On the human vertebra computational modeling: a literature review

The increasing development in computational technology has allowed the use of numerical modeling and analysis to investigate the mechanical behavior of single human vertebra. Among the several approaches, computed tomography (CT)-based finite element (FE) modeling has been widely used and validated in vitro, reaching different levels of accuracy. Recently, the CT-based FE modeling of the single human vertebra has been applied to clinical cohorts of patients to estimate the vertebral mechanical competence in healthy and pathological conditions, such as osteoporosis and metastasis, as well as to evaluate the efficacy of drug treatments. The ultimate aim is to obtain a comprehensive understanding of the mechanical behavior of vertebra and thus translate the computational technology from bench to bedside to develop accurate clinical tools for the clinical practice to improve diagnosis and prevention of fracture and assess the efficacy of treatments. Different key aspects have been included in the FE modeling approaches. As such, this work aims to furnish a comprehensive state of the art for the FE modeling of the single vertebra, focusing on geometrical and constitutive aspects, as well as boundary conditions. An overview of the main results obtained have been furnished. Finally, limitations of single human vertebra models and possible future research directions have been highlighted.