title: Application of digital volume correlation to study the efficacy of prophylactic vertebral augmentation.
abstract: Prophylactic augmentation is meant to reinforce the vertebral body, but in some cases it is suspected to actually weaken it. Past studies only investigated structural failure and the surface strain distribution. To elucidate the failure mechanism of the augmented vertebra, more information is needed about the internal strain distribution. This study aims to measure, for the first time, the full-field three-dimensional strain distribution inside augmented vertebrae in the elastic regime and to failure.
  
  
  
  Eight porcine vertebrae were prophylactically-augmented using two augmentation materials. They were scanned with a micro-computed tomography scanner (38.8μm voxel resolution) while undeformed, and loaded at 5%, 10%, and 15% compressions. Internal strains (axial, antero-posterior and lateral-lateral components) were computed using digital volume correlation.
  
  
  
  For both augmentation materials, the highest strains were measured in the regions adjacent to the injected cement mass, whereas the cement-interdigitated-bone was less strained. While this was already visible in the elastic regime (5%), it was a predictor of the localization of failure, which became visible at higher degrees of compression (10% and 15%), when failure propagated across the trabecular bone. Localization of high strains and failure was consistent between specimens, but different between the cement types.
  
  
  
  This study indicated the potential of digital volume correlation in measuring the internal strain (elastic regime) and failure in augmented vertebrae. While the cement-interdigitated region becomes stiffer (less strained), the adjacent non-augmented trabecular bone is affected by the stress concentration induced by the cement mass. This approach can help establish better criteria to improve vertebroplasty.
authors.affiliation: Department of Industrial Engineering, Alma Mater Studiorum, Università di Bologna, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Danesi
authors.affiliation: School of Engineering, University of Portsmouth, United Kingdom. Electronic address: gianluca.tozzi@port.ac.uk.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Tozzi
authors.affiliation: Department of Industrial Engineering, Alma Mater Studiorum, Università di Bologna, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cristofolini
mesh_terms: D000818:Animals; D001843:Bone Cements / Q000627:therapeutic use*; D005260:Female; D016103:Spinal Fractures / Q000517:prevention & control*; D013131:Spine / Q000000981:diagnostic imaging / Q000601:surgery; D013552:Swine; D013718:Tensile Strength; D054854:Vertebroplasty / Q000379:methods*; D055114:X-Ray Microtomography
chemical_list: D001843:Bone Cements
keywords: Bone fracture; Cement-bone interface; Digital volume correlation; Full-field three-dimensional strain measurement; Micro-damage; Prophylactic vertebral augmentation