数字化建模对老年骨质疏松椎体压缩性骨折PVP的应用研究  

Digital Modeling Study of Vertebraplasty in Elderly Patients with Osteoporotic Vertebral Compression Fractures

作　　者：郝定均[1] 谢恩[1] 张子如[1] 吴起宁[1] 何立民[1] 

机构地区：[1]西安交通大学附属红会医院脊柱外科,陕西西安710054

出　　处：《实用骨科杂志》2013年第7期610-614,共5页Journal of Practical Orthopaedics

基　　金：国家自然科学基金(81100930);陕西省社发公关项目(2010K15-02-02)

摘　　要：目的应用有限元数字化建模分析法探讨经皮穿刺椎体成型术治疗老年骨质疏松椎体压缩性骨折时病椎注射骨水泥后应力分布的变化。方法筛选老年骨质疏松L2椎体压缩性骨折患者7名,病椎双侧分别注射6mL的骨水泥,分析手术前后CT。利用有限元分析方法,建立L2病椎及相邻椎体手术前后的有限元模型。结果骨水泥注射后上下终板的应力均增加,应力主要分布区域为椎体中部,随着骨水泥容量增加,L2上终板、下终板应力分布术后较术前集中,但应力值无明显增加(P>0.05)。结论有限元数字化建模可以有效分析老年骨质疏松椎体压缩性骨折PVP生物力学的改变,注入较小剂量骨水泥不足以引起由于应力集中而造成相邻椎体骨折,较小剂量的骨水泥注入是安全有效的。Objective Using finite element analysis,we explored the change of vetebral stress distribution after injection of bore cement during percutaneous vetebra plasty（PVP）,senile osteoporotic vertenral compression fracture patients. Methods Seven patients of L2 osteoporotie vertebral compression fractures in the elderly patients being filtered. In vertebral double sided, 6 mL bone cement was injected respectively. Preoperative and postoperative CT data was compared. Used finite element analysis method,vertebral preoperative and postoperative adjacent vertebral body finite element model was created. Results After the injection of bone cement, upper and lower end plates of stress were increasing. Stress was the main in the central area of the vertebral body. As bone cement capacity increaseed ,up- per and lower end plates of the stress increaseed. Conclusion Finite element digital model can be an effective analysis of senile osteoporotie vertebral compression fracture in biomechanics changes after PVP. Injection of smaller doses of adjacent vertebral body fractures caused by bone cement is not sufficient to increase the compression. Bone cement injection is safe and effective in small doses.

关 键 词：经皮椎体成形术 终板 应力分布 有限元 

分 类 号：R683.2[医药卫生—骨科学]