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**Chapter 0**

**Chapter 6**

**Simulation of Subject Specific Bone Remodeling**

Vertebral compression fractures are very common low-bone-density related conditions among the elderly and have a significant adverse health effect [1]. According to a survey by the National Osteoporosis Foundation, osteoporosis related fractures cost an estimated \$19 billion in 2005 and the cost is predicted to go up to \$25.3 billion by the year of 2025 [2]. The fractures affects up to 25% of postmenopausal women [3]. Men are equally affected by this, but because of greater peak bone mass, it occurs about 10 years later than women [4]. The thoraco-lumbar region in the vertebra is the most common region where fractures occur, with T8, T12, L1 and L4 being the most commonly fractured segments [5]. The vertebral compression fracture can be avoided by preventative medication and physical therapy if the trend of the bone structure change is known. However, directly monitoring the density and structural change of patient's bones is practically impossible based on current technology. Examination of the patients' bones at regular intervals is costly, and not very helpful: the patients have to wait for months or years to know the effect of their lifestyles on their vertebra, while at this point any bone changes might already have occurred and damages made. Instead, simulation, as an cost-effective and non-intrusive method, is a better way to "know" the bone change in advance based on realistic input of loads and patients conditions, and thus prevent bone

Changes in the cancellous bone structure have been studied since Julius Wolff first discovered the adaptive nature of the bone [6]. Different simulation techniques and models have been proposed [7, 8]. However, in the previous studies standard load which is within the nominal range experienced by the human vertebra were used. In reality this load varies for different human subjects for various activities performed. This was a limitation in terms of the ability to measure accurate loads. With technologies like the state-of-the-art motion capture systems combined with musculoskeletal modeling and simulation softwares, accurate loads on different segments of the body can be calculated. This helps in more accurate simulation

This study aims at developing a simulation tool to predict the long term effects on the micro-architecture of the vetebral cancellous bone, given the person's present daily lifestyle,

> ©2012 Sonar and Carroll, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly

©2012 Sonar and Carroll, licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Ajay Sonar and James Carroll

http://dx.doi.org/10.5772/51822

**1. Introduction**

fractures occurring.

cited.

results.

Additional information is available at the end of the chapter

