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Baler, R. V., Wijnhoven, I. B., del Valle, V. I., Giovanetti, C. M., & Vivanco, J. F. (2019). Microporosity Clustering Assessment in Calcium Phosphate Bioceramic Particles. Front. Bioeng. Biotechnol., 7(281), 7 pp.
Abstract: There has been an increase in the application of different biomaterials to repair hard tissues. Within these biomaterials, calcium phosphate (CaP) bioceramics are suitable candidates, since they can be biocompatible, biodegradable, osteoinductive, and osteoconductive. Moreover, during sintering, bioceramic materials are prone to form micropores and undergo changes in their surface topographical features, which influence cellular physiology and bone ingrowth. In this study, five geometrical properties from the surface of CaP bioceramic particles and their micropores were analyzed by data mining techniques, driven by the research question: what are the geometrical properties of individual micropores in a CaP bioceramic, and how do they relate to each other? The analysis not only shows that it is feasible to determine the existence of micropore clusters, but also to quantify their geometrical properties. As a result, these CaP bioceramic particles present three groups of micropore clusters distinctive by their geometrical properties. Consequently, this new methodological clustering assessment can be applied to advance the knowledge about CaP bioceramics and their role in bone tissue engineering.
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Kosterhon, M., Müller, A., Rockenfeller, R., Aiyangar, A. K., Gruber, K., Ringel, F., et al. (2024). Invasiveness of decompression surgery affects modeled lumbar spine kinetics in patients with degenerative spondylolisthesis. Front. Bioeng. Biotechnol., 11, 1281119.
Abstract: Introduction: The surgical treatment of degenerative spondylolisthesis with accompanying spinal stenosis focuses mainly on decompression of the spinal canal with or without additional fusion by means of a dorsal spondylodesis. Currently, one main decision criterion for additional fusion is the presence of instability in flexion and extension X-rays. In cases of mild and stable spondylolisthesis, the optimal treatment remains a subject of ongoing debate. There exist different opinions on whether performing a fusion directly together with decompression has a potential benefit for patients or constitutes overtreatment. As X-ray images do not provide any information about internal biomechanical forces, computer simulation of individual patients might be a tool to gain a set of new decision criteria for those cases.
Methods: To evaluate the biomechanical effects resulting from different decompression techniques, we developed a lumbar spine model using forward dynamic-based multibody simulation (FD_MBS). Preoperative CT data of 15 patients with degenerative spondylolisthesis at the level L4/L5 who underwent spinal decompression were identified retrospectively. Based on the segmented vertebrae, 15 individualized models were built. To establish a reference for comparison, we simulated a standardized flexion movement (intact) for each model. Subsequently, we performed virtual unilateral and bilateral interlaminar fenestration (uILF, bILF) and laminectomy (LAM) by removing the respective ligaments in each model. Afterward, the standardized flexion movement was simulated again for each case and decompression method, allowing us to compare the outcomes with the reference. This comprehensive approach enables us to assess the biomechanical implications of different surgical approaches and gain valuable insights into their effects on lumbar spine functionality.
Results: Our findings reveal significant changes in the biomechanics of vertebrae and intervertebral discs (IVDs) as a result of different decompression techniques. As the invasiveness of decompression increases, the moment transmitted on the vertebrae significantly rises, following the sequence intact -> uILF -> bILF -> LAM. Conversely, we observed a reduction in anterior-posterior shear forces within the IVDs at the levels L3/L4 and L4/L5 following LAM.
Conclusion: Our findings showed that it was feasible to forecast lumbar spine kinematics after three distinct decompression methods, which might be helpful in future clinical applications.
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