Biomechanical comparison of different bilateral percutaneous vertebroplasty in 1 treating osteoporotic vertebral compression fractures: finite element analysis 2

Weihua Yang¹Jing Chen²Bei Lin¹Eryou Feng^1*

• ¹Fujian Medical University Union Hospital, Fuzhou, China
• ²Anxi County Hospital, Quanzhou, China

Purpose 14 This study aimed to analyze the biomechanical effects of two bone cement injection 15 techniques by establishing a finite element model of osteoporotic vertebral 16 compression fractures. 17 Methods 18 CT data from a healthy male volunteer were used to construct a three-dimensional 19 finite element model of the L1 – L3 vertebrae. A simulated vertebral compression 20 fracture was created at L2, followed by virtual vertebroplasty using two cement 21 distribution patterns: the vertical group (VG) and the inclined group (IG). Stress 22 distribution, maximum von Mises stress in the vertebrae and intervertebral discs, and 23 the maximum displacement of L2 were compared between the two groups. 24 Results 25 In the L2 vertebra, the maximum stress in the VG is reduced under all six loading 26 conditions. VG showed reduced maximum stress in the L1 vertebra during extension, 27 left bending, and left/right rotation. For the L3 vertebra, VG achieved the lowest 28 maximum stress under all loading conditions. In the L1-L2 intervertebral disc, VG 29 resulted in lower maximum stress than IG during flexion, extension, and lateral 30 bending. while in the L2–L3 disc, VG produced the lowest maximum stress under all 31 six conditions. Furthermore, under flexion and extension, the maximum displacement 32 of L2 was smaller in VG compared with IG. 33 Conclusions 34 The vertical cement distribution pattern effectively reduces vertebral and 35 intervertebral disc stress and provides greater stability of the fractured vertebra 36 compared with the inclined distribution pattern.