Biomechanical Study of the Effects of Balloon Kyphoplasty on the Adjacent Vertebrae

We used the finite element method (FEM) to investigate the stress profiles of vertebrae in patients who underwent balloon kyphoplasty (BKP) for vertebral fracture. BKP is often performed for persistent pain after vertebral fractures. However, fractures are frequently reported in the adjacent vertebrae after BKP. The purpose was to clarify the mechanism of fractures that occur in the adjacent vertebrae after BKP. The subjects were two patients (first case: 74-year-old woman;second case: 88-year-old woman) who had BKP for osteoporotic vertebral fractures (L1). A bone analysis software program, Mechanical Finder, was used to construct three-dimensional finite element models (T11-L3) from computed tomographic (CT) digital imaging and communications in medicine (DICOM) data. Moment loadings were examined to evaluate stress concentrations on the vertebrae. Young’s moduli were lower in the second case than in the first case at all vertebral levels. Maximum Drucker-Prager stresses after BKP were larger in the second case than in the first case for compression, flexion, extension, and axial rotation. Strain energy density decreased in L1 and increased in the adjacent ver-tebrae. Our results suggest that post-BKP fractures of the adjacent vertebrae not only are due to bone fragility, but also can be caused by increased rigidity in the vertebrae filled with bone cement, which increases stress concentration on the adjacent verte-brae and raises the likelihood of fracture.

Biomechanical Study of Vertebral Compression Fracture Using Finite Element Analysis

This research aimed to mechanically analyze vertebral stress concentration in one healthy subject and one subject with osteoporotic first lumbar (L1) vertebral compression fracture by using finite element analysis (FEA). We constructed three-dimensional image-based finite element (FE) models (Th12L2) by using computed tomographic (CT) digital imaging and communications in medicine (DICOM) for each patient and then conducted exercise stress simulations on the spine models. The loadings on the 12th thoracic vertebra (Th12) due to compression, flexion, extension, lateral bending, and axial rotation were examined within the virtual space for both spine models. The healthy and vertebral compression fracture models were then compared based on the application of equivalent vertebral stress. The comparison showed that vertebral stress concentration increased with all stresses in the vertebral compression fracture models. In particular, compression and axial rotation caused remarkable increases in stress concentration in the vertebral compression fracture models. These results suggest that secondary vertebral compression fractures are caused not only by bone fragility but possibly also by the increase in vertebral stress concentration around the site of the initial

Experimental and Numerical Analysis of Thermal Deformation of Electronic Packages,QFP and MCM

Moiré inteferometry and FEA (finite element analysis) were used to evaluate the thermal deformation of two electronic packages, QFP (quad flat package) and MCM (multi chip module).Thermal loading was applied by cooling the packages from 100℃ to room temperature (25℃). Moiré fringes were obtained on the cross sections of the packages to clarify the effect of the CTE (coefficient of thermal expansion) mismatch of the micro components, such as silicon, metal and resin. In QFP, the effects of packaging resin and PCB (printed circuit board) on the thermal deformation were investigated. The effect of location of three silicon chips in MCM was also examined.

Biomechanical Effects of Implant Materials on Posterior Lumbar Interbody Fusion: Comparison of Polyetheretherketone and Titanium Spacers Using Finite Element Analysis and Considering Bone Density

Few biomechanical data exist regarding whether the polyetheretherketone (PEEK) spacer or titanium spacer is better for posterior lumbar interbody fusion (PLIF). This study evaluated the biomechanical influence that these types of spacers with different levels of hardness exert on the vertebra by using finite element analysis including bone strength distribution. To evaluate the risk of spacer subsidence for PLIF, we built a finite element model of the lumbar spine using computed tomography data of osteoporosis patients. Then, we simulated PLIF in L3/4 and built models with the hardness of the interbody spacer set as PEEK and titanium. Bones around the spacer were subjected to different load conditions. Then, fracture elements and some stress states of the two modalities were compared. In both models of PLIF simulation, fracture elements and stress were concentrated in the bones around the spacer. Fracture elements and stress values of the model simulating the PEEK spacer were significantly smaller compared to those of the titanium simulation model. For PLIF of osteoporotic vertebrae, this suggested that the PEEK spacer is in a mechanical environment less susceptible to subsidence caused by microfractures of bone tissue and bone remodeling-related fusion aspects. Therefore, PEEK spacers are bio-mechanically more useful.

Use of Nonlinear Finite Element Analysis of Bone Density to Investigate the Biomechanical Effect in the Bone around Intervertebral Cages in Posterior Lumbar Interbody Fusion

Preventing subsidence of intervertebral cages in posterior lumbar interbody fusion (PLIF) requires understanding its mechanism, which is yet to be done. We aimed to describe the mechanism of intervertebral cage subsidence by using finite element analysis through simulation of the osteoporotic vertebral bodies of an elderly woman. The data from computed tomography scans of L2-L5 vertebrae in a 72-year-old woman with osteoporosis were used to create 2 FE models: one not simulating implant placement (LS-INT) and one simulating L3/4 PLIF using polyetheretherketone (PEEK) cages (LS-PEEK). Loads and moments simulating the living body were applied to these models, and the following analyses were performed: 1) Drucker-Prager equivalent stress distribution at the cage contact surfaces;2) the distribution of damage elements in L2-L5 during incremental loading;and 3) the distribution of equivalent plastic strain at the cage contact surfaces. In analysis 1, the Drucker-Prager equivalent stress on the L3 and L4 vertebral endplates was greater for LS-PEEK than for LS-INT under all loading conditions and tended to be particularly concentrated at the contact surfaces. In analysis 2, compared with LS-INT, LS-PEEK showed more damage elements along the bone around the cages in the L3 vertebral body posterior to the cage contact surfaces, followed by the area of the L4 vertebral body posterior to the cage contact surfaces. In analysis 3, in the L3 inferior surface in LS-PEEK the distribution of equivalent plastic strain was visualized as gradually expanding along the cages from the area posterior to the cages to the area anterior to them with increased loading. These analyses suggested that in PLIF for osteoporotic vertebral bodies, the localized stress concentration generated by the use of PEEK cages may cause accumulation of microscopic damage in the fragile osteoporotic vertebral bodies around the cages, which may result in cage subsidence.

Engineered chitosan for improved 3D tissue growth through Paxillin-FAK-ERK activation

Scaffold engineering has attracted significant attention for three-dimensional(3D)growth,prolifer-ation and differentiation of stem cells in vitro.Currently available scaffolds suffer from issues such as poor ability for cell adhesion,migration and proliferation.This paper addresses these issues with 3D porous chitosan scaffold,fabricated and functionalized with cysteine-terminated Arg-Gly-Asp(Cys-RGD)tri-peptide on their walls.The study reveals that the compressive moduli of the scaffold is independent to RGD functionalization but shows dependence on the applied freezing temperature(TM)during the fabrication process.The low freezing TM(-80℃)produces scaffold with high compressive moduli(14.64±1.38 kPa)and high TM(-30℃)produces scaffold with low compressive moduli(5.6±0.38 kPa).The Cys-RGD functionalized scaffolds lead to significant improvements in adhesion(150%)and proliferation(300%)of human mesenchymal stem cell(hMSC).The RGD-integrin coupling activates the focal adhesion signaling(Paxillin-FAK ERK)path-ways,as confirmed by the expression of p-Paxillin,p-FAK and p-ERK protein,and results in the observed improvement of cell adhesion and proliferation.The proliferation of hMSC on RGD func-tionalized surface was evaluated with scanning electron microscopy imaging and distribution though pore was confirmed by histochemistry of transversely sectioned scaffold.The hMSC adhe-sion and proliferation in scaffold with high compressive moduli showed a constant enhancement(with a slope value 9.97)of compressive strength throughout the experimental period of 28 days.The improved cell adhesion and proliferation with RGD functionalized chitosan scaffold,together with their mechanical stability,will enable new interesting avenues for 3D cell growth and differen-tiation in numerous applications including regenerative tissue implants.