Biomechanical CT-computed bone strength predicts the risk of subsequent vertebral fracture

Song, Fei<sup>1</sup>; Wei, Yi<sup>2</sup>; Feng, Wentian<sup>1</sup>; Fu, Ruisen<sup>1</sup>; Li, Zuchang<sup>2</sup>; Gao, Xing<sup>1</sup>; Cheng, Xiaoguang<sup>3</sup>; Yang, Haisheng<sup>1</sup>

Affiliations

¹Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing 100124, China

²Department of Spinal Surgery, Beijing Jishuitan Hospital, Beijing 100035, China

³Department of Radiology, Beijing Jishuitan Hospital, Beijing 100035, China

Abstract and keywords

Following primary fractures and percutaneous kyphoplasty (PKP), patients have a high risk of incurring a subsequent vertebral fracture (SVF). Given that SVF is a consequence of mechanical deterioration of the vertebra, we sought to examine whether vertebral strength derived from QCT-based finite element analysis (i.e., BCT) can predict the risk of SVF. Sixty-six patients who underwent PKP were categorized into two groups: control or non-SVF group (age: 70 ± 7 years; n = 40) and SVF group (age: 69 ± 8 years; n = 26). BCT was performed on L4 or L3 vertebrae to noninvasively measure vertebral strength. Vertebral strength was also estimated based upon the geometry and material properties of the vertebra. Additionally, trabecular volumetric bone mineral density (vBMD) and L1 Hounsfield unit (HU) were measured. t-Test, χ2 test or Mann Whitney U test were used to compare differences in these parameters between the two groups. The predictive abilities of BCT strength and other measured parameters were evaluated using the receiver operating characteristic (ROC) analysis. Results showed no significant difference in either vBMD or L1 HU between the control and SVF groups (p > 0.05), whereas BCT-computed and estimated vertebral strength values were significantly reduced by 33 % and 24 % for the SVF group relative to the non-SVF group, respectively. ROC curve indicated that BCT strength had the largest area under the curve, compared to other parameters. These results suggest that BCT-computed vertebral strength may serve as a surrogate for assessing risk of SVF.

Keywords: Subsequent vertebral fracture; Osteoporosis; Bone strength; Finite element analysis; Quantitative computed tomography

Links

DOI: 10.1016/j.bone.2022.116601

PubMed: 36336262

WoS: 000890592900003

History

Received: 2022-06-18

Revised: 2022-10-14

Accepted: 2022-10-31

Online: 2022-11-3

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Cited By (1)

Year	Entry
2023	Gao X, Din RU, Cheng X, Yang H. Biomechanical MRI detects reduced bone strength in subjects with vertebral fractures. Bone. August 2023;173:116810.