The micro-mechanics of cortical shell removal in the human vertebral body

An improved understanding of the biomechanical role of the vertebral cortical shell with respect to the trabecular bone may improve diagnosis of osteoporosis and provide insight into the effects of disease, aging, and drug treatments. In this study, we present results from finite element simulations of removal of the shell from the vertebral body and the associated mechanical effects in terms of overall change in vertebral structural stiffness and of the tissue-level stresses. Specimen-specific micro-mechanical finite element models of thirteen vertebrae were generated from micro-CT scans with 60-μm voxel size. An algorithm was developed to automatically isolate the thin (and discontinuous) shell and the images were converted into finite element models by mapping each image voxel into a finite element. After removal of the endplates, compressive loading conditions were applied and linear elastic analyses were run for three cases – with and without the shell, and shell-only models. The models contained up to 13.6 million elements and were solved using a maximum of 144 CPUs in parallel, 300 GB memory, and a custom code with a parallel mesh partitioner and algebraic multigrid solver. Results indicated that the shell was on average, 0.38 ± 0.06 mm thick, accounted for 21–39% of the overall bone mass, but accounted for 38–68% of the overall vertebral stiffness. Examination of the tissue-level stresses indicated that this disproportionately large mechanical effect of shell removal was due in part to unloading of the remaining peripheral trabeculae adjacent to the shell. Stress paths were also preferentially within vertically-aligned bone: the cortical shell and vertically-aligned trabeculae. Taken together, these results demonstrate two important roles of the thin vertebral cortical shell: it can carry significant load by virtue of representing a large proportion of the vertically-aligned bone tissue within the vertebra, and, as a shell, it also maximizes the load carrying capacity of the trabecular centrum, particularly around the periphery.