Published online Nov 18, 2017. doi: 10.5312/wjo.v8.i11.829
Peer-review started: March 10, 2017
First decision: June 30, 2017
Revised: July 5, 2017
Accepted: September 12, 2017
Article in press: September 13, 2017
Published online: November 18, 2017
To reduce post treatments of kyphoplasty, as a common treatment for osteoporotic vertebrae.
This study suggests a new method for treating vertebrae by setting the hexagonal porous structure instead of the rigid bone cement mass in the kyphoplasty (KP). The KP procedure was performed on the fresh ovine vertebra of the level L1. Micro finite element modeling was performed based on micro computed tomography of ovine trabecular cube. The hexagonal porous structure was set on one cube instead of the bone cement mass. For the implant designing, two geometrical parameters were considered: Spacing diameter and thickness.
The results of micro finite element analyses indicated the improvement in the mechanical behavior of the vertebra treated by the hexagonal porous structures, as compared to those treated by vertebroplasty (VP) and KP under static loading. The improvement in the mechanical behavior of the vertebra, was observed as 54% decrease in the amount of maximum Von Misses stress (improvement of stress distribution), in trabecular cube with embedded hexagonal structure, as compared to VP and KP. This is comparable to the results of the experimental study already performed; it was shown that the improvement of mechanical behavior of the vertebra was observed as: 83% increase in the range of displacements before getting to the ultimate strength (increasing the toughness) after setting hexagonal pearls inside vertebrae. Both the material and geometry of implant influenced the amount of Von Mises stress in the structure.
The new proposed method can be offered as a substitute for the KP. The implant geometry had a more obvious effect on the amount of Von Mises stress, as compared to the implant material.
Core tip: By embedding the hexagonal porous structure with two variable parameters including spacing diameter and thickness, as a substitute for the bone cement mass in the vertebral kyphoplasty, lower levels of maximum Von Mises stress could be achieved, thereby indicating the reduction of stress concentration in the interface area between the bone cement mass and the cancellous bone, as well as the reduction of post treatments. Furthermore, setting porous structures with different geometries inside vertebrae could provide the possibility of bone regeneration, the transfer of growth factors and recreation of mechanical properties.