@article {10222,
	title = {A method for patient-specific evaluation of vertebral cancellous bone strength- In vitro validation},
	journal = {CLINICAL BIOMECHANICS},
	volume = {22},
	number = {3},
	year = {2007},
	pages = {282-291},
	abstract = {Background.\&nbsp;In\&nbsp;the context\&nbsp;of\&nbsp;osteoporosis, important determinants\&nbsp;of\&nbsp;the fracture risk are the apparentstrength\&nbsp;and stiffness\&nbsp;of\&nbsp;cancellous\&nbsp;bone, as well as its brittleness and energy absorption capacity. Standard medical imaging, however, cannot measure these mechanical properties directly. Consequently, an estimation\&nbsp;of\&nbsp;the risk\&nbsp;for\&nbsp;fracture is made by correlating relative density or mineral density at\&nbsp;a\&nbsp;skeletal site with statistics\&nbsp;of\&nbsp;fracture occurrence, which provides limited and partial indications on fracture risks.\&nbsp;Abetter\&nbsp;method\&nbsp;for\&nbsp;evaluating the\&nbsp;patient-specific\&nbsp;mechanical properties\&nbsp;of\&nbsp;cancellous\&nbsp;bone\&nbsp;is therefore required.\&nbsp;Methods.\&nbsp;In\&nbsp;order to asses the mechanical properties\&nbsp;of\&nbsp;vertebral\&nbsp;cancellous\&nbsp;bone, we developed\&nbsp;a\&nbsp;finite element parametric model\&nbsp;of\&nbsp;lattice trabecular architecture that,\&nbsp;in\&nbsp;the future, will be suitable\&nbsp;for\&nbsp;use withbone\&nbsp;imaging modalities. The model inputs are apparent morphological parameters (trabecular thickness and trabecular separation) and the\&nbsp;bone\&nbsp;mineral density. We conducted uniaxial compression tests on 36 canine\&nbsp;vertebral\&nbsp;cancellous\&nbsp;bone\&nbsp;specimens (C7 and L1) to validate model predictions\&nbsp;of\&nbsp;strength\&nbsp;and stiffness\&nbsp;in\&nbsp;vitro.\&nbsp;Findings. Predictions\&nbsp;of\&nbsp;strength\&nbsp;and stiffness matched the experimental results within relative absolute errors\&nbsp;of\&nbsp;17.7\% and 12.8\%, respectively (average\&nbsp;of\&nbsp;differences between model-predicted and measured values, divided by the average\&nbsp;of\&nbsp;measured values). We also employed the model\&nbsp;for\&nbsp;evaluation\&nbsp;of\&nbsp;strengthand stiffness\&nbsp;of\&nbsp;human L1 and L5 vertebrae and found mean\&nbsp;strength\&nbsp;of\&nbsp;1.67 MPa (confidence interval 0.42 MPa) and mean elastic modulus\&nbsp;of\&nbsp;190 MPa (confidence interval 50 MPa), which are well within the range\&nbsp;ofpreviously reported apparent\&nbsp;strength\&nbsp;and stiffness properties.\&nbsp;Interpretation. The present model can be used to improve medical imaging-based\&nbsp;evaluation\&nbsp;of\&nbsp;the spine\&nbsp;inosteoporotic individuals by providing more specific information on the individual\&nbsp;bone{\textquoteright}s susceptibility to fracture once clinical\&nbsp;bone\&nbsp;scans will be able to provide more reliable measures\&nbsp;of\&nbsp;trabecular thickness and separation. (c) 2006 Elsevier Ltd. All rights reserved.},
	url = {http://www.sciencedirect.com/science/article/pii/S0268003306002063},
	author = {Diamant, I and Shahar, R. and Masharawi, Y. and Gefen, A}
}
