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人椎体转移瘤的孔隙弹性特征用于指导脊柱肿瘤的跨学科评估

Poroelastic Characterization of Human Vertebral Metastases to Inform a Transdisciplinary Assessment of Spinal Tumors.

作者信息

La Barbera Luigi, Villa Tomaso, Costa Francesco, Boschetti Federica, De Robertis Mario, Anselmi Leonardo, Capo Gabriele, Pancetti Saverio, Fornari Maurizio

机构信息

Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering "Giulio Natta", Politecnico di Milano, 20133 Milan, Italy.

Fondazione IRCCS Istituto Nazionale Neurologico "C. Besta", 20133 Milan, Italy.

出版信息

J Clin Med. 2025 Apr 23;14(9):2913. doi: 10.3390/jcm14092913.

Abstract

: Vertebral metastases often lead to pathological fractures and spinal cord compression, thus impacting patient quality of life. This study aimed to quantify the poroelastic mechanical properties of vertebral metastatic tissue explanted during spine surgery and correlate it with clinical data. : Nine patients (61.7 ± 13.1 years) were prospectively recruited from April 2021 to February 2022, where 78% had a vertebral fracture. Demographic and metastases data, including primary origin, spinal level, lesion volume, and SINS score, were collected, and tissue specimens were explanted during surgery. Using a newly developed portable experimental setup, confined compression creep tests were conducted to measure the aggregate modulus and permeability of each sample. Dealing with limited samples, the results were expressed as the median (min; max). : Specimens from the unfractured vertebrae had higher aggregate modulus (200.35 (149.80; 250.90) kPa vs. 14.47 (8.27; 35.89) kPa) and higher permeability (0.02 (0.01; 0.03) mm/N·s vs. 0.41 (0.10; 4.68) mm/N·s) compared with the specimens from the fractured vertebrae. Histology revealed prominent levels of neoplastic cell infiltration and disruption of typical bone matrix architecture. Specimens with low neoplastic cellularity had comparable or slightly higher poroelastic properties compared to high cellularity. No clear trend was observed between the mechanical properties and SINS score, nor between the mechanical properties, percentage lesion volume, and fractures. : Despite the limited sample size, the poroelastic characterization revealed relevant insights to investigate in future research. A transdisciplinary assessment of vertebral metastases, incorporating poroelastic testing, deserves further attention and could enhance the treatment options.

摘要

椎体转移瘤常导致病理性骨折和脊髓受压,从而影响患者生活质量。本研究旨在量化脊柱手术中取出的椎体转移组织的多孔弹性力学性能,并将其与临床数据相关联。2021年4月至2022年2月前瞻性招募了9名患者(61.7±13.1岁),其中78%有椎体骨折。收集了人口统计学和转移瘤数据,包括原发部位、脊柱节段、病变体积和SINS评分,并在手术中取出组织标本。使用新开发的便携式实验装置,进行了受限压缩蠕变试验,以测量每个样本的总模量和渗透率。由于样本数量有限,结果以中位数(最小值;最大值)表示。与骨折椎体的标本相比,未骨折椎体的标本具有更高的总模量(200.35(149.80;250.90)kPa对14.47(8.27;35.89)kPa)和更高的渗透率(0.02(0.01;0.03)mm/N·s对0.41(0.10;4.68)mm/N·s)。组织学显示肿瘤细胞浸润水平显著,典型骨基质结构破坏。肿瘤细胞数量少的标本与肿瘤细胞数量多的标本相比,具有相当或略高的多孔弹性性能。在力学性能与SINS评分之间,以及力学性能、病变体积百分比和骨折之间均未观察到明显趋势。尽管样本量有限,但多孔弹性特征为未来研究提供了相关见解。结合多孔弹性测试对椎体转移瘤进行跨学科评估值得进一步关注,并且可以增加治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1d56/12072970/a870de49aaa5/jcm-14-02913-g0A1.jpg

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