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Volume 11
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10.3390/diagnostics11030455
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Article

MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine?

by
Nico Sollmann
1,2,3,
Nithin Manohar Rayudu
4,
Long Yu Yeung
4,
Anjany Sekuboyina
1,
Egon Burian
1,
Michael Dieckmeyer
1,
Maximilian T. Löffler
1,5,
Benedikt J. Schwaiger
1,
Alexandra S. Gersing
6,
Jan S. Kirschke
1,2,
Thomas Baum
1 and
Karupppasamy Subburaj
4,7,*
1
Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
2
TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, 81675 Munich, Germany
3
Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
4
Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore 487372, Singapore
5
Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Hugstetter Str. 55, 79106 Freiburg im Breisgau, Germany
6
Institute of Neuroradiology, University Hospital, LMU Munich, Marchioninistrasse 15, 81377 Munich, Germany
7
Changi General Hospital, 2 Simei Street 3, Singapore 529889, Singapore
*
Author to whom correspondence should be addressed.
Diagnostics 2021, 11(3), 455; https://doi.org/10.3390/diagnostics11030455
Submission received: 5 February 2021 / Revised: 27 February 2021 / Accepted: 2 March 2021 / Published: 6 March 2021
(This article belongs to the Section Medical Imaging and Theranostics)
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Abstract

Assessment of osteoporosis-associated fracture risk during clinical routine is based on the evaluation of clinical risk factors and T-scores, as derived from measurements of areal bone mineral density (aBMD). However, these parameters are limited in their ability to identify patients at high fracture risk. Finite element models (FEMs) have shown to improve bone strength prediction beyond aBMD. This study aims to investigate whether FEM measurements at the lumbar spine can predict the biomechanical strength of functional spinal units (FSUs) with incidental osteoporotic vertebral fractures (VFs) along the thoracolumbar spine. Multi-detector computed tomography (MDCT) data of 11 patients (5 females and 6 males, median age: 67 years) who underwent MDCT twice (median interval between baseline and follow-up MDCT: 18 months) and sustained an incidental osteoporotic VF between baseline and follow-up scanning were used. Based on baseline MDCT data, two FSUs consisting of vertebral bodies and intervertebral discs (IVDs) were modeled: one standardly capturing L1-IVD–L2-IVD–L3 (FSU_L1–L3) and one modeling the incidentally fractured vertebral body at the center of the FSU (FSU_F). Furthermore, volumetric BMD (vBMD) derived from MDCT, FEM-based displacement, and FEM-based load of the single vertebrae L1 to L3 were determined. Statistically significant correlations (adjusted for a BMD ratio of fracture/L1–L3 segments) were revealed between the FSU_F and mean load of L1 to L3 (r = 0.814, p = 0.004) and the mean vBMD of L1 to L3 (r = 0.745, p = 0.013), whereas there was no statistically significant association between the FSU_F and FSU_L1–L3 or between FSU_F and the mean displacement of L1 to L3 (p > 0.05). In conclusion, FEM measurements of single vertebrae at the lumbar spine may be able to predict the biomechanical strength of incidentally fractured vertebral segments along the thoracolumbar spine, while FSUs seem to predict only segment-specific fracture risk.
Keywords: bone mineral density; finite element analysis; functional spinal unit; incidental fracture; multi-detector computed tomography; osteoporosis; vertebral fracture bone mineral density; finite element analysis; functional spinal unit; incidental fracture; multi-detector computed tomography; osteoporosis; vertebral fracture

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MDPI and ACS Style

Sollmann, N.; Rayudu, N.M.; Yeung, L.Y.; Sekuboyina, A.; Burian, E.; Dieckmeyer, M.; Löffler, M.T.; Schwaiger, B.J.; Gersing, A.S.; Kirschke, J.S.; et al. MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine? Diagnostics 2021, 11, 455. https://doi.org/10.3390/diagnostics11030455

AMA Style

Sollmann N, Rayudu NM, Yeung LY, Sekuboyina A, Burian E, Dieckmeyer M, Löffler MT, Schwaiger BJ, Gersing AS, Kirschke JS, et al. MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine? Diagnostics. 2021; 11(3):455. https://doi.org/10.3390/diagnostics11030455

Chicago/Turabian Style

Sollmann, Nico, Nithin Manohar Rayudu, Long Yu Yeung, Anjany Sekuboyina, Egon Burian, Michael Dieckmeyer, Maximilian T. Löffler, Benedikt J. Schwaiger, Alexandra S. Gersing, Jan S. Kirschke, and et al. 2021. "MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine?" Diagnostics 11, no. 3: 455. https://doi.org/10.3390/diagnostics11030455

APA Style

Sollmann, N., Rayudu, N. M., Yeung, L. Y., Sekuboyina, A., Burian, E., Dieckmeyer, M., Löffler, M. T., Schwaiger, B. J., Gersing, A. S., Kirschke, J. S., Baum, T., & Subburaj, K. (2021). MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine? Diagnostics, 11(3), 455. https://doi.org/10.3390/diagnostics11030455

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