Subject-specific mechanical properties of vertebral cancellous bone assessed using a low-dose X-ray device

Abstract

Objectives According to the inter-individual variability of bone mechanical properties, subject-specific evaluation of the cancellous bone Young's modulus is needed to build finite-element models predicting vertebral strength with accuracy. Relationships based on the density assessed by quantitative computed tomography were proposed. However, quantitative computed tomography is not always suited for the analysis of the whole spine for patients’ follow-up because of the high radiation dose. Hence, this study aims at evaluating the mechanical properties of the vertebral cancellous bone using a low-dose X-ray device. Material and methods Nineteen vertebrae were considered. Biplanar radiographs were made using the low-dose EOS ® system with a dual-energy modality to evaluate antero-posterior and lateral areal bone mineral densities. A cylindrical sample was extracted from each vertebral body and tested until failure to assess the Young's modulus and the ultimate stress of the vertebral cancellous bone. Results and discussion Mechanical properties were significantly related to the EOS ® areal densities. On one hand, the relationships remained less predictive than those based on quantitative computed tomography, but on the other hand, they better predict mechanical properties than previous studies using dual X-ray absorptiometry (clinical gold standard system for density assessment). Conclusion The study shows the feasibility to predict the Young's modulus of the vertebral cancellous bone from the whole vertebral areal bone mineral density (BMD). It gives promising prospects to build finite-element models, including both subject-specific geometry and subject-specific mechanical properties by using a low-dose X-ray device for regions where high radiation doses would limit tomography assessment possibilities.