic loading conditions.Med. Biol. Eng. Comput. 2012; 50: 903-915
- Three-dimensional biomechanical finite element analysis of lumbar disc herniation in middle aged and elderly.J. Healthc. Eng. 2022; 15: 7107702
- New in vivo measurements of pressures in the intervertebral disc in daily life.Spine (Phila Pa 1976). 1999; 24 (15): 755-762
- Vertebral compression fractures: a review of current management and multimodal therapy.J. Multidiscip. Healthc. 2013; 6: 205-214
- Biomechanics following skip-level cervical disc arthroplasty versus skip-level cervical discectomy and fusion: a finite element based study.BMC Musculoskelet. Disord. 2019; 20: 49
- Bone cement distribution in the vertebral body affects chances of recompression after percutaneous vertebroplasty treatment in elderly patients with osteoporotic vertebral compression fractures.Clin. Interv. Aging. 2017; 12: 431-436
Article info
Publication history
Published online: January 13, 2023
Accepted:
January 10,
2023
Received:
June 24,
2022
Identification
Copyright
© 2023 Published by Elsevier Ltd.
