椎体成形术后相邻椎体终板应力变化的有限元分析  

Finite element analysis of stress change of adjacent vertebral endplate after PVP

作　　者：徐晖[1] 李健[2] 程立明[3] 高梁斌[2] 张平[2] 张美超[4] 

机构地区：[1]温州医学院附属第二医院骨科,浙江温州325027 [2]广州医学院附属广州市第二人民医院矫形外科,广州510150 [3]中山大学附属第三医院骨科,广州510630 [4]南方医科大学生物力学实验室,广州510515

出　　处：《中国临床解剖学杂志》2005年第3期307-309,312,共4页Chinese Journal of Clinical Anatomy

摘　　要：目的:利用有限元方法分析椎体成形术对相邻椎体终板应力变化的影响。方法:在已建立的胸腰段骨质疏松性椎体压缩性骨折三维有限元模型上,模拟经皮穿刺椎体成形术(PVP)过程在胸12椎体中置入骨水泥,分析轴向压缩、前屈和后伸3种加载状态下手术前后相邻椎体终板的应力变化。结果:胸11下位终板和腰1上位终板手术前后总体应力变化不大。但两终板中间部分的应力在各种状态下术后较术前均有增加。结论:注入较小剂量(胸124.0ml)骨水泥,PVP不足以引起由于应力集中而造成相邻椎体骨折可能性增加。PVP中较小剂量的骨水泥注入是安全有效的。Objective: To explore stress change of the endplate of adjacent vertebra by finite element method after percutaneous vertebroplasty (PVP )operation. Methods: To establish three-dimensional finite element model of thoracolumbar osteoporotic vertebral compression fracture. For simulating PVP, two column-like PAMA mass were placed bilateral symmetrically into T12 vertebra. The stress change on inferior endplate of T11 and superior endplate of L1 was analyzed before and after the operation of cement augmentation under following loading conditions: compression, anteflexion and retroversion. Results: The stress change of adjacent endplates was similar after PVP. On the other hand, the stress on the center of the endplates of T11 and L1 increased after operation. Conclusions: The stress on inferior endplate of T11 and superior endplate of L1 was similar before and after infusing normal volume cement under all loading conditions. PVP would not increase the possibility of adjacent vertebral body fracture under normal PAMA volume. PVP is safe and effective.

关 键 词：椎骨 经皮穿刺椎体成形术 有限元分析 椎体压缩性骨折 终板 

分 类 号：R318.01[医药卫生—生物医学工程]