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骨质疏松性椎体压缩骨折椎体强化术后不同椎体高度对相邻椎体应力影响的有限元分析     被引量:37

Biomechanical effects of different vertebral heights after augmentation of osteoporotic vertebral compression fracture on the adjacent vertebrae : a three-dimensional finite element analysis

文献类型:期刊文献

中文题名:骨质疏松性椎体压缩骨折椎体强化术后不同椎体高度对相邻椎体应力影响的有限元分析

英文题名:Biomechanical effects of different vertebral heights after augmentation of osteoporotic vertebral compression fracture on the adjacent vertebrae : a three-dimensional finite element analysis

作者:赵文韬[1,2];秦大平[1,3];张晓刚[1,3];王志鹏[1,3];仝尊[1,3]

第一作者:赵文韬

机构:[1]甘肃中医药大学;[2]云南中医学院;[3]甘肃中医药大学附属医院

第一机构:甘肃中医药大学

年份:2018

卷号:24

期号:9

起止页码:1141

中文期刊名:中国骨质疏松杂志

外文期刊名:Chinese Journal of Osteoporosis

收录:CSTPCD;;北大核心:【北大核心2017】;CSCD:【CSCD2017_2018】;

语种:中文

中文关键词:骨质疏松性椎体压缩骨折;椎体强化术;椎体高度;有限元分析

外文关键词:osteoporotic vertebral compression fracture;vertebral augmentation;von Mises stress;finite element analysis

摘要:目的运用有限元分析骨质疏松性椎体压缩骨折椎体强化手术后,不同椎体高度对相邻椎体应力的影响。方法运用四例T12椎体经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)患者术后CT影像资料,构建Genant半定量方法分级后,T_(12)椎体高度为0~3级,T_(11)~L_1节段三维有限元模型各一例。运用有限元分析方法,模拟施加垂直、屈曲、左侧屈、右侧屈四个不同状态的载荷后,观察椎体强化术后不同椎体高度相邻椎体的应力。结果 T_(12)椎体强化术后呈现T_(12)椎体高度丢失越严重,T_(11)椎体承受载荷越大的趋势,各种状态最大载荷均出现在T_(12)椎体高度为3级时,各级椎体高度之间载荷大小差异没有统计学意义(P>0.05)。L_1椎体垂直和右侧屈状态压力呈现T12椎体高度丢失越严重,椎体承受载荷越大的趋势,而且T_(12)椎体高度为3级时垂直和右侧屈承受最大载荷,各级之间载荷大小差异没有统计学意义(P>0.05)。总体呈现为骨折椎体高度丢失越多,相邻椎体应力越大的趋势。结论为了减少相邻椎体的应力。
Objective To analyze the effects of different vertebral height on the stress of adjacent vertebrae after augmentation of osteoporotic vertebral compression fracture(OVCF)by finite element method.Methods Four cases of three-dimensional finite element model of T 11-L 1 which included T 12 Genant semi-quantitative grades 0,1,2,and 3 were established using CT image data of 4 cases of T 12 PKP with cement,which simulated unilateral augmentation.These models were assumed to represent vertical compression and flexion,left flexion,and right flexion loads,and the von Mises stresses of the T 11 and L 1 vertebral bodies were assessed under different vertebral heights after bone cement augmentation.Results The stress of T 11 vertebra showed that the more T 12 vertebral body height loss,the more load T 11 bore after T 12 augmentation.The maximum load of various states was with grade 3 T 12 vertebral height,and there were no statistically significant differences in load between different vertebral heights(P>0.05).L 1 vertebra under vertical and right lateral flexion load showed that the more T 12 vertebral body height loss,the greater the load on L 1 vertebral body.When the height of T 12 vertebral body was grade 3,the vertical and right flexion of L 1 bore the maximum load,and there were no statistically significant differences in load between different vertebral heights(P>0.05).However,it appears that the more vertebral body height loss,the greater the stress on the adjacent vertebrae.Conclusion In order to reduce the stress on adjacent vertebral body after augmentation,the vertebral height of OVCF in the process of vertebral augmentation should be restored as much as possible.

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