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Application of digital volume correlation to study the efficacy of prophylactic vertebral augmentation
BACKGROUND: Prophylactic augmentation is meant to reinforce the vertebral body, but in some cases it is suspected to actually weaken it. Past studies only investigated structural failure and the surface strain distribution. To elucidate the failure mechanism of the augmented vertebra, more information is needed about the internal strain distribution. This study aims to measure, for the first time, the full-field three-dimensional strain distribution inside augmented vertebrae in the elastic regime and to failure. METHODS: Eight porcine vertebrae were prophylactically-augmented using two augmentation materials. They were scanned with a micro-computed tomography scanner (38.8mum voxel resolution) while undeformed, and loaded at 5%, 10%, and 15% compressions. Internal strains (axial, antero-posterior and lateral-lateral components) were computed using digital volume correlation. FINDINGS: For both augmentation materials, the highest strains were measured in the regions adjacent to the injected cement mass, whereas the cement-interdigitated-bone was less strained. While this was already visible in the elastic regime (5%), it was a predictor of the localization of failure, which became visible at higher degrees of compression (10% and 15%), when failure propagated across the trabecular bone. Localization of high strains and failure was consistent between specimens, but different between the cement types. INTERPRETATION: This study indicated the potential of digital volume correlation in measuring the internal strain (elastic regime) and failure in augmented vertebrae. While the cement-interdigitated region becomes stiffer (less strained), the adjacent non-augmented trabecular bone is affected by the stress concentration induced by the cement mass. This approach can help establish better criteria to improve vertebroplasty
Application of digital volume correlation (DVC) to study the efficacy of prophylactic augmentation
Methods for the characterization of the long-term mechanical performance of cements for vertebroplasty and kyphoplasty: Critical review and suggestions for test methods
There is a growing interest towards bone cements for use in vertebroplasty and kyphoplasty, as such spine procedures are becoming more and more common. Such cements feature different compositions, including both traditional acrylic cements and resorbable and bioactive materials. Due to the different compositions and intended use, the mechanical requirements of cements for spinal applications differ from those of traditional cements used in joint replacement. Because of the great clinical implications, it is very important to assess their long-term mechanical competence in terms of fatigue strength and creep. This paper aims at offering a critical overview of the methods currently adopted for such mechanical tests. The existing international standards and guidelines and the literature were searched for publications relevant to fatigue and creep of cements for vertebroplasty and kyphoplasty. While standard methods are available for traditional bone cements in general, no standard indicates specific methods or acceptance criteria for fatigue and creep of cements for vertebroplasty and kyphoplasty. Similarly, a large number of papers were published on cements for joint replacements, but only few cover fatigue and creep of cements for vertebroplasty and kyphoplasty. Furthermore, the literature was analyzed to provide some indications of tests parameters and acceptance criteria (number of cycles, duration in time, stress levels, acceptable amount of creep) for possible tests specifically relevant to cements for spinal applications
Elastic full-field strain analysis and microdamage progression in the vertebral body from digital volume correlation
The strain distribution in vertebral body has been measured in vitro in the elastic regime but only on the bone surface by means of strain gauges and digital image correlation. Digital volume correlation (DVC) based on micro-computed tomography (micro-CT) images allowed measurements of the internal strain distribution in bone at both tissue (trabecular and cortical bone) and organ (vertebra) levels. However, DVC has been mainly used to investigate failure of the vertebral body but has not yet been deployed to investigate the internal strain distribution in the elastic regime. The aim of this study was to investigate strain in the elastic regime and up to failure inside the vertebral body, including analysis of strain in all directions. Three porcine thoracic vertebrae were loaded in a step-wise fashion at increasing steps of compression (5, 10 and 15%). Micro-CT images were acquired at each step of compression. DVC successfully provided the internal strain distribution both in the elastic regime and up to failure. Micro-CT images successfully identified regions of failure initiation and progression, which were well quantified by DVC-computed strains. Interestingly, the same regions where failure eventually occurred experienced the largest strain magnitude also for the lowest degrees of compression (yet in the elastic regime)
A preliminary in vitro biomechanical evaluation of prophylactic cement augmentation of the thoracolumbar vertebrae
In this paper, the biomechanical effectiveness of prophylactic augmentation in preventing fracture was investigated. In vitro biomechanical tests were performed to assess which factors make prophylactic augmentation effective/ineffective in reducing fracture risk. Nondestructive and destructive in vitro tests were performed on isolated osteoporotic vertebrae. Five sets of three-adjacent-vertebrae were tested. The central vertebra of each triplet was tested in the natural condition (control) non-destructively (axial-compression, torsion) and destructively (axial-compression). The two adjacent vertebrae were first tested nondestructively (axial-compression, torsion) pre-augmentation; prophylactic augmentation (uni-or bi-pedicular access) was then performed delivering 5.04mL to 8.44mL of acrylic cement by means of a customized device; quality of augmentation was CT-assessed; the augmented vertebrae were re-tested nondestructively (axial-compression, torsion), and eventually loaded to failure (axial-compression). Vertebral stiffness was correlated with the first-failure, but not with ultimate failure. The force and work to ultimate failure in prophylactic-augmented vertebrae was consistently larger than in the controls. However, in some cases the first-failure force and work in the augmented vertebrae were lower than for the controls. To investigate the reasons for such unpredictable results, the correlation with augmentation quality was analyzed. Some augmentation parameters seemed more correlated with mechanical outcome (statistically not-significant due to the limited sample size): uni-pedicular access resulted in a single cement mass, which tended to increase the force and work to first-and ultimate failure. The specimens with the highest strength and toughness also had: at least 25% cement filling, cement mass shifted anteriorly, and cement-endplate contact. These findings seem to confirm that prophylactic augmentation may aid reducing the risk of fracture. However, inadequate augmentation may have detrimental consequences. This study suggests that, to improve the strength of the augmented vertebrae, more attention should be dedicated to the quality of augmentation in terms of amount and position of the injected cement
Effect of the in Vitro Boundary Conditions on the Surface Strain Experienced by the Vertebral Body in the Elastic Regime
The vertebral strength and strain can be assessed in vitro by both using isolated vertebrae and sets of three adjacent vertebrae (the central one is loaded through the disks). Our goal was to elucidate if testing single-vertebra-specimens in the elastic regime provides different surface strains to three-vertebrae-segments. Twelve three-vertebrae sets were extracted from thoracolumbar human spines. To measure the principal strains, the central vertebra of each segment was prepared with eight strain-gauges. The sets were tested mechanically, allowing comparison of the surface strains between the two boundary conditions: first when the same vertebra was loaded through the disks (three-vertebrae-segment) and then with the endplates embedded in cement (single-vertebra). They were all subjected to four nondestructive tests (compression, traction, torsion clockwise, and counterclockwise). The magnitude of principal strains differed significantly between the two boundary conditions. For axial loading, the largest principal strains (along vertebral axis) were significantly higher when the same vertebra was tested isolated compared to the three-vertebraesegment. Conversely, circumferential strains decreased significantly in the single vertebrae compared to the three-vertebraesegment, with some variations exceeding 100% of the strain magnitude, including changes from tension to compression. For torsion, the differences between boundary conditions were smaller. This study shows that, in the elastic regime, when the vertebra is loaded through a cement pot, the surface strains differ from when it is loaded through the disks. Therefore, when single vertebrae are tested, surface strain should be taken with caution
Going Beyond Counting First Authors in Author Co-citation Analysis
The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
We provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
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