|
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 |
Biomechanical effects of different vertebral heights after augmentation of osteoporotic vertebral compression fracture on the adjacent vertebrae: a three-dimensional finite element analysis |
|
DOI:10.3969/j.issn.1006.7108.2018.09.005 |
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 |
英文关键词:Osteoporotic vertebral compression fracture Vertebral augmentation Von Mises stress Finite element analysis |
基金项目: |
|
摘要点击次数: 945 |
全文下载次数: 734 |
中文摘要: |
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,T12椎体高度为0~3级,T11~L1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 T12椎体强化术后呈现T12椎体高度丢失越严重,T11椎体承受载荷越大的趋势,各种状态最大载荷均出现在T12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)。L1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T12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)。但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,在进行椎体强化手术过程中应当尽可能恢复骨折椎体的椎体高度。 |
英文摘要: |
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 T11-L1 which included T12 Genant semi-quantitative grades 0, 1, 2, and 3 were established using CT image data of 4 cases of T12 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 T11 and L1 vertebral bodies were assessed under different vertebral heights after bone cement augmentation. Results The stress of T11 vertebra showed that the more T12 vertebral body height loss, the more load T11 bore after T12 augmentation. The maximum load of various states was with grade 3 T12 vertebral height, and there were no statistically significant differences in load between different vertebral heights (P>0.05). L1 vertebra under vertical and right lateral flexion load showed that the more T12 vertebral body height loss, the greater the load on L1 vertebral body. When the height of T12 vertebral body was grade 3, the vertical and right flexion of L1 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. |
查看全文 查看/发表评论 下载PDF阅读器 |
关闭 |
|
|
|