Biomechanics and Prophylactic Treatment of Spinal Metastases: A Finite Element Based Study

Preventing burst fracture is critical in maintaining quality of life in patients affected by metastatic cancer to the spine. The objective of this study was to use parametric finite element modeling to improve burst fracture risk assessment and treatment options for patients with spinal metastases. The model was used to evaluate the effects of complex loading and geometric factors in the metastatic spine. Axial loading was found to be the primary load type contributing to burst fracture initiation. Upper thoracic vertebrae were found to be at increased risk of burst fracture. Fracture risk was reduced by presence of the ribcage and increased kyphotic angle. Transcortical tumours were found to have a lower risk of burst fracture as compared to contained tumour scenarios. Protocols were developed for pathologic burst fracture risk assessment and prophylactic treatment based on these findings. This work is important in directing treatment for patients with spinal metastases.

Year	Entry
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Year

Entry

1986

McGill SM, Norman RW. Partitioning of the L4-L5 dynamic moment into disc, ligamentous, and muscular components during lifting. Spine. September 1986;11(7):666-678.

1992

Mizrahi J, Silva MJ, Hayes WC. Finite element stress analysis of simulated metastatic lesions in the lumbar vertebral body. J Biomed Eng. November 1992;14(6):467-475.

1986

Miller JAA, Schultz AB, Warwick DN, Spencer DL. Mechanical properties of lumbar spine motion segments under large loads. J Biomech. 1986;19(1):79-84.

2000

Whealan KM, Kwak SD, Tedrow JR, Inoue K, Snyder BD. Noninvasive imaging predicts failure load of the spine with simulated osteolytic defects. J Bone Joint Surg. September 2000;82A(9):1240-1251.

1984

Brickley-Parsons D, Glimcher MJ. Is the chemistry of collagen in intervertebral discs an expression of Wolff's Law? a study of the human lumbar spine. Spine. March 1984;9(2):148-163.