有限元法评估经皮椎体成形和后凸成形治疗脊柱三明治骨折的生物力学变化  

Biomechanical characteristics of percutaneous kyphoplasty versus percutaneous vertebroplasty for spinal sandwich fracture by finite element analysis

作　　者：王吉博[1] 

机构地区：[1]遵义医学院,广东省珠海市519041

出　　处：《中国组织工程研究》2017年第35期5703-5708,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:研究证明脊柱三明治骨折经皮椎体后凸成形和经皮椎体成形强化后椎体后骨折发生率相较于传统保守治疗有明显的效果,但经皮椎体后凸成形与经皮椎体成形治疗的生物学性能还需要进一步探索。目的:比较后凸成形和经皮椎体成形2种疗法治疗脊柱三明治骨折的生物力学特性。方法:基于脊柱三明治骨折有限元模型,构建治疗骨折的后凸成形及经皮椎体成形有限元模型。在两种模型加载荷的工况下,分析变形和应力分布特征。结果与结论:经皮椎体成形模型治疗L1、T11三明治骨折,治疗前与治疗后情况相比,脊柱处胸腰段刚度变化不明显,夹心椎处最大应力变化及变形量基本没有明显改善,夹心椎前柱处应力集中现象无明显改观(26.12 MPa减小到23.37 MPa,减小了10.53%)。而后凸成形模型脊柱处胸腰段刚度明显增加,夹心椎处的最大应力变化及变形量明显减少(27.15 MPa减小到17.52 MPa,减小了36.71%)。BACKGROUND： Percutaneous kyphoplasty （PKP） and percutaneous vertebroplasty （PVP） have been shown to obtain satisfactory clinical efficacy in the treatment of spinal sandwich fracture compared with conventional conservative method, but a further investigation on the related biomechanical characteristics is required. OBJECTIVE： To compare the biomechanics characteristics of PVP and PKP for spinal sandwich fracture. METHODS： The finite element models of PVP and PKP were constructed based on the finite element model of spinal sandwich fracture. The deformation and stress distribution characteristics were analyzed after loaded. RESULTS AND CONCLUSION： After PVP for L1, T11sandwich fracture, the stiffness at the thoracic and lumbar segments, the maximum stress and deformation at the sandwich vertebrae showed no obvious improvement, and the stress concentration at the anterior column of sandwich vertebrae was not improved significantly （from 26.12 Mpa to 23.37 Mpa, reduced by 10.53%）. Meanwhile, PKP significantly increased the stiffness at the thoracic and lumbar segments, the maximum stress and deformation of the sandwich vertebrae were significantly decreased （from 27.15 Mpa to 17.52 Mpa, reduced by 36.71%）.

关 键 词：骨科植入物 脊柱植入物 脊柱模型 经皮椎体成形术 后凸成形术治疗法 生物力学评估 

分 类 号：R318[医药卫生—生物医学工程]