Department of Orthopedics and Traumatology, Central Clinical Hospital of Ministry of Interior, Warsaw, Poland.
Health Rehabilitation Center, Cracow, Poland.
Adv Exp Med Biol. 2018;1096:31-39. doi: 10.1007/5584_2018_192.
Metastases to distant organs are a frequent occurrence in cancer diseases. The skeletal system, especially the spine, is one such organ. The objective of this study was to apply a numerical modeling, using a finite element method (FEM), for the evaluation of deformation and stress in lumbar spine in bone metastases to the spine. We investigated 20 patients (10 women and 10 men) aged 38-81 years. In women, osteolytic lesions in lumbar spine accompanied breast cancer, in men it was prostate cancer. Geometry of FEM models were built based on CT scans of metastatic lumbar spine. We made the models for osteolytic metastases, osteosclerotic metastases, and metastases after surgery. Images were compared. We found a considerable concentration of strain, especially located in the posterior part of the vertebral body. In osteolytic lesions, the strain was located below the vertebral body with metastases. In osteosclerotic lesions, the strain was located in the anterior and posterior parts in and below the vertebral body with metastases. Surgery abolished the pathological strain. We conclude that metastases to the lumbar spine introduce a pathological strain on the lumbar body. The immobilization of the vertebral body around fractures abolished the strain.
远处器官转移是癌症的常见现象。骨骼系统，尤其是脊柱，就是这样的一个器官。本研究的目的是应用数值模型，采用有限元法（FEM），评估脊柱转移瘤患者脊柱的变形和应力。我们调查了 20 名患者（10 名女性和 10 名男性），年龄 38-81 岁。女性的溶骨性病变发生在腰椎，伴随乳腺癌，而男性则是前列腺癌。基于转移性腰椎的 CT 扫描构建了 FEM 模型的几何形状。我们制作了溶骨性转移、成骨性转移和手术后转移的模型。对图像进行了比较。我们发现了相当大的应变集中，尤其是位于椎体的后部。在溶骨性病变中，应变位于椎体下方有转移的部位。在成骨性病变中，应变位于椎体的前部和后部以及有转移的下方。手术消除了病理性应变。我们得出结论，脊柱转移瘤会导致腰椎体产生病理性应变。骨折周围椎体的固定消除了应变。
