Effects of Breast and Prostate Cancer Metastases on Lumbar Spine Biomechanics: Rapid In Silico Evaluation
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.
KeywordsCancer metastases Finite element method Lumbar spine Osteolytic lesions Osteosclerotic lesions Strain
Conflicts of Interest
The authors declare no conflicts of interest in relation to this article.
- Asdourian PL, Weidenbaum M, De Wald RL, Hammerberg KW, Ramsey RG (1990b) The pattern of vertebral involvement in metastatic vertebral breast cancer. Clin Orthop Relat Res (250):164–170Google Scholar
- Batson O (1942) The role of vertebral veins in metastatic processes. Ann Intern Med l:38–45Google Scholar
- Di Martino A, Caldaria A, De Vivo V, Denaro V (2016) Metastatic epidural spinal cord compression. Expert Rev Anticancer Ther 12:1–10Google Scholar
- Groblewska M, Mroczko B, Czygier M, Szmitkowski M (2008) Cytokines as markers of osteolysis in the diagnostics of patients with bone metastases. Postepy Hig Med Dosw 62:668–675Google Scholar
- Kopaczewski B, Jankowski R, Nowak S (2009) Prognostic factors and therapeutic recommendations in patients with metastasis of the spine. Neuroskop 11:77–85Google Scholar
- Pawlak WZ, Gabriel Wcisło G, Leśniewski-Kmak K, Korniluk J (2002) The metastatic bone disease as a first clinical symptom in cancer. Współczesna Onkologia 4:206–215Google Scholar
- Shiozawa Y, Pedersen EA, Havens AM, Jung Y, Mishra A, Joseph J, Kim JK, Patel LR, Ying C, Ziegler AM, Pienta MJ, Song J, Wang J, Loberg RD, Krebsbach PH, Pienta KJ, Taichman RS (2011) Human prostate cancer metastases target the hematopoietic stem cell niche to establish footholds in mouse bone marrow. J Clin Invest 121:1298–1312CrossRefPubMedPubMedCentralGoogle Scholar