应用有限元法对比分析单侧入路退针法与固定点注射骨水泥椎体成形的生物力学变化  

Biomechanics changes between needle withdrawal and fixation point injection bone cement vertebral plasty using finite element method

作　　者：隆全利[1] 宓士军[1] 

机构地区：[1]唐山市丰润区人民医院骨科,河北省唐山市064000

出　　处：《中国组织工程研究与临床康复》2009年第48期9429-9432,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：唐山市计划指导科研项目.

摘　　要：采用1例L1椎体骨质疏松性骨折疼痛患者的原始影像资料,男,70岁,患者伤椎采用单侧入路退针法注射实施椎体成形术,进针点选择左侧椎弓根近中心部位,内倾角度为24.5°,先将针穿刺到达椎体的前中1/3部位,注射骨水泥3mL,然后缓慢向后退针至椎体的1/2部位,并停留3min,注射2mL,再退针到椎体的中后1/3部位进行注射1mL。模拟传统的将全部6mL骨水泥在椎体中前1/3固定点一次性注入方法,获取椎体L1～2节段断层图像,分别建立有限元模型,对椎体上表面分别依次施加载500,1000,1500,2000,2500N的轴向压缩负载,进行生物力学对比分析。随着施加负载的增加,应变和应力也逐渐增加,椎体呈现弹性性质,出现了近似线性的小变形情况。传统注射较退针注射有较大的应力和应变。结果提示,退针注射法注射骨水泥,较传统的一次性固定点注射法有更好的生物力学分布。The primary imagine is from a seventy-old man and his L1 is osteoporosisand painful. The patient is given operation in the injured vertebrae by onelateral, the needing point is in the left central of lateral mass of vertebrae, introversion angle is 24.5°, using withdraw way. First puncture the needle to the front one third, and inject 3 mL bone cement in, and withdraw the needle to the middle of the vertebrae, staying 3 minutes, and then inject 2 mL bone cement, and then withdraw the needle to the hind 1/3 of the body, injecting 1 mL in it. Contrasting with the way inject the all 6 mL bone cement one time in the front 1/3, which is the tradition way （simulate） and get L1.2 fault image, getting a validated finite element mordel, exerting the load of 500, 1 000, 1 500, 2 000, 2 500 N on the supine surface of the vertebra respectively and evaluate the stress distribution of the vertebro bodies. With the increasing load, the deformity and the strain increase with it. The vertebral bodies show the property of elasticcity, nearly linear minor deformity is. The way using withdrawal way injecting bone cement has more stress distribution and deformity than the way by tradition. The way using withdrawal way injecting bone cement has better stress distribution than the way by tradition.

关 键 词：椎体成形术 退针注射 穿刺 固定点注射 

分 类 号：R318[医药卫生—生物医学工程]