Pretty Porous

Osteoporosis treatment

Avoiding complications during osteoporosis treatment

Percutaneous vertebroplasty involves injecting a so-called bone cement into the vertebrae of patients suffering from osteoporosis. The treatment is minimally invasive: the surgeon gradually injects a few milliliters of the bone cement whilst continuously MRI images of the patient’s brain, to determine the best fit and, at the same time, most physically useful, meaningful parameters”, Koch explains. This process is done automatically, whereby the most relevant parameters are those that describe the physical properties of the materials. For instance, diffusion coefficients for the capillary walls can be found in the scientific literature or from the geometry of the capillaries. “A total of about ten parameters used in our model have an influence on the calculations”, says Koch.

“The concentration profile with which the contrast medium moves through the capillaries is ultimately unknown, which means that you have to play through a reasonable range of values”. Finally, the researcher has to merge the flow model with the MRI images. Only then can useful conclusions be drawn about the development of the lesions. To this end, Koch also models the MRI imaging in a subordinated simulation. In this way, the researchers hope to gain a better understanding of the flow processes of an MS sufferer’s brain than can be achieved with existing models. Special research for porous media The technical know-how about porous media available in Stuttgart is not just a reflection of Koch’s research. In autumn 2017, the University received approval for a German Research Foundation (DFG) collaborative research center (CRC) focused on “boundary surface-driven multi-field processes in porous media”. Over 20 scientists from several of the University’s institutes participate in checking the results with x-ray images. “It’s a standard treatment”, says Röhrle, “but, unfortunately, complications, such as bone cement leaking out of the vertebra, do occur from time-to-time. Moreover, the surgeon never knows how the bone cement will alter the mechanical behavior of the human musculoskeletal system”. Ultimately, the patient’s vertebrae, ligaments, tendons and muscles will have adapted to the altered structure of the backbone. “Then there’s the fact that, in the final analysis, the injected bone cement spreads differently in every patient”.


Professor Oliver Röhrle
Photo: University Stuttgart / Max Kovalenko

„It’s a standard treatment, but, unfortunately, complications, such as bone cement leaking out of the vertebra, do occur from time-to-time. Moreover, the surgeon never knows how the bone cement will alter the mechanical behavior of the human musculoskeletal system.“

Oliver Röhrle, Professor for Continuum Biomechanics and Mechanobiology at the University of Stuttgart.

From a fluid mechanics perspective, percutaneous vertebroplasty is a typical example for the processes in porous media. The injected bone cement sets within the vertebra, so that when it first enters the bone it causes a volume change and then, after setting results in a phase change from fluid to solid. “We’re trying to use simulations to describe these processes”, says Röhrle. And, at the same time, to take account of the properties of at least three materials – bone, bone marrow and bone cement. To validate the Stuttgart model, the scientists will be collaborating with the AO Research Institute Davos. “They have experimental laboratory set-ups there as well as the clinical problems that we require for our model development”, Röhrle explains. Only once the results of this first phase are available will the project participants be able to approach the question in which they are really interested: what exactly happens when a vertebra breaks or cracks?

— Michael Vogel (Forschung Leben, Ausgabe 11/2018)