Palanca, M., Cavazzoni, G. and Dall'Ara, E. orcid.org/0000-0003-1471-5077 (2023) The role of bone metastases on the mechanical competence of human vertebrae. Bone, 173. 116814. ISSN 8756-3282
Abstract
Spine is the most common site for bone metastases. The evaluation of the mechanical competence and failure location in metastatic vertebrae is a biomechanical and clinical challenge. Little is known about the failure behaviour of vertebrae with metastatic lesions. The aim of this study was to use combined micro-Computed Tomography (microCT) and time-lapsed mechanical testing to reveal the failure location in metastatic vertebrae.
Fifteen spine segments, each including a metastatic and a radiologically healthy vertebra, were tested in compression up to failure within a microCT. Volumetric strains were measured using Digital Volume Correlation. The images of undeformed and deformed specimens were overlapped to identify the failure location.
Vertebrae with lytic metastases experienced the largest average compressive strains (median ± standard deviation: −8506 ± 4748microstrain), followed by the vertebrae with mixed metastases (−7035 ± 15605microstrain), the radiologically healthy vertebrae (−5743 ± 5697microstrain), and the vertebrae with blastic metastases (−3150 ± 4641microstrain). Strain peaks were localised within and nearby the lytic lesions or around the blastic tissue. Failure between the endplate and the metastasis was identified in vertebrae with lytic metastases, whereas failure localised around the metastasis in vertebrae with blastic lesions.
This study showed for the first time the role of metastases on the vertebral internal deformations. While lytic lesions lead to failure of the metastatic vertebra, vertebrae with blastic metastases are more likely to induce failure in the adjacent vertebrae. Nevertheless, every metastatic lesion affects the vertebral deformation differently, making it essential to assess how the lesion affects the bone microstructure. These results suggest that the properties of the lesion (type, size, location within the vertebral body) should be considered when developing clinical tools to predict the risk of fracture in patients with metastatic lesions.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2023 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). |
Keywords: | Digital volume correlation; Ex vivo test; Failure location; Metastasis; Strain analysis; Vertebrae; Humans; X-Ray Microtomography; Spinal Fractures; Spine; Bone Neoplasms; Fractures, Bone; Lumbar Vertebrae |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Medicine and Population Health |
Funding Information: | Funder Grant number ENGINEERING AND PHYSICAL SCIENCE RESEARCH COUNCIL EP/S032940/1 Engineering and Physical Sciences Research Council EP/K03877X/1 European Commission 832430 |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 31 Jan 2024 16:18 |
Last Modified: | 31 Jan 2024 16:18 |
Status: | Published |
Publisher: | Elsevier BV |
Refereed: | Yes |
Identification Number: | 10.1016/j.bone.2023.116814 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:208218 |