Academic Journal

Fracture Patterns of an Osteolytic Hole Involved Lumbar Vertebra, Assessed for a Case Study by Computational Models.

Bibliographic Details
Title: Fracture Patterns of an Osteolytic Hole Involved Lumbar Vertebra, Assessed for a Case Study by Computational Models.
Authors: Nazari AR; Department of Civil Engineering, Technical & Vocational University, Tehran, Iran.; Biomechanics Research Lab, Technical & Vocational University, Tehran, Iran.
Source: International journal for numerical methods in biomedical engineering [Int J Numer Method Biomed Eng] 2026 Aug; Vol. 42 (8), pp. e70202.
Publication Type: Journal Article
Language: English
Journal Info: Publisher: Wiley Country of Publication: England NLM ID: 101530293 Publication Model: Print Cited Medium: Internet ISSN: 2040-7947 (Electronic) Linking ISSN: 20407939 NLM ISO Abbreviation: Int J Numer Method Biomed Eng Subsets: MEDLINE
Imprint Name(s): Original Publication: [Oxford, UK] : Wiley
MeSH Terms: Lumbar Vertebrae*/physiopathology , Lumbar Vertebrae*/diagnostic imaging , Lumbar Vertebrae*/injuries , Osteolysis*/physiopathology , Spinal Fractures*/physiopathology , Computer Simulation*, Humans ; Biomechanical Phenomena ; Stress, Mechanical
Abstract: Osteolytic vertebrae containing central lesions are associated with a high risk of burst fracture, as the presence of such lesions indicates substantial bone destruction. The present study aimed to investigate fracture patterns in a clinically relevant case of a lumbar vertebra with an osteolytic cavity under various loading conditions using a computational modeling approach. Osteolytic damage progression was simulated through a virtual thermal flux approach, while stiffness degradation was represented using a continuum damage mechanics framework. Potential crack locations within the vertebra were defined based on an established clinical classification, and crack propagation was evaluated using the Virtual Crack Closure Technique (VCCT). The results demonstrated that the mechanical competence and fracture patterns of the osteolytic vertebra were strongly dependent on the intensity of osteolytic damage and the applied loading conditions. The earliest onset of instability occurred under lateral bending loading when the average osteolytic damage reached approximately 50%. Under kyphotic loading, vertical cracks propagated around the osteolytic cavity and could significantly compromise vertebral stability when combined with compressive and bending loads associated with daily activities. Such loading conditions may promote the connection of horizontal endplate cracks with vertical cracks, resulting in a burst fracture pattern. Therefore, vertebrae containing osteolytic cavities should be carefully protected against lateral bending loads during the treatment period, and exposure to heavy loading postures should be strictly avoided. Future studies should investigate the sensitivity of vertebral load-carrying capacity to variations in the size, shape, and location of osteolytic lesions.
(© 2026 John Wiley & Sons Ltd.)
References: J. Berger and J. Zustin, “Black Hole in the Spine,” Spine Journal 14 (2014): 716–717.
C. G. Fisher, C. P. DiPaola, T. C. Ryken, M. H. Bilsky, C. I. Shaffrey, and D. R. Fourney, “A Novel Classification System for Spinal Instability in Neoplastic Disease: An Evidence‐Based Approach and Expert Consensus From the Spine Oncology Study Group,” Spine 35 (2010): E1221–E1229.
N. T. Tran, N. A. Watson, A. F. Tencer, R. P. Ching, and P. A. Anderson, “Mechanism of the Burst Fracture in the Thoracolumbar Spine, the Effect of Loading Rate,” Spine 20, no. 18 (1995): 1984–1988.
T. McCormack, E. Karaikovic, and R. W. Gaines, “The Load Sharing Classification of Spine Fractures,” Spine 19, no. 15 (1994): 1741–1744.
E. C. Benzel, Biomechanics of Spine Stabilization (American Association of Neurological Surgeons, 2001).
A. Krishnaney, M. P. Steinmetz, and E. C. Benzel, “Biomechanics of Metastatic Spine Cancer,” Neurosurgery Clinics of North America 15, no. 4 (2004): 375–380.
M. Charlebois, M. Jirásek, and P. K. Zysset, “A Nonlocal Constitutive Model for Trabecular Bone Softening in Compression,” Biomechanics and Modeling in Mechanobiology 9, no. 5 (2010): 597–611.
R. Hambli, A. Bettamer, and S. Allaoui, “Finite Element Prediction of Proximal Femur Fracture Pattern Based on Orthotropic Behaviour Law Coupled to Quasi‐Brittle Damage,” Medical Engineering & Physics 34, no. 2 (2012): 202–210.
R. Hambli, “A Quasi‐Brittle Continuum Damage Finite Element Model of the Human Proximal Femur Based on Element Deletion,” Medical & Biological Engineering & Computing 51, no. 1–2 (2013): 219–231.
G. M. Campbell, A. P. Jaime, S. Giravent, et al., “Assessment of Bone Fragility in Patients With Multiple Myeloma Using QCT‐Based Finite Element Modeling,” Journal of Bone and Mineral Research 32, no. 1 (2017): 151–156.
C. M. Whyne, S. S. Hu, and J. C. Lotz, “Burst Fracture in the Metastatically Involved Spine: Development, Validation, and Parametric Analysis of a Three‐Dimensional Poroelastic Finite‐Element Model,” Spine 28, no. 7 (2003): 652–660.
M. C. Costa, P. Eltes, A. Lazary, P. P. Varga, M. Viceconti, and E. Dall'Ara, “Biomechanical Assessment of Vertebrae With Lytic Metastases With Subject‐Specific Finite Element Models,” Journal of the Mechanical Behavior of Biomedical Materials 98 (2019): 268–290.
J. H. Keyak and Y. Falkinstein, “Comparison of In Situ and In Vitro CT Scan‐Based Finite Element Model Predictions of Proximal Femoral Fracture Load,” Medical Engineering & Physics 25, no. 9 (2003): 781–787.
T. S. Kaneko, J. S. Bell, M. R. Pejcic, J. Tehranzadeh, and J. H. Keyak, “Mechanical Properties, Density and Quantitative CT Scan Data of Trabecular Bone With and Without Metastases,” Journal of Biomechanics 37, no. 4 (2004): 523–530.
G. Salvatore, A. Berton, H. Giambini, et al., “Biomechanical Effects of Metastasis in the Osteoporotic Lumbar Spine: A Finite Element Analysis,” BMC Musculoskeletal Disorders 19, no. 1 (2018): 38.
I. Dehghan‐Hamani, N. Arjmand, and A. Shirazi‐Adl, “Subject‐Specific Loads on the Lumbar Spine in Detailed Finite Element Models Scaled Geometrically and Kinematics‐Driven by Radiography Images,” International Journal for Numerical Methods in Biomedical Engineering 35 (2019): e3182.
R. N. Alkalay and T. P. Harrigan, “Mechanical Assessment of the Effects of Metastatic Lytic Defect on the Structural Response of Human Thoracolumbar Spine,” Journal of Orthopaedic Research 34, no. 10 (2016): 1808–1819.
M. Prado, A. Rezaei, and H. Giambini, “Density‐Dependent Material and Failure Criteria Equations Highly Affect the Accuracy and Precision of QCT/FEA‐Based Predictions of Osteoporotic Vertebral Fracture Properties,” Annals of Biomedical Engineering 49 (2020): 663–672, https://doi.org/10.1007/s10439‐020‐02595‐w.
C. Falcinelli, E. Schileo, L. Balistreri, et al., “Multiple Loading Conditions Analysis Can Improve the Association Between Finite Element Bone Strength Estimates and Proximal Femur Fractures: A Preliminary Study in Elderly Women,” Bone 67 (2014): 71–80.
Z. Yosibash, R. Mayo, G. Dahan, N. Trabelsi, G. Amir, and C. Milgrom, “Predicting the Stiffness and Strength of Human Femurs With Real Metastatic Tumors,” Bone 69 (2014): 180–190.
J. Keyak, T. Kaneko, H. Skinner, and B. Hoang, “The Effect of Simulated Metastatic Lytic Lesions on Proximal Femoral Strength,” Clinical Orthopaedics and Related Research 459 (2007): 139–145.
P. K. Zysset and L. Rincón, “An Alternative Fabric‐Based Yield and Failure Criterion for Trabecular Bone,” in Mechanics of Biological Tissue, ed. G. A. Holzapfel and R. W. Ogden (Springer, 2006).
K. Imai, I. Ohnishi, M. Bessho, and K. Nakamura, “Nonlinear Finite Element Model Predicts Vertebral Bone Strength and Fracture Site,” Spine 31, no. 16 (2006): 1789–1794.
E. Dall'Ara, R. Schmidt, D. Pahr, et al., “A Nonlinear Finite Element Model Validation Study Based on a Novel Experimental Technique for Inducing Anterior Wedge‐Shape Fractures in Human Vertebral Bodies In Vitro,” Journal of Biomechanics 43, no. 12 (2010): 2374–2380.
K. H. J. Groenen, T. Bitter, T. C. G. van Veluwen, et al., “Case‐Specific Non‐Linear Finite Element Models to Predict Failure Behavior in Two Functional Spinal Units,” Journal of Orthopaedic Research 36, no. 12 (2018): 3208–3218.
C. Falcinelli, A. Di Martino, A. Gizzi, G. Vairo, and V. Denaro, “Mechanical Behavior of Metastatic Femurs Through Patient‐Specific Computational Models Accounting for Bone‐Metastasis Interaction,” Journal of the Mechanical Behavior of Biomedical Materials 93 (2019): 9–22.
C. Falcinelli, A. Di Martino, A. Gizzi, G. Vairo, and V. Denaro, “Fracture Risk Assessment in Metastatic Femurs: A Patient Specific CT‐Based Finite‐Element Approach,” Meccanica 55 (2020): 861–881.
P. Gaziano, C. Falcinelli, and G. Vairo, “A Computational Insight on Damage‐Based Constitutive Modelling in Femur Mechanics,” European Journal of Mechanics ‐ A/Solids 93 (2022): 104538.
A. Gustafsson, M. Tognini, F. Bengtsson, T. C. Gasser, H. Isaksson, and L. Grassi, “Subject‐Specific FE Models of the Human Femur Predict Fracture Path and Bone Strength Under Single‐Leg‐Stance Loading,” Journal of the Mechanical Behavior of Biomedical Materials 113 (2021): 104118.
M. Marco, E. Giner, R. Larraínzar‐Garijo, J. R. Caeiro, and M. H. Miguélez, “Modelling of Femur Fracture Using Finite Element Procedures,” Engineering Fracture Mechanics 196 (2018): 157–167.
M. Marco, E. Giner, J. R. Caeiro‐Rey, M. H. Miguélez, and R. Larraínzar‐Garijo, “Numerical Modelling of Hip Fracture Patterns in Human Femur,” Computer Methods and Programs in Biomedicine 173 (2019): 67–75.
L. Molinari and C. Falcinelli, “On the Human Vertebra Computational Modeling: A Literature Review,” Meccanica 57, no. 3 (2022): 599–622.
J. Carlsson, O. Karlsson, H. Isaksson, and A. Gustafsson, “Phase‐Field Simulation of Crack Growth in Cortical Bone Microstructure: Parameter Identification and Comparison Against Experiments,” Biomechanics and Modeling in Mechanobiology 24 (2025): 599–613.
P. Lucksanasombool, W. A. Higgs, R. J. E. Higgs, and M. Swain, “Fracture Toughness of Bovine Bone: Influence of Orientation and Storage Media,” Biomaterials 22, no. 23 (2001): 3127–3132.
A. Kumar and R. Ghosh, “Particularly Optimized Enriched Element‐Free Galerkin Method (POE‐EFGM) for Orthotropic Fracture Analysis of Cortical Bone,” Engineering Fracture Mechanics 25 (2021): 107943.
P. Allahyari, M. Silani, V. Yaghoubi, et al., “On the Fracture Behavior of Cortical Bone Microstructure: The Effects of Morphology and Material Characteristics of Bone Structural Components,” Journal of the Mechanical Behavior of Biomedical Materials 137 (2023): 105530.
A. Kumar, H. Pathak, and R. Ghosh, “Cortical Bone Fracture Analysis Including the Combined Influence of Osteon Orientations, Applied Load and Crack Lengths: A Numerical Investigation,” Proceedings of the Institution of Mechanical Engineers, Part H: Journal of Engineering in Medicine 238, no. 11–12 (2024): 1091–1102.
Z. Soltani, M. Xu, R. Radovitzky, M. A. Stadelmann, D. Hackney, and R. N. Alkalay, “CT‐Based Finite Element Simulating Spatial Bone Damage Accumulation Predicts Metastatic Human Vertebrae Strength and Stiffness,” Frontiers in Bioengineering and Biotechnology 12 (2024): 1424553.
G. Cavazzoni, E. Dall'Ara, and M. Palanca, “Microstructure of the Human Metastatic Vertebral Body,” Frontiers in Endocrinology 15 (2025): 1508504.
A. R. Nazari, “Simulation of Cancer Progression in Bone by a Virtual Thermal Flux With a Case Study on Lumbar Vertebrae With Multiple Myeloma,” Medical Engineering & Physics 126 (2024): 104147.
A. R. Nazari, “Application of Virtual Crack Closure Technique to Simulate a Burst Fracture for an Osteolytic Vertebra, a Case Study,” Biomedical Physics & Engineering Express 11 (2025): 055024, https://doi.org/10.1088/2057‐1976/adfde5.
I. Lapczyk and J. A. Hurtado, “Progressive Damage Modeling in Fiber‐Reinforced Materials,” Composites. Part A, Applied Science and Manufacturing 38 (2007): 2333–2341.
A. R. Nazari, M. Z. Kabir, and H. Hosseni‐Toudeshky, “Investigation Into Stiffness Degradation Progress in Glass/Vinylester Laminated Beams Under Large Deformations,” Scientia Iranica. Series A, Civil Engineering 25, no. 5 (2018): 2389–2403.
Z. P. Bažant and B. H. Oh, “Crack Band Theory for Fracture of Concrete,” Materials and Structures 16 (1983): 155–177.
R. S. Ochia, A. F. Tencer, and R. P. Ching, “Effect of Loading Rate on Endplate and Vertebral Body Strength in Human Lumbar Vertebrae,” Journal of Biomechanics 36, no. 12 (2003): 1875–1881.
R. Hambli, “Multiscale Prediction of Crack Density and Crack Length Accumulation in Trabecular Bone Based on Neural Networks and Finite Element Simulation,” International Journal for Numerical Methods in Biomedical Engineering 27 (2011): 461–475.
ABAQUS, Analysis User's Manual, Version 6.10 (Dassault Systèmes Simulia Inc., 2010).
R. Krueger, “The Virtual Crack Closure Technique: History, Approach and Applications,” (2002), NASA/CR‐2002‐2211628, ICASE Report No. 2002–10.
J. P. M. Gonçalves, M. F. S. F. de Moura, P. M. S. T. de Castro, and A. T. Marques, “Interface Element Including Point‐To‐Surface Constraints for Three Dimensional Problems With Damage Propagation,” Engineering Computations 17 (2000): 28–47.
P. P. Camanho and C. G. Davila, “Mixed‐Mode Decohesion Finite Elements for the Simulation of Delamination in Composite Materials,” (2002), NASA/TM‐2002‐211737.
F. A. M. Pereira, J. J. L. Morais, N. Dourado, M. F. S. F. de Moura, and M. I. R. Dias, “Fracture Characterization of Bone Under Mode II Loading Using the End Loaded Split Test,” Journal of the Mechanical Behavior of Biomedical Materials 4, no. 8 (2011): 1764–1773.
J. McCormack, S. M. Stover, J. C. Gibeling, and D. P. Fyhrie, “Effects of Mineral Content on the Fracture Properties of Equine Cortical Bone in Double‐Notched Beams,” Bone 50 (2012): 1275–1280.
P. Shitole, A. Gupta, and A. Ghosh, “Fracture Mechanism and Fracture Toughness at the Interface Between Cortical and Cancellous Bone,” Journal of Biomechanical Engineering 141, no. 11 (2019): 114502.
L. Yan, A. Cinar, S. Ma, R. Abel, U. Hansen, and T. J. Marrow, “A Method for Fracture Toughness Measurement in Trabecular Bone Using Computed Tomography, Image Correlation and Finite Element Methods,” Journal of the Mechanical Behavior of Biomedical Materials 109 (2020): 103838.
R. B. Cook and P. Zioupos, “The Fracture Toughness of Cancellous Bone,” Journal of Biomechanics 42, no. 13 (2009): 2054–2060.
T. S. Keller, “Predicting the Compressive Mechanical Behavior of Bone,” Journal of Biomechanics 27 (1994): 1159–1168.
M. Levy and Z. Yosibash, “Heterogeneous Fracture Toughness of Human Cortical Bone Tissue,” International Journal of Fracture 249, no. 17 (2025): 17, https://doi.org/10.1007/s10704‐024‐00836‐w.
G. Chen, H. Yang, M. Gan, et al., “Polyostotic Fibrous Dysplasia of the Thoracic Spine: Case Report and Review of the Literature,” Spine Journal 36, no. 22 (2011): E1485–E1488.
B. O. Oyajobi, “Multiple Myeloma/Hypercalcemia,” Arthritis Research & Therapy 9, no. Suppl 1 (2007): S4.
P. Pollintine, P. Dolan, J. H. Tobias, and M. A. Adams, “Intervertebral Disc Degeneration Can Lead to “Stress‐Shielding” of the Anterior Vertebral Body,” Spine 29, no. 7 (2004): 774–782.
A. Shirazi‐Adl, A. M. Ahmed, and S. C. Shrivastava, “Mechanical Response of a Lumbar Motion Segment in Axial Torque Alone and Combined With Compression,” Spine 11 (1986): 914–927.
A. R. Nazari, “A Structural Description for Severe Degeneration of Intervertebral Discs to Computationally Interpret Experimental Results Obtained by Stress Profilometry,” European Spine Journal 34 (2025): 4619–4630.
A. L. Nachemson, “Disc Pressure Measurements,” Spine 6 (1984): 93–97.
A. G. Patwardhan, R. M. Havey, K. P. Meade, B. Lee, and B. Dunlap, “A Follower Load Increases the Load Carrying Capacity of the Lumbar Spine in Compression,” Spine 24, no. 10 (1999): 1003–1009.
Z. Shao, G. Rompe, and M. Schiltenwolf, “Radiographic Changes in the Lumbar Intervertebral Discs and Lumbar Vertebrae With Age,” Spine 27, no. 3 (2002): 263–268.
H. Schmidt, F. Galbusera, A. Rohlmann, T. Zander, and H. J. Wilke, “Effect of Multilevel Lumbar Disc Arthroplasty on Spine Kinematics and Facet Joint Loads in Flexion and Extension: A Finite Element Analysis,” European Spine Journal 21, no. S5 (2010): 663–674.
Y. M. Lu, W. C. Hutton, and V. M. Gharpuray, “Can Variations in Intervertebral Disc Height Affect the Mechanical Function of the Disc?,” Spine 21 (1996): 2208–2216.
Y. M. Lu, W. C. Hutton, and V. M. Gharpuray, “Do Bending, Twisting, and Diurnal Fluid Changes in the Disc Affect the Propensity to Prolapse? A Viscoelastic Finite Element Model,” Spine 21 (1996): 2570–2579.
H. Yamada, Strength of Biological Materials, ed. F. G. Evans (Williams & Wilkins Company, 1970).
H. Schmidt, A. Kettler, F. Heuer, U. Simon, L. Claes, and H. J. Wilke, “Intradiscal Pressure, Shear Strain, and Fiber Strain in the Intervertebral Disc Under Combined Loading,” Spine 32, no. 7 (2007): 748–755.
O. I. Olubiyi, F. Brown, and O. M. Teytelboym, “Lucent Lesions of Vertebral Body: Differential Diagnosis, a Biweekly Review of Clinical Radiologic Practice,” Contemporary Diagnostic Radiology 42, no. 11 (2019): 8.
V. Ranatunga, “Finite Element Modeling of Delamination Crack Propagation in Laminated Composites,” in Proceedings of the World Congress on Engineering 2011, vol. III (Congress, 2011).
H. W. Wang, H. W. Zhou, H. W. Ji, and X. C. Zhang, “Application of Extended Finite Element Method in Damage Progress Simulation of Fiber Reinforced Composites,” Materials and Design 55 (2014): 191–196.
K. Kawaguchi, H. Saiwai, K. Iida, et al., “Postoperative Time Course of Avulsion‐Type Herniation Focused on the Development of New Modic Changes and Their Effect on Short‐Term Residual Low Back Pain,” Global Spine Journal 15, no. 2 (2025): 1031–1040.
A. R. Nazari, “Computational Description of a Spinal Compression Mechanism Based on Stress‐Shielding in an Anteroposteriorly Osteolytic Lumbar Vertebra,” Orthopedic Research Online Journal 10, no. 5 (2024): OPROJ.000750.
Contributed Indexing: Keywords: burst fracture; compression fracture; lumbar vertebra; osteolytic damage; osteolytic hole
Entry Date(s): Date Created: 20260803 Date Completed: 20260803 Latest Revision: 20260803
Update Code: 20260803
DOI: 10.1002/cnm.70202
PMID: 42543691
Database: MEDLINE
Description
ISSN:2040-7947
DOI:10.1002/cnm.70202