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Density-Dependent Material and Failure Criteria Equations Highly Affect the Accuracy and Precision of QCT/FEA-Based Predictions of Osteoporotic Vertebral Fracture Properties

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Abstract

About 700,000 vertebral fractures occur in the US as a result of bone loss. Quantitative computed tomography (QCT)-based finite element analysis (FEA) is a promising tool for fracture risk prediction that is becoming attractive in the clinical setting. The goals of this study were (1) to perform individual and pooled specimen optimization using inverse QCT/FEA modeling to obtain ash density-elastic modulus equations incorporating the whole vertebral body and accounting for all variables used during FE modeling, and (2) to determine the effect of material equations and failure criteria on the accuracy and precision of mechanical properties. Fifty-four (54) human vertebrae were used to optimize material equations based on experimental outcomes and, together with a previously proposed material equation, were implemented in our models using three different failure criteria to obtain fracture loads. Our robust QCT/FEA approach predicted 78% of the failure loads. Material equations resulted in poor accuracy in the predicted stiffness, yet yielded good precision and, more importantly, strong correlations with fracture loads. Both material and fracture criterion equations are equally important in estimating accurate and precise QCT/FEA predictions. Results suggest that both elastic modulus and fracture criterion equations should be validated against experimental outcomes to better explain the response of the tissue under various conditions.

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Acknowledgments

This study was supported by the University of Texas at San Antonio. The authors would like to thank the Mayo Clinic x-ray Imaging Core for imaging of the cadaveric spines.

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Authors and Affiliations

  1. Department of Biomedical and Chemical Engineering, The University of Texas at San Antonio, San Antonio, TX, 78249, USA

    Maria Prado & Hugo Giambini

  2. Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA

    Asghar Rezaei

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  1. Maria Prado
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Correspondence to Hugo Giambini.

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Associate Editor Joel D Stitzel oversaw the review of this article.

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Prado, M., Rezaei, A. & Giambini, H. Density-Dependent Material and Failure Criteria Equations Highly Affect the Accuracy and Precision of QCT/FEA-Based Predictions of Osteoporotic Vertebral Fracture Properties. Ann Biomed Eng 49, 663–672 (2021). https://doi.org/10.1007/s10439-020-02595-w

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