Effect of size and location of simulated lytic lesions on the structural properties of human vertebral bodies, a micro-finite element study

• Published in: Bone Reports 2020-06, Vol.12, p.100257-100257, Article 100257
• Main Authors: Costa, M.C., Campello, L.B. Bresani, Ryan, M., Rochester, J., Viceconti, M., Dall'Ara, E.
• Format: Article
• Language: English
• Subjects: Biomechanics; Finite element; from the Special Issue on Computational Methods in Bone Research; Edited by Dr Penny Atkins and Dr Patrik Christen; Lytic lesions; Mechanical properties; microFE; Parametric analysis; Spinal metastases; Vertebral strength
• ISSN: 2352-1872; 2352-1872
• DOI: 10.1016/j.bonr.2020.100257

Currently, the Spinal Instability Neoplastic Score system is used in clinics to evaluate the risk of fracture in patients with spinal metastases. This method, however, does not always provide a clear guideline due to the complexity in accounting for the effect of metastatic lesions on vertebral stability. The aim of this study was to use a validated micro Finite Element (microFE) modelling approach to analyse the effect of the size and location of lytic metastases on the mechanical properties of human vertebral bodies. Micro Computed Tomography based microFE models were generated with and without lytic lesions simulated as holes within a human vertebral body. Single and multiple lytic lesions were simulated with four different sizes and in five different locations. Bone was assumed homogenous, isotropic and linear elastic, and each vertebra was loaded in axial compression. It was observed that the size of lytic lesions was linearly related with the reduction in structural properties of the vertebral body (reduction of stiffness between 3% and 30% for lesion volume between 4% and 35%). The location of lytic lesions did not show a clear effect on predicted structural properties. Single or multiple lesions with the same volume provided similar results. Locally, there was a homogeneous distribution of axial principal strains among the models with and without lytic lesions. This study highlights the potential of microFE models to study the effect of lesions on the mechanical properties of the human vertebral body. [Display omitted] •MicroFE models can show the effect of lytic lesions on vertebral properties.•The size of the lesions was more critical than the location of the lesions.•Lesions affecting the cortical shell had a larger effect on the local strains.•Multiple lesions showed a similar effect to single lesions.