Prophylactic Vertebroplasty: A Parametric Finite Element Study

INTRODUCTION: There has been a dramatic rise in the use of vertebroplasty for the treatment of vertebral compression fractures over the last decade. There are estimated to be over 700,000 such fractures each year in the United States alone, many of which lead to severe pain and a significant reduction in quality of life [1]. In the short term, vertebroplasty has been shown to reduce the pain and increase patient mobility [2]. However, there are concerns that the treatment may predispose patients to additional fractures in the adjacent vertebrae due to changes in the load distribution. To reduce this likelihood, augmentation of identified at-risk vertebrae prior to fracture (prophylactic vertebroplasty) has been proposed as a potential therapy. Such a treatment would maintain the vertebral height and may therefore reduce the adverse loading conditions on the adjacent vertebrae. Whilst some previous biomechanical studies have examined the effect of prophylactic vertebroplasty on the augmented vertebra, there has been only limited experimental work to study the adjacent vertebrae, with low number of specimens [3]. The aim of this study was to parametrically examine key patient and treatment variables on the effects of prophylactic vertebroplasty on the adjacent vertebrae. The study employed a specimen-specific finite element model of a threevertebra segment and direct comparison was made to the experimental characterization of the same specimen.