Mechanical and morphological properties of parietal bone in patients with sagittal craniosynostosis

Sara Ajami, Naiara Rodriguez-florez, Juling Ong, Noor Ul Owase Jeelani, David Dunaway, Greg James, Freida Angullia, Curtis Budden, Selim Bozkurt, Amel Ibrahim, Patrizia Ferretti, Silvia Schievano, Alessandro Borghi

Research output: Contribution to journalArticlepeer-review

Abstract

Limited information is available on the effect of sagittal craniosynostosis (CS) on morphological and material properties of the parietal bone. Understanding these properties would not only provide an insight into bone response to surgical procedures but also improve the accuracy of computational models simulating these surgeries. The aim of the present study was to characterise the mechanical and microstructural properties of the cortical table and diploe in parietal bone of patients affected by sagittal CS. Twelve samples were collected from pediatric patients (11 males, and 1 female; age 5.2 ± 1.3 months) surgically treated for sagittal CS. Samples were imaged using micro-computed tomography (micro-CT); and mechanical properties were extracted by means of micro-CT based finite element modelling (micro-FE) of three-point bending test, calibrated using sample-specific experimental data. Reference point indentation (RPI) was used to validate the micro-FE output. Bone samples were classified based on their macrostructure as unilaminar or trilaminar (sandwich) structure. The elastic moduli obtained using RPI and micro-FE approaches for cortical tables (E RPI 3973.33 ± 268.45 MPa and E micro-FE 3438.11 ± 387.38 MPa) in the sandwich structure and diploe (E RPI1958.17 ± 563.79 MPa and E micro-FE 1960.66 ± 492.44 MPa) in unilaminar samples were in strong agreement (r = 0.86, p < .01). We found that the elastic modulus of cortical tables and diploe were correlated with bone mineral density. Changes in the microstructure and mechanical properties of bone specimens were found to be irrespective of patients’ age. Although younger patients are reported to benefit more from surgical intervention as skull is more malleable, understanding the material properties is critical to better predict the surgical outcome in patients <1 year old since age-related changes were minimal.

Original languageEnglish
Article number104929
JournalJournal of the Mechanical Behavior of Biomedical Materials
Volume125
Early online date29 Oct 2021
DOIs
Publication statusPublished - Jan 2022

Bibliographical note

This work was supported by the Great Ormond Street Hospital Charity Clinical Research Starter Grant (award number 17DD46) as well as the NIHR GOSH/UCL Biomedical Research Centre Advanced Therapies for Structural Malformations and Tissue Damage pump-prime funding call (grant n. 17DS18), EPSRC grant - the Engineering and Physical Sciences Research Council (EP/N02124X/1), and the European Research Council (ERC-2017-StG-757923). This report incorporates independent research from the National Institute for Health Research Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Funding Information:
We would like to acknowledge UCL Institute of Orthopaedics and Musculoskeletal Science for mechanical testing instruments and Prof Timothy Arnett for the micro-CT scanner used in this research. This work was supported by the Great Ormond Street Hospital Charity Clinical Research Starter Grant (award number 17DD46 ) as well as the NIHR GOSH / UCL Biomedical Research Centre Advanced Therapies for Structural Malformations and Tissue Damage pump-prime funding call (grant n. 17DS18 ), the Engineering and Physical Sciences Research Council (grant n. EP/N02124X/1 ), and the European Research Council ( ERC-2017-StG-757923 ). This report incorporates independent research from the National Institute for Health Research Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Funding Information:
We would like to acknowledge UCL Institute of Orthopaedics and Musculoskeletal Science for mechanical testing instruments and Prof Timothy Arnett for the micro-CT scanner used in this research. This work was supported by the Great Ormond Street Hospital Charity Clinical Research Starter Grant (award number 17DD46) as well as the NIHR GOSH/UCL Biomedical Research Centre Advanced Therapies for Structural Malformations and Tissue Damage pump-prime funding call (grant n. 17DS18), the Engineering and Physical Sciences Research Council (grant n. EP/N02124X/1), and the European Research Council (ERC-2017-StG-757923). This report incorporates independent research from the National Institute for Health Research Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Publisher Copyright:
© 2021

Funding Information:
We would like to acknowledge UCL Institute of Orthopaedics and Musculoskeletal Science for mechanical testing instruments and Prof Timothy Arnett for the micro-CT scanner used in this research. This work was supported by the Great Ormond Street Hospital Charity Clinical Research Starter Grant (award number 17DD46 ) as well as the NIHR GOSH / UCL Biomedical Research Centre Advanced Therapies for Structural Malformations and Tissue Damage pump-prime funding call (grant n. 17DS18 ), the Engineering and Physical Sciences Research Council (grant n. EP/N02124X/1 ), and the European Research Council ( ERC-2017-StG-757923 ). This report incorporates independent research from the National Institute for Health Research Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Funding Information:
We would like to acknowledge UCL Institute of Orthopaedics and Musculoskeletal Science for mechanical testing instruments and Prof Timothy Arnett for the micro-CT scanner used in this research. This work was supported by the Great Ormond Street Hospital Charity Clinical Research Starter Grant (award number 17DD46) as well as the NIHR GOSH/UCL Biomedical Research Centre Advanced Therapies for Structural Malformations and Tissue Damage pump-prime funding call (grant n. 17DS18), the Engineering and Physical Sciences Research Council (grant n. EP/N02124X/1), and the European Research Council (ERC-2017-StG-757923). This report incorporates independent research from the National Institute for Health Research Biomedical Research Centre Funding Scheme. The views expressed in this publication are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health.

Publisher Copyright:
© 2021

Copyright © 2021. Published by Elsevier Ltd.

Keywords

  • Craniosynostosis
  • Cranial bone microstructure
  • Biomechanics of cranial bone
  • Pediatric
  • Craniosynostoses/diagnostic imaging
  • Humans
  • Female
  • Infant
  • Child
  • Parietal Bone/diagnostic imaging
  • X-Ray Microtomography

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