{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T05:56:51Z","timestamp":1763359011403,"version":"build-2065373602"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009431","name":"Humanitas University","doi-asserted-by":"publisher","award":["5XMILLE 2020 Grant"],"award-info":[{"award-number":["5XMILLE 2020 Grant"]}],"id":[{"id":"10.13039\/501100009431","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background and Objectives: Vertebral metastases often lead to pathological fractures and spinal cord compression, thus impacting patient quality of life. This study aimed to quantify the poroelastic mechanical properties of vertebral metastatic tissue explanted during spine surgery and correlate it with clinical data. Methods: Nine patients (61.7 \u00b1 13.1 years) were prospectively recruited from April 2021 to February 2022, where 78% had a vertebral fracture. Demographic and metastases data, including primary origin, spinal level, lesion volume, and SINS score, were collected, and tissue specimens were explanted during surgery. Using a newly developed portable experimental setup, confined compression creep tests were conducted to measure the aggregate modulus and permeability of each sample. Dealing with limited samples, the results were expressed as the median (min; max). Results: Specimens from the unfractured vertebrae had higher aggregate modulus (200.35 (149.80; 250.90) kPa vs. 14.47 (8.27; 35.89) kPa) and higher permeability (0.02 (0.01; 0.03) mm4\/N\u00b7s vs. 0.41 (0.10; 4.68) mm4\/N\u00b7s) compared with the specimens from the fractured vertebrae. Histology revealed prominent levels of neoplastic cell infiltration and disruption of typical bone matrix architecture. Specimens with low neoplastic cellularity had comparable or slightly higher poroelastic properties compared to high cellularity. No clear trend was observed between the mechanical properties and SINS score, nor between the mechanical properties, percentage lesion volume, and fractures. Conclusions: Despite the limited sample size, the poroelastic characterization revealed relevant insights to investigate in future research. A transdisciplinary assessment of vertebral metastases, incorporating poroelastic testing, deserves further attention and could enhance the treatment options.<\/jats:p>","DOI":"10.3390\/jcm14092913","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T08:26:43Z","timestamp":1745396803000},"page":"2913","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Poroelastic Characterization of Human Vertebral Metastases to Inform a Transdisciplinary Assessment of Spinal Tumors"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9822-2116","authenticated-orcid":false,"given":"Luigi","family":"La Barbera","sequence":"first","affiliation":[{"name":"Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering \u201cGiulio Natta\u201d, Politecnico di Milano, 20133 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2663-6755","authenticated-orcid":false,"given":"Tomaso","family":"Villa","sequence":"additional","affiliation":[{"name":"Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering \u201cGiulio Natta\u201d, Politecnico di Milano, 20133 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5191-9477","authenticated-orcid":false,"given":"Francesco","family":"Costa","sequence":"additional","affiliation":[{"name":"Fondazione IRCCS Istituto Nazionale Neurologico \u201cC. Besta\u201d, 20133 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1932-7535","authenticated-orcid":false,"given":"Federica","family":"Boschetti","sequence":"additional","affiliation":[{"name":"Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering \u201cGiulio Natta\u201d, Politecnico di Milano, 20133 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5669-2286","authenticated-orcid":false,"given":"Mario","family":"De Robertis","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5968-1986","authenticated-orcid":false,"given":"Leonardo","family":"Anselmi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2810-7622","authenticated-orcid":false,"given":"Gabriele","family":"Capo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saverio","family":"Pancetti","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20089 Milan, Italy"},{"name":"Department of Pathology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Fornari","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, IRCCS Humanitas Research Hospital, 20089 Milan, Italy"},{"name":"Department of Biomedical Sciences, Humanitas University, 20089 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"i25","DOI":"10.1093\/nop\/npaa056","article-title":"The importance of multidisciplinary care for spine metastases: Initial tumor management","volume":"7","author":"Newman","year":"2020","journal-title":"Neuro-Oncol. Pract."},{"key":"ref_2","first-page":"335","article-title":"Prevalence of bone metastases and bone-targeting agent use among solid tumor patients in the United States","volume":"7","author":"Hernandez","year":"2015","journal-title":"Clin. Epidemiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"564","DOI":"10.3171\/spi.2005.2.5.0564","article-title":"Surgical management of spinal metastases: Analysis of prognostic factors during a 10-year experience","volume":"2","author":"North","year":"2005","journal-title":"J. Neurosurg. Spine"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1038\/s41572-020-00216-3","article-title":"Bone metastases","volume":"6","author":"Coleman","year":"2020","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.jmbbm.2016.12.017","article-title":"The impact of metastasis on the mineral phase of vertebral bone tissue","volume":"69","author":"Burke","year":"2017","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Confavreux, C.B., Follet, H., Mitton, D., Pialat, J.B., and Cl\u00e9zardin, P. (2021). Fracture Risk Evaluation of Bone Metastases: A Burning Issue. Cancers, 13.","DOI":"10.3390\/cancers13225711"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Esperan\u00e7a-Martins, M., Roque, D., Barroso, T., Abrunhosa-Branquinho, A., Belo, D., Simas, N., and Costa, L. (2023). Multidisciplinary Approach to Spinal Metastases and Metastatic Spinal Cord Compression\u2014A New Integrative Flowchart for Patient Management. Cancers, 15.","DOI":"10.3390\/cancers15061796"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"100320","DOI":"10.1016\/j.jbo.2020.100320","article-title":"Separation surgery for metastatic epidural spinal cord compression: A qualitative review","volume":"25","author":"Cofano","year":"2020","journal-title":"J. Bone Oncol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"S146","DOI":"10.1007\/s00586-012-2232-0","article-title":"Assessment of prognostic factors in patients with metastatic epidural spinal cord compression (MESCC) from solid tumor after surgery plus radiotherapy: A single institution experience","volume":"21","author":"Tancioni","year":"2012","journal-title":"Eur. Spine J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"116814","DOI":"10.1016\/j.bone.2023.116814","article-title":"The role of bone metastases on the mechanical competence of human vertebrae","volume":"173","author":"Palanca","year":"2023","journal-title":"Bone"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"116028","DOI":"10.1016\/j.bone.2021.116028","article-title":"Type, size, and position of metastatic lesions explain the deformation of the vertebrae under complex loading conditions","volume":"151","author":"Palanca","year":"2021","journal-title":"Bone"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"115598","DOI":"10.1016\/j.bone.2020.115598","article-title":"Conventional finite element models estimate the strength of metastatic human vertebrae despite alterations of the bone\u2019s tissue and structure","volume":"141","author":"Stadelmann","year":"2020","journal-title":"Bone"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1016\/j.jmbbm.2019.06.027","article-title":"Biomechanical assessment of vertebrae with lytic metastases with subject-specific finite element models","volume":"98","author":"Costa","year":"2019","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1016\/j.tranon.2018.03.002","article-title":"The Role of the Size and Location of the Tumors and of the Vertebral Anatomy in Determining the Structural Stability of the Metastatically Involved Spine: A Finite Element Study","volume":"11","author":"Galbusera","year":"2018","journal-title":"Transl. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"3208","DOI":"10.1002\/jor.24117","article-title":"Case-specific non-linear finite element models to predict failure behavior in two functional spinal units","volume":"36","author":"Groenen","year":"2018","journal-title":"J. Orthop. Res."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/j.jbiomech.2005.11.014","article-title":"Biomechanics of vertebral level, geometry, and transcortical tumors in the metastatic spine","volume":"40","author":"Tschirhart","year":"2007","journal-title":"J. Biomech."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/j.jbiomech.2003.09.027","article-title":"Effects of tumor location, shape and surface serration on burst fracture risk in the metastatic spine","volume":"37","author":"Tschirhart","year":"2004","journal-title":"J. Biomech."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1317","DOI":"10.1016\/S0021-9290(01)00086-0","article-title":"Parametric finite element analysis of vertebral bodies affected by tumors","volume":"34","author":"Whyne","year":"2001","journal-title":"J. Biomech."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1007\/s00223-008-9174-x","article-title":"Bone volume fraction explains the variation in strength and stiffness of cancellous bone affected by metastatic cancer and osteoporosis","volume":"83","author":"Nazarian","year":"2008","journal-title":"Calcif. Tissue Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1114\/1.1313773","article-title":"Biphasic material properties of lytic bone metastases","volume":"28","author":"Whyne","year":"2020","journal-title":"Ann. Biomed. Eng."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"E1221","DOI":"10.1097\/BRS.0b013e3181e16ae2","article-title":"A Novel Classification System for Spinal Instability in Neoplastic Disease An Evidence-Based Approach and Expert Consensus From the Spine Oncology Study Group","volume":"35","author":"Fisher","year":"2010","journal-title":"Spine"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1016\/j.bone.2010.08.012","article-title":"Effects of three different preservation methods on the mechanical properties of human and bovine cortical bone","volume":"47","author":"Stefan","year":"2010","journal-title":"Bone"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"593","DOI":"10.1016\/S0021-9290(02)00437-2","article-title":"New insight into deformation-dependent hydraulic permeability of gels and cartilage, and dynamic behavior of agarose gels in confined compression","volume":"36","author":"Gu","year":"2003","journal-title":"J. Biomech."},{"key":"ref_24","first-page":"2814","article-title":"Diffusion and convection in normal and neoplastic tissues","volume":"34","author":"Swabb","year":"1974","journal-title":"Cancer Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1442","DOI":"10.1038\/bjc.1998.705","article-title":"Intratumoral infusion of fluid: Estimation of hydraulic conductivity and implications for the delivery of therapeutic agents","volume":"78","author":"Boucher","year":"1998","journal-title":"Br. J. Cancer"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1006\/mvre.1993.1044","article-title":"Characterization of neuroblastoma xenograft in rat flank. I. Growth, interstitial fluid pressure, and interstitial fluid velocity distribution profiles","volume":"46","author":"Lee","year":"1993","journal-title":"Microvasc. Res."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Serratrice, N., Faddoul, J., Tarabay, B., Attieh, C., Chalah, M.A., Ayache, S.S., and Abi Lahoud, G.N. (2022). Ten Years After SINS: Role of Surgery and Radiotherapy in the Management of Patients With Vertebral Metastases. Front. Oncol., 12.","DOI":"10.3389\/fonc.2022.802595"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.suronc.2019.08.007","article-title":"Approaching spinal metastases spread profile","volume":"31","author":"Amelot","year":"2019","journal-title":"Surg. Oncol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"379","DOI":"10.3171\/2011.11.SPINE116","article-title":"Vertebral compression fracture risk after stereotactic body radiotherapy for spinal metastases","volume":"16","author":"Boehling","year":"2012","journal-title":"J. Neurosurg. Spine"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/2913\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:20:03Z","timestamp":1760030403000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/9\/2913"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,23]]},"references-count":29,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["jcm14092913"],"URL":"https:\/\/doi.org\/10.3390\/jcm14092913","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,4,23]]}}}