Biomechanical Consequences of Osteoporotic Vertebral Fractures and Vertebroplasty
Vertebral compression fractures are the most common fracture type related to osteoporosis, with an estimated 1.4 million new fractures occurring worldwide every year. These fractures are not only associated with pain and a decreased quality of life, but they can also change the local spinal alignment, which can alter the (local) biomechanics of the spine (Fig. 1).
An excepted surgical treatment of an acute vertebral fracture is injecting the fractured vertebra with bone cement; a procedure also known as percutaneous vertebroplasty (Fig. 2). Percutaneous vertebroplasty can effectively reduce pain and improve the quality of life of the treated patients. Relief of pain is a very important aspect of the treatment, however as bone cement can only impede further collapse of the fractured vertebra, the spinal alignment is not restored to its pre-fractured state with this technique. What risks this change in spinal alignment poses for the fracture risk of the remaining (osteoporotic) vertebrae is unknown at the moment.
In addition, it has been suggested that the injected bone cement might cause problems. The stiffness of bone cement is much higher than that of the osteoporotic bone in which it is injected and therefore can cause stress peaks which can lead to new fractures in adjacent vertebrae. At this moment there is no consensus on this issue and further research is necessary. In our project we aim to improve insight in the biomechanical consequences of osteoporotic vertebral fractures and percutaneous vertebroplasty in order to optimize the treatment in future patients.
Our spine research has partly been done in collaboration with Jasper Homminga from the technical University of Twente. See also the project ‘Aging Spine‘ and the dissertation of our former Ph.D. student René Aquarius.
Karlijn Groenen, M.Sc.
2013 July 2nd
Causes and Effects of Spinal Fractures