Role of trabecular microfractures in failure of human vertebrae estimated by the finite element method

ABSTRACT Spine fractures are the most frequent complication of osteoporosis, a disease characterized by low bone mass and structural deterioration of bone tissue. In case of the spine, the trabecular network plays the main role in load carrying and distribution. A correct description of mechanical properties of this bone structure helps to differentiate between strong and weak bones and can be useful for fracture prediction and treatment monitoring. By means of the finite element method (FEM), applied to CT images, we modelled biomechanical processes in probes during loading and correlated the estimated failure load with the maximum compressive strength (MCS), obtained in real biomechanical tests. We studied a sample of 151 specimens taken from the trabecular part of human vertebrae in vitro, visualised using CT imaging at an isotropic resolution of 26 m and tested by uniaxial compression. Besides the standard way of estimating failure load, which takes into account only strong micro-fractures, we also included small micro-fractures, what improved the correlation with MCS (Pearson’s correlation coefficient r=0.78 vs. r=0.58 ). This correlation coefficient was larger than that for both the standard morphometric parameters ( r=0.73 for bone volume fraction) and for texture measures defined by the local (an-) isotropic scaling indices method (r=0.55 ) and Minkowski Functionals (r=0.61 ). However, the performance of the FEM was different for subsamples selected according to the MCS value. The correlation increased for strong specimens (r=0.88 ), slightly decreased for weak specimens (r=0.68 ) and markedly dropped for specimens with medium MCS, e.g. between 60test, effective strain, microfractures.