Development of Guidelines for the Prophylactic Treatment of Metastatically Involved Vertebral Bodies.
Abstract
Up to 1/3 of all cancer patients develop metastases to the spinal column and over 50% of spinal metastases with neurologic manifestations in females are found to arise from primary breast neoplasms (2). Using a combination of finite element modeling, materials and mechanical testing we aimed to quantify fracture risk in metastatically involved vertebral bodies in order to both understand the mechanism of burst fracture and develop a definitive set of clinical guidelines for the prophylactic treatment vertebral body metastases. To this end, we have determined the biphasic material properties of tumor tissue which has metastasized to bone and correlated these properties to tumor cellularity. We have demonstrated the importance of utilizing poroelasticity in modeling metastatically involved vertebral bodies. We constructed and experimentally validated a three-dimensional poroelastic finite element model of a metastatically involved spinal motion segment and parametrically assessed the effects of loading rate, tumor size, bone density and pedicle involvement on the risk of burst fracture and neurologic compromise. We have determined that the mechanism of burst fracture in the metastatically involved spine is due to pressurization of the vertebral body and elevated tensile hoop strains, causing failure of the posterior vertebral body wall.
Document Details
- Document Type
- Technical Report
- Publication Date
- Aug 01, 1999
- Accession Number
- ADA377917
Entities
People
- Cari M. Whyne
- Serena Hu
Organizations
- University of California, San Francisco