Estimation du risque de fracture ostéoporotique du rachis thoraco-lombaire par un modèle en élément finis personnalisé

Abstract : Osteoporosis is a bone disease which decreases bone quantity and quality, and increases fracture risk, notably at the vertebral level. CT-scan-based finite element models allow predicting vertebral strength, and thus fracture risk, but their use in routine clinical practice is limited by the cost and accessibility of CT-scan. However, vertebral strength prediction from a finite element model based on low dose images, such as dual X-ray absorptiometry or EOS stereo-radiography in dual energy, would allow a wider use. This PhD thesis contributes to develop fracture risk estimation by such a model. The low dose approach is evaluated in comparison to CT-based finite element model, and a sensitivity study is performed to identify the most important parameters of the model. Hexahedral morpho-realistic meshing techniques from 3D reconstruction and estimation methods for the 3D bone mineral density distribution from low dose images are developed and evaluated. Moreover, taking advantage of EOS system's possibility to take full body radiographs in standing position, a preliminary method is proposed to estimate the load applied to vertebra in vivo. We hope those methods will be used soon in vivo, and will contribute to estimating osteoporotic fracture risk estimation in clinical situations.
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Christophe Travert. Estimation du risque de fracture ostéoporotique du rachis thoraco-lombaire par un modèle en élément finis personnalisé. Biomécanique [physics.med-ph]. Ecole nationale supérieure d'arts et métiers - ENSAM, 2012. Français. ⟨NNT : 2012ENAM0052⟩. ⟨pastel-00834740⟩

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