Trabecular Architecture and Mechanical Heterogeneity Effects on Vertebral Body Strength
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BIOMECHANICS (G NIEBUR AND J WALLACE, SECTION EDITORS)
Trabecular Architecture and Mechanical Heterogeneity Effects on Vertebral Body Strength Joshua D. Auger 1 & Neilesh Frings 2 & Yuanqiao Wu 1 & Andre Gutierrez Marty 1 & Elise F. Morgan 1,2 Accepted: 24 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review We aimed to synthesize the recent work on the intra-vertebral heterogeneity in density, trabecular architecture and mechanical properties, its implications for fracture risk, its association with degeneration of the intervertebral discs, and its implications for implant design. Recent Findings As compared to the peripheral regions of the centrum, the central region of the vertebral body exhibits lower density and more sparse microstructure. As compared to the anterior region, the posterior region shows higher density. These variations are more pronounced in vertebrae from older persons and in those adjacent to degenerated discs. Mixed results have been reported in regard to variation along the superior-inferior axis and to relationships between the heterogeneity in density and vertebral strength and fracture risk. These discrepancies highlight that, first, despite the large amount of study of the intravertebral heterogeneity in microstructure, direct study of that in mechanical properties has lagged, and second, more measurements of vertebral loading are needed to understand how the heterogeneity affects distributions of stress and strain in the vertebra. These future areas of study are relevant not only to the question of spine fractures but also to the design and selection of implants for spine fusion and disc replacement. Summary The intra-vertebral heterogeneity in microstructure and mechanical properties may be a product of mechanical adaptation as well as a key determinant of the ability of the vertebral body to withstand a given type of loading. Keywords Density . Microstructure . Vertebra . Loading . Intervertebral disc
Introduction The vertebral body is one of the most important structural elements in the body. Through its shape and composition, and its role in anchoring neighboring elements—the ribs, vertebral arch, intervertebral discs, and spinal ligaments and tendons—the vertebral body exemplifies the mechanical functions of the skeleton: protecting vital organs, supporting load, and facilitating movement (Fig. 1). The vertebral body is also a main site of hematopoiesis and mineral storage, the two This article is part of the Topical Collection on Biomechanics * Elise F. Morgan [email protected] 1
Department of Mechanical Engineering, Boston University, 110 Cummington Mall, Boston, MA 02215, USA
2
Department of Biomedical Engineering, Boston University, Boston, MA 02215, USA
other main functions of the skeleton, owing to the large volume of marrow and high ratio of bone surface to bone volume in the trabecular compartment [1, 2]. It is worth noting that these last two characteristics also mean that the porosity of the vertebral body is hi
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