Impending Metastatic Lumbar Spine Fractures
Project objectives
The vertebral column is among the sites most frequently affected by metastases. The increase in the life expectancy of metastatic patients has increased the interest in trying to preserve a good quality of life. Vertebroplasty begins to be defined as a technique to prevent vertebral body fracture. However, there are no guidelines defining patients at risk of impending fracture who may benefit from vertebroplasty.
The objective of this study was to analyze the risk of impending fracture of the metastatic lumbar spine as well as the effectiveness of preventive vertebroplasty and the risk of fracture of the adjacent levels. To do this, finite element analysis was used. It's a technique ingengineering applied in the medical field to study the distribution of forces and stresses. This method is progressively replacing classic in vitro approaches, thanks to the multiple advantages that the technique offers.
With this study it was possible to define the fracture risk in correlation with the volume of the metastasis and the presence of osteoporosis. Indeed, many patients with metastatic cancer are postmenopausal women with primary osteoporosis or premenopausal women who develop osteoporosis secondary to hormone therapy or chemotherapy. The efficacy of vertebroplasty for preventive purposes has also been demonstrated and the risk of fracture of the adjacent levels has been quantified.
Further experiments have recently been conducted to investigate the risk of fractures in the presence of osteothickening or osteolytic metastases and the effects of metastases in several vertebral bodies.
Future studies are oriented to describe the influence of the localization of the tumor lesion in the vertebral body, the involvement of the pedicles and the bone cortex and the presence of multiple metastases.
Start and end date
February 2013 - Ongoing
Project managers
Prof. Vincenzo Denaro - Coordinator
Coordinating institution of the project
Università Campus Bio-Medico di Roma
Other Institutions involved in the project
Mayo Clinic, Biomechanics Laboratory and Department of Orthopedics - Rochester, MN, USA