Cooperation of length scales and orientations in the deformation of bovine bone

Bone has a complex hierarchical structure. Combined wide angle X-ray diffraction and small angle X-ray scattering were used together with in situ tensile testing to investigate the deformation and failure mechanisms of bovine cortical bone at three material levels: (1) the atomic level, corresponding to the mineral crystal phase; (2) the nano level, corresponding to the collagen fibrils; (3) the macroscopic level. It was found that deformation was linear at all three levels up to a strain of 0.2% in the longitudinal tensile direction. At this critical strain a sudden 50% decrease in the fibrillar and mineral strains was observed. This suggests the presence of partial local damage that leads to inhomogeneous strain distributions within the probed gauge volume. This also gives rise to diffraction peak broadening in the mineral phase, as well as strain relaxation at the nanoscale. Above the critical strain the longitudinally oriented strains below the nanoscale remained constant at a reduced level until failure. This suggests that the lateral orientation of the nanostructures toughens the bone, while a higher material level dominated the subsequent deformation process, either by sliding between the lamellar layers or by the growth of microcracks. Analysis of the diffraction data also shows that the bone has compressive residual stress in the crystal phase. A better understanding of the basic mechanics of the hierarchical bone structure could be the basis to enhance research in biomimetics, developing new advanced materials, and to find solutions for orthopedic problems.     

下胸段单钉T11~12镍钛合金弹性内固定系统有限元分析及临床意义

目的　建立T11~12前路病灶清除植骨+单钉单棒镍钛合金弹性固定系统三维有限元模型,分析弹性固定系统所受应力对其进行改进。 方法 对一名成年男性进行螺旋CT扫描,将所得数据导入计算机,通过Mimics13.0软件和Ansys11.0有限元软件建立T11~12前路病灶清除植骨+单钉单棒镍钛合金弹性固定系统三维有限元模型,并在椎体上表面施加500 N压力和10 Nm的力矩模拟腰椎前屈、后伸、侧屈和旋转4种生理载荷,观察不同载荷下固定器械的应力分布,并对其进行比较。 结果 单钉单棒弹性固定系统在用于侧前方固定时,其下位螺钉根部与“U”形棒中段承受应力始终较大,而螺钉的中部与“U”形棒的上部则较小。螺钉根部在4种运动状态下,旋转运动加载的应力最大,而侧弯运动时最小,“U”型棒中部在4种运动状态下应力均较大。但均小于镍钛合金的屈服强度。 结论 T11~12运动节段前路椎间植骨单钉单棒弹性固定患者在正常运动状态下不会由于定械某部位应力过高而导致断钉断棒。     

基于躯干细化模型腰椎间盘突出症患者与健康人群在3种日常活动下的运动学差异

目的建立由不同腰椎节段和集成胸椎、骨盆构成的躯干细化模型,分析腰椎间盘突出症(lumbar disc herniation,LDH)患者与健康人群在3种日常活动下的运动学差异,并与采用全腰节段的躯干简略模型作对比,探讨进行LDH患者运动学分析时采用躯干细化模型的必要性。方法使用NDI运动捕捉系统采集15名健康男性和7名男性LDH患者在水平行走、躯干前屈、对侧拾物中各节段的运动角度,分别通过两种模型比较患者与健康人群的运动学差异。结果水平行走过程中,LDH患者胸椎节段和骨盆旋转增加,全腰节段运动角度无明显变化,但L4～5节段旋转角度显著减小;躯干前屈过程中,LDH患者所有腰椎节段屈伸角度都不同程度地减小,L3～4节段屈伸角度与健康人群差异性较大;对侧拾物过程中矢状面上的表现与躯干前屈类似,但LDH患者L3～4节段和L4～5节段侧弯角度显著低于健康人群。结论 LDH患者在日常活动中主要限制了损伤腰椎节段的运动。在某些运动中,只有躯干细化模型才能发现损伤腰椎节段的异常运动。因此,在进行LDH患者运动学分析时,有必要将腰椎细分成5个独立节段。     

Predicting fracture using 2D finite element modelling

A decrease in bone density at the hip or spine has been shown to increase the risk of fracture. A limitation of the bone mineral density (BMD) measurement is that it provides only a measure of a bone sample's average density when projected onto a 2D surface. Effectively, what determines bone fracture is whether an applied load exceeds ultimate strength, with both bone tissue material properties (can be approximated through bone density), and geometry playing a role. The goal of this project was to use bone geometry and BMD obtained from radiographs and DXA measurements respectively to estimate fracture risk, using a two-dimensional finite element model (FEM) of the sagittal plane of lumbar vertebrae. The Canadian Multicentre Osteoporosis Study (CaMos) data was used for this study. There were 4194 men and women over the age of 50 years, with 786 having fractures. Each subject had BMD testing and radiographs of their lumbar vertebrae. A single two dimensional FEM of the first to fourth lumbar vertebra was automatically generated for each subject. Bone tissue stiffness was assigned based on the BMD of the individual vertebrae, and adjusted for patient age. Axial compression boundary conditions were applied with a force proportional to body mass. The resulting overall strain from the applied force was found. Men and women were analyzed separately. At baseline, the sensitivity of BMD to predict fragility fractures in women and men was 3.77% and 0.86%, while the sensitivity of FEM to predict fragility fractures for women and men was 10.8% and 11.3%. The FEM ROC curve demonstrated better performance compared to BMD. The relative risk of being considered at high fracture risk using FEM at baseline, was a better predictor of 5 year incident fragility fracture risk compared to BMD.     

Anatomical studies on the ovine spinal cord

The root attachment lengths were consistently greater in the cranial cervical (C3), midthoracic (T7), caudal lumbar (L5) and cranial sacral (S1) cord segment levels than the corresponding caudal cervical, caudal thoracic, cranial lumbar and caudal sacral levels respectively. As to the root emergence length the greatest values were obtained bilaterally at C3, T1, L4 and S1 cord segment levels respectively. The interroot intervals were maximum at C3, T13, L1 and S1 cord levels in the respective regions. The longest cord segments were located at C2, T13, L3 and S1 levels; the shortest were at C8, T1, L6, and S4 cord levels. The greatest diameter and cross-sectional area were confined to the last cervical, first 2 thoracic, last lumbar and first sacral cord segment levels. The spinal cord segments C2, T13, L4 and S1 were most voluminous in the respective regions. The topography of cord segments and the level of termination of the spinal cord have been studied and recorded.     

在不同状态下胸腰段小关节应力分析

目的：研究在不同运动状态下胸腰段小关节的应力分析.方法：建立T10～L3节段有限元模型,选取屈曲、旋转、屈曲加旋转3种运动状态,分别对T10～L3活动节段有限元模型施加载荷,分析比较各节段小关节的应力分布情况.结果：在屈曲状态下,各节段小关节的应力很小;在旋转和屈曲加旋转状态下,各节段一侧小关节应力较大,其下关节面的应力比上关节面的要大,而且T12与L1一侧小关节应力比其它节段的应力相对较大.结论：旋转和屈曲加旋转状态下胸腰段小关节应力较大,T12及L1的小关节应力比其它节段的较大,可能是胸腰段小关节容易损伤和T12与L1的小关节比其它节段的小关节容易损伤的力学机制;为探讨胸腰段的损伤机制提供参考.     

人颈椎前纵韧带生物力学特性实验研究

目的研究正常国人颈椎前纵韧带的生物力学特性．为临床提供生物力学参数。方法取正常国人8具新鲜尸体颈椎C1-C4、C4-T1不同节段前纵韧带在Shimadzu AUTOGRAPH电子万能试验机上进行单向拉伸实验研究。结果得出了前纵韧带C1～C4、C4一T1段的拉伸破坏载荷、伸长比、Lagrange张应力、Lagrange张应变、Euler应力、弹性模量等数据。对应力、应变数据以最小二乘法进行拟合，得出颈椎前纵韧带C1-C4、C4-T1段的应力应变关系表达式及曲线。结论前纵韧带C1-C4段应力大于C4-T1段，前纵韧带C1-C4、C4-T1应变差异不显著，C4-T1段前纵韧带弹性模骨大于C1-C4殷前纵韧带。     

Combination of soy protein and high dietary calcium on bone biomechanics and bone mineral density in ovariectomized rats

OBJECTIVE: To determine if feeding soy in combination with a high-calcium diet would preserve bone mineral density and biomechanical bone strength to a greater extent than either soy or calcium alone. DESIGN: Rats were sham-operated (n = l0) and fed a control diet (AIN93G containing 0.2% calcium, 20% casein) or ovariectomized (n = 40) and randomized to one of the following diets (n = 10 per group): control, high calcium (2.5% calcium, 20% casein), soy (0.2% calcium, 20% soy protein), or soy plus high calcium (2.5% calcium, 20% soy protein) for 8 weeks. Bone mineral density of femurs and lumbar vertebrae 1 through 6 were measured by dual energy x-ray absorptiometry. Biomechanical strength properties of femurs and the fifth lumbar vertebrae were measured by three-point bending and compression, respectively. RESULTS: The dietary combination of soy and high calcium did not result in higher femur bone mineral density compared with other ovariectomized groups, and there were no differences in femur yield load or peak load among groups. In contrast, soy plus high calcium resulted in a higher (P < 0.05) vertebral bone mineral density compared with all other ovariectomized groups. Vertebral strength was preserved among rats fed either soy plus high calcium, soy, or high calcium whereas the ovariectomized group fed a control diet had lower (P < 0.05) vertebral strength than the sham-operated group. CONCLUSION: Bone mineral density of the lumbar spine was the only bone outcome that significantly benefited from the combination of soy and high calcium compared with soy or high calcium alone.     

微创椎间融合不对称固定的稳定性和椎体应变分布研究

目的研究腰椎微创经椎间孔椎体间融合术(MI-TLIF)不对称内固定条件下节段稳定性和椎体前柱应变分布特点。方法采用新鲜小牛腰椎标本8例,完成L4~L5节段完整状态测试后建立TLIF手术损伤模型,分别测试右侧椎弓根螺钉固定(UPS)、右侧椎弓根螺钉加对侧经关节突椎弓根螺钉(UPS+TFPS)固定、双侧椎弓根螺钉固定(BPS)状态的三维运动范围(ROM),同时在L4椎体前柱表面用电阻应变片技术测量在前屈和侧弯运动中电阻应变数据。结果 UPS+TFPS和BPS固定状态的稳定性效果接近,UPS固定抗旋转稳定性不足。UPS+TFPS固定后椎体前柱应变在前屈和侧弯运动下较BPS固定分别增加21.8%和24.2%。结论 UPS+TFPS固定提供有效稳定的同时可以实现更好的椎体-内植物载荷共享。     

Effects of lasofoxifene on bone in surgically postmenopausal cynomolgus monkeys

OBJECTIVE: The purpose of this study was to evaluate the effects on bone of two doses of the selective estrogen receptor modulator lasofoxifene in surgically postmenopausal cynomolgus monkeys for 24 months. The primary endpoint of this study was biomechanical testing of animals treated for 2 years. DESIGN: The design of the study was a five-group (sham-ovariectomy, ovariectomy, conjugated [0.02 mg/kg], and two doses of lasofoxifene [1.0 and 5.0 mg/kg]), parallel arm design, with the treatments lasting for 24 months. Bone biomarker and estradiol data were collected at baseline and 3, 6, 12, 18, and 24 months after surgery. Vertebral bone mineral density was determined at baseline and every 6 months after ovariectomy. Hip bone density was determined at baseline and 12 and 24 months postovariectomy. Iliac bone biopsies were collected at 7 months, and the second lumbar vertebra and left femur were collected at 24 months after initiation of treatment for histomorphometric examination. The third lumbar vertebra and right femur were tested for mechanical strength after 24 months of treatment. RESULTS: Lasofoxifene and conjugated estrogens prevented ovariectomy-induced increases in serum alkaline phosphatase and CrossLaps and resulted in increased vertebral (all three treatments) and hip (conjugated estrogens and high-dose lasofoxifene only) bone mineral density, although both doses of lasofoxifene exceeded the doses projected to be used in women. In the 7-month iliac biopsy specimens, both doses of lasofoxifene reduced bone turnover rates. These histomorphometric changes were not present in either the vertebral or femoral compartments measured after 24 months of treatment. Lasofoxifene-treated animals did not differ from ovariectomized controls in mechanical strength testing of either the third lumbar vertebra or right femur. CONCLUSIONS: Lasofoxifene prevented ovariectomy-induced increased bone turnover and loss of bone mineral density without having a detrimental effect on bone strength.     

前屈型压缩性损伤对腰椎稳定性的影响

测试前屈压缩损伤对腰椎节段运动稳定性的影响。在７具成人新鲜尸体标本上，截取Ｔ１２至Ｌ１的脊柱标本，通过脊柱三维运动试验机和双平面立体测量术的计算机图象处理系统，分析了前屈型压缩破坏前后，该节段标本在前屈，后伸，左／右侧弯和左／右旋转状态下的运动范围。     

腰椎爆裂骨折椎体松质骨内力学分布特点的有限元研究

目的运用有限元方法模拟腰椎爆裂骨折的过程,观察腰椎在轴向压缩载荷作用下松质骨内的应力分布情况。方法建立正常人体胸腰段(T12~L2)运动节段的三维有限元模型,在T12椎体上表面施加不同等级的压力(0.4、0.6、0.8、1.0、1.2 k N),模拟腰椎爆裂骨折发生时椎体承受的不同等级的轴向压缩载荷。将连接椎体上下终板凹面顶点的连线7等分,在此基础上将L1椎体中的松质骨划分为7个具有统计节点的层面,每个统计层面划分成6个统计区。分别测量L1椎体松质骨内3个层面(第1、4、7层面)18个统计区的平均应力。在同一等级载荷下对3个层面内的平均应力进行单因素方差分析,分析腰椎椎体松质骨内不同载荷作用下的应力分布情况。结果在5个不同等级载荷下,第1、7层松质骨平均应力分别与第4层比较有统计学意义(P0.05),而第1、7层平均应力比较无统计学意义(P0.05)。轴向加载时,相比第1、7层应力,椎体松质骨中间层面(第4层)应力最小。结论腰椎在轴向压缩载荷作用下,椎体松质骨内存在应力集中的现象,接近椎体上下软骨板的松质骨应力较大,而椎体松质骨中间层面应力较小,椎体内应力集中分布在上下软骨板的特点与腰椎爆裂骨折所致终板破裂的生物力学机制相一致,提示腰椎椎体骨结构损伤可能与椎体内应力集中有关。     

单节段腰椎活动度对邻近节段运动的影响

背景：有研究报道腰椎融合后其邻近节段运动范围和压力会明显增大;但也有报道腰椎融合与动态固定非融合或正常腰椎相比,其邻近节段运动范围和压力未见明显增加,甚至出现减少。然而,腰椎的活动度多少到底对邻近节段会有什么影响呢？ 目的：观察单节段腰椎不同范围活动度对邻近关节运动范围的影响。 方法：取6具新鲜成人L2~S2腰椎标本,依次对成人L4~L5椎体进行不同方式处理形成5种不同活动度状态：完整标本状态;部分失稳状态;动态固定状态;完全失稳状态;刚性固定状态。在脊柱三维运动试验机上,采用“载荷控制”法进行屈伸、侧弯和旋转等运动方向测试,分别将其他4个状态与完整标本状态进行比较。 结果与结论：处理节段L4~L5椎体在各处理状态的下运动范围明显不同,形成了完全不同范围的活动度。与完整标本状态相比较,其他4个状态旋转时,上方邻近节段L3~L4的运动范围在刚性固定状态下明显减少;下方邻近节段L5~S1各方向和上方邻近节段L3~L4其余方向的运动范围无显著性差异。单节段腰椎刚性固定状态下,整个脊柱标本的运动范围明显减少。说明在“载荷控制”方法的实验下,单节段腰椎活动度多少对邻近节段的屈伸、侧弯等运动范围影响不明显,对上方邻近节段的旋转运动范围影响较大;腰椎刚性固定融合后,不一定要恢复到正常腰椎的活动范围,也许对预防邻近节段病有利。     

Structural and functional characteristics of the thoracolumbar multifidus muscle in horses

The multifidus muscle fascicles of horses attach to vertebral spinous processes after crossing between one to six metameres. The fascicles within one or two metameres are difficult to distinguish in horses. A vertebral motion segment is anatomically formed by two adjacent vertebrae and the interposed soft tissue structures, and excessive mobility of a vertebral motion segment frequently causes osteoarthropathies in sport horses. The importance of the equine multifidus muscle as a vertebral motion segment stabilizer has been demonstrated; however, there is scant documentation of the structure and function of this muscle. By studying six sport horses postmortem, the normalized muscle fibre lengths of the the multifidus muscle attached to the thoracic (T)4, T9, T12, T17 and lumbar (L)3 vertebral motion segments were determined and the relative areas occupied by fibre types I, IIA and IIX were measured in the same muscles after immunohistochemical typying. The values for the normalized muscle fibre lengths and the relative areas were analysed as completely randomized blocks using an anova (P ≤ 0.05). The vertebral motion segments of the T4 vertebra include multifidus bundles extending between two and eight metameres; the vertebral motion segments of the T9, T12, T17 and L3 vertebrae contain fascicles extending between two and four metameres The muscle fibres with high normalized lengths that insert into the T4 (three and eight metameres) vertebral motion segment tend to have smaller physiological cross‐sectional areas, indicating their diminished capacity to generate isometric force. In contrast, the significantly decreased normalized muscle fibre lengths and the increased physiological cross‐sectional areas of the fascicles of three metameres with insertions on T9, T17, T12, L3 and the fascicles of four metameres with insertions on L3 increase their capacities to generate isometric muscle force and neutralize excessive movements of the vertebral segments with great mobility. There were no significant differences in the values of relative areas occupied by fibre types I, IIA and IIX. In considering the relative areas occupied by the fibre types in the multifidus muscle fascicles attached to each vertebral motion segment examined, the relative area occupied by the type I fibres was found to be significantly higher in the T4 vertebral motion segment than in the other segments. It can be concluded that the equine multifidus muscle in horses is an immunohistochemically homogeneous muscle with various architectural designs that have functional significance according to the vertebral motion segments considered. The results obtained in this study can serve as a basis for future research aimed at understanding the posture and dynamics of the equine spine.     

Lignan-rich sesame seed negates the tumor-inhibitory effect of tamoxifen but maintains bone health in a postmenopausal athymic mouse model with estrogen-responsive breast tumors

OBJECTIVE: Flaxseed, the richest source of mammalian lignan precursors, enhances the tumor growth-inhibitory effect of tamoxifen while exerting no adverse effects on other estrogen-responsive tissues such as bone. Ingestion of sesame seed produces mammalian lignans comparable with flaxseed, but its anticancer potential is unknown. This study determined the interactive effects of sesame seed and tamoxifen on established MCF-7 tumor growth and bone health in ovariectomized athymic mice simulating a postmenopausal condition. DESIGN: Mice with established MCF-7 tumors were treated for 8 weeks with (1) basal diet (negative control), (2) 10% sesame seed, (3) basal diet + tamoxifen implant, (4) 10% sesame seed + tamoxifen implant, or (5) basal diet + estrogen implant (positive control). Weekly palpable tumor size, final tumor weight, cell proliferation, and apoptosis were measured. Bone mineral content, bone mineral density, and biomechanical strength testing were performed on the femur and lumbar vertebrae. RESULTS: Sesame seed induced regression of established tumor size similar to the negative control but tended to negate the tumor-inhibitory effect of tamoxifen, in part by reducing apoptosis. Sesame seed combined with tamoxifen induced higher bone mineral content, bone mineral density, and biomechanical strength in the femur and lumbar vertebrae than either treatment alone. A significant positive relationship was found between final tumor weight and bone strength parameters. CONCLUSIONS: Sesame seed is not protective and negatively interferes with tamoxifen in inducing regression of established MCF-7 tumor size but beneficially interacts with tamoxifen on bone in ovariectomized athymic mice.     

生物力学评价颈椎前路椎弓根螺钉植入骨质疏松椎骨内的稳定性

背景：前路颈椎间盘切除植骨融合是治疗颈椎病的有效术式,该术式能够提供坚强固定且植骨融合率相对较高。但是,对于2个节段以上同时受累的颈椎,由于植骨跨度较大,内固定和植骨块稳定性较差,容易产生植骨融合失败、假关节形成等并发症,影响疗效。 目的：观察颈椎前路椎弓根螺钉植入骨质疏松椎骨内的生物力学稳定性。 方法：纳入12具人颈椎骨,包括6具骨密度正常颈椎骨和6具骨质疏松颈椎骨,共60个椎骨标本资料进行分析,将30个骨质疏松椎骨标本植入颈椎前路椎弓根螺钉设为颈椎前路椎弓根螺钉组,将30个骨密度正常椎骨标本植入前路椎体螺钉设为前路椎体螺钉组。从上述两组中根据骨密度值抽取40个椎骨,分别设置为即时正常骨密度组、即时骨密度疏松组、疲劳正常骨密度组以及疲劳骨质疏松组,每组10个椎骨。采用双能X射线骨密度仪测定各椎体骨密度值,采用ElectroForce 3510材料试验机对两种螺钉进行生物力学指标测试。 结果与结论：颈椎前路椎弓根螺钉组骨矿盐含量、椎体螺钉拔出力、椎体螺钉拔出刚度、椎弓根螺钉拔出力、椎弓根螺钉拔出刚度均显著高于前路椎体螺钉组(P < 0.05)。颈椎前路椎弓根螺钉即时正常骨密度标本最大轴向拔出力、即时骨质疏松标本最大轴向拔出力、疲劳正常骨密度标本最大轴向拔出力、疲劳骨质疏松标本最大轴向拔出力均显著高于高于前路椎体螺钉(P < 0.05)。结果证实,与颈椎前路椎体螺钉相比,颈椎前路椎弓根螺钉在骨质疏松椎骨内生物力学性能更加稳定。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程     

腰椎间盘退变及腰椎融合的有限元研究进展

退变椎间盘腰椎有限元模型即通过椎间盘材料特性及形态结构的改变模拟椎间盘退变的病理过程。椎间盘退变后椎间盘刚度的增加对腰椎应力分布有明显的影响。椎体融合器植入后椎体的应力变化与融合器的形态、材料特性以及松质骨、终板的密度密切相关。     

A review of magnetic resonance (MR) imaging of trabecular bone micro-architecture: contribution to the prediction of biomechanical properties and fracture prevalence.

Bone mineral density and three-dimensional trabecular structure play a significant role in predicting bone strength and biomechanical properties. MR is a non-invasive technique for determining trabecular architecture both in vivo and in vitro. In this paper we review the use of magnetic resonance imaging to obtain high resolution images of trabecular bone structure and quantify the three-dimensional architecture of the trabecular bone network. Studies assessing the anisotropy of the trabecular architecture in human cadaveric specimens from the distal and proximal femur, and the thoracic and lumbar vertebrae, are reviewed. The contributions of the MR derived measures of 3D trabecular bone structure to the biomechanical strength of the specimen are presented. In vivo, the relationship between the high resolution MR derived trabecular bone structure parameters in the distal radius and calcaneus in patients with hip fractures, are compared to age matched normal controls. MR derived measures are compared to measures of trabecular bone mineral density (BMD) in the hip using dual X-ray absorptiometry (DXA).     

Effect of strain rate on tensile properties of sheep disc anulus fibrosus.

We investigated the effect of loading rate on tensile properties of sheep bone-anulus-bone specimens in axial direction. Disc anulus Samples with adjacent bone attachments were prepared from lateral, posterior and anterior regions of sheep lumbar spinal segments. The specimens were then tested at different strain rates under non-destructive cyclic tensile loading followed by destructive tensile loading. Each specimen was prepared by embedding the bony parts in the polymethylmetacrylate (PMMA) exposing the anulus portion to support tension. The results of non-destructive cyclic tests indicated a decrease in the hysteresis energy loss as strain rate increased. In the destructive tests, no significant differences in ultimate stress, ultimate strain and strain energy density were observed at different strain rates or annulus locations. However, there was a significant increase in the modulus at linear region as strain rate increased. Two major modes of failure were observed; rupture in the anulus mid-substance and at the anulus-endplate junction. The former failure was more frequent with no clear pattern across strain rates and locations, while the latter failure at anulus-endplate junction occurred primarily at slow strain rates.