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International audience; Pharmaceutical treatments can slow bone degradation, thus reducing the fracture risk inherent in osteoporosis. Antiresorptive treatments block the over-activation of osteoclasts vs osteoblasts, but the resulting decrease in bone remodeling frequency may weaken bone structure over time, with no gain in bone volume. Anabolic treatments, however, induce gain in bone volume. The quantitative results from existing studies on the effects of treatments over time are general and nonpatient-specific, while numerical models simulating evolution of patient-specific bone microarchitecture consider a spatially random distribution of the remodeling process. Here, we propose a new approach to simulate the remodeling over decades of an individual patient's bone microarchitecture, based on the hypothesis that the oldest sites, which are hypermineralized and more brittle, are remodeled first. Taking these older sites as prime targets of remodeling, simulations show that severe osteoporosis profoundly degrades the mechanical properties of the bone structure, which can be restored and even improved by anabolic, more than by antiresorptive, therapies.

International audience

International audience; The porcine model is frequently used during development and validation of new spinal devices, because of its likeness to the human spine. These spinal devices are frequently composed of pedicle screws with a reputation for stable fixation but which can suffer pull-outs during preclinical implantation on young animals, leading to high morbidity. With a view to identifying the best choices to optimize pedicle screw fixation in the porcine model, this study evaluates ex vivo the impact of weight (age) of the animal, the level of the vertebrae (lumbar or thoracic) and the type of screw anchorage (mono-or bi-cortical) on pedicle screw pullouts. Among the 80 pig vertebrae (90-and 140-day-old) tested in this study, the average screw pullout forces ranged between 419.9N and 1341.2N. In addition, statistical differences were found between test groups, pointing out the influence of the three parameters stated above. We found that the the more caudally the screws are positioned (lumbar level), the greater their pullout resistance is, moreover, screw stability increases with the age, and finally, the screws implanted with a mono-cortical anchorage sustained lower pullout forces than those implanted with a bi-cortical anchorage. We conclude that the best anchorage can be obtained with older animals, using a lumbar fixation and long screws traversing the vertebra and inducing bi-cortical anchorage. In very young animals, pedicle screw fixations need to be bi-cortical and more numerous to prevent pullout.

Pedicle screw is a widely used anchorage system for spinal devices for surgical treatments of paediatric deformities. Its fixation depends on various parameters such as bone quality and the screw-b...

Scoliosis is a 3D deformity of the spine, most of the time occurring during youth and worsening during growth in childhood. To treat such deformations, nowadays common surgical treatment is based o...

In adulthood, bone tissue is continuously renewed by processes governed by basic multicellular units composed of osteocytes, osteoclasts and osteoblasts, which are subjected to local mechanical loads. Osteocytes are known to be integrated mechanosensors that regulate the activation of the osteoclasts and osteoblasts involved in bone resorption and apposition processes, respectively. After collagen tissue apposition, a process of collagen mineralisation takes place, gradually increasing the effective stiffness of bone. This study presents a new model based on physicochemical parameters involved in spongy bone remodelling under pathological conditions. Our model simulates the transient evolution of both geometry and effective Young's modulus of the trabeculae, also taking turnover into account. Various loads were applied on a trabecula in order to determine the evolution of bone volume fraction under pathological conditions. A parametric study performed on the model showed that one key parameter here is the kinetic constant of hydroxyapatite crystallisation. We subsequently tested our model on a pathological case approaching osteoporosis, involving a decrease in the number of viable osteocytes present in bone. The model converges to a lower value (- 5%) for bone volume fraction than with a normal quantity of osteocytes. This useful tool offers new perspectives for predicting bone remodelling deficits on a local scale in patients with pathological conditions such as osteoporosis and in bedridden patients, as well as for astronauts subjected to weightlessness in space.