新型骨水泥螺钉与传统方式治疗Kummell病的生物力学分析  被引量:4

Biomechanical properties of a novel bone cement screw and traditional methods for Kummell’s disease

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作  者:詹乙 康鑫 王宇航 张海平[1] 何思敏[1] 孙宏慧 郝定均[1] 王彪[1] Zhan Yi;Kang Xin;Wang Yuhang;Zhang Haiping;He Simin;Sun Honghui;Hao Dingjun;Wang Biao(Honghui Hospital,Xi’an Jiaotong University,Xi’an 710054,Shaanxi Province,China;Shaanxi University of Chinese Medicine,Xi’an 712046,Shaanxi Province,China)

机构地区:[1]西安交通大学附属红会医院,陕西省西安市710054 [2]陕西中医药大学,陕西省西安市712046

出  处:《中国组织工程研究》2022年第21期3381-3388,共8页Chinese Journal of Tissue Engineering Research

基  金:国家自然科学基金(81802167),项目负责人:王彪;陕西省重点研发计划(2020GXLH-Y-003),项目负责人:王彪,陕西省重点研发计划(2020SFY-095),项目负责人:何思敏。

摘  要:背景:Kummell病用普通的骨水泥填充方式治疗时可能发生骨水泥移位这种严重的并发症。目的:应用三维有限元法分析新型骨水泥螺钉系统与椎体成形及椎体成形联合椎弓根成形治疗Kummell病的生物力学性能。方法:将收集到的Kummell病患者CT数据资料导入到Mimics图像处理软件中读取图像,建立T12、L1、L2椎体3节段三维有限元模型(L1为患病节段),利用Creo软件重建出新型骨水泥螺钉模型。对Kummell病三维有限元模型进行5种方案的修复治疗:单侧新型骨水泥螺钉置入、双侧新型骨水泥螺钉置入、椎体成形联合单侧椎弓根成形、椎体成形联合双侧椎弓根成形、单纯椎体成形,分析前屈、后伸、左屈、右屈、旋转工况下T12下终板最大等效应力、骨水泥最大等效应力、骨水泥相对位移及骨水泥的稳定性。结果与结论:(1)不同方案下T12下终板受力分布变化不大,椎体成形联合单侧和双侧椎弓根成形组在不同工况下的最大等效应力值均较大,其余3组最大等效应力值较小;(2)单纯椎体成形组骨水泥最大等效应力值明显大于其他4种方案,而且应力分布不均匀;(3)单纯椎体成形组大多数工况下的骨水泥相对位移最大,其余方案在不同工况下的骨水泥相对位移不同,单侧和双侧新型骨水泥螺钉组在前屈、后伸和侧屈工况下的骨水泥相对位移较小,在旋转工况下单侧和双侧新型骨水泥螺钉组及椎体成形联合单侧和双侧椎弓根成形组骨水泥相对位移无明显差别;(4)单侧和双侧新型骨水泥螺钉组骨水泥位移载荷比大于其他方案;(5)结果表明对于Kummell病,使用新型骨水泥螺钉治疗会具有更稳定的结构,能够有效避免骨水泥移位的产生,但需临床证实其在Kummell病治疗中的实用性。BACKGROUND:The serious complication of bone cement displacement is easy to occur when Kummell’s disease is treated with common bone cement filling method.OBJECTIVE:To analyze the biomechanical properties of the novel bone cement screw system,percutaneous vertebroplasty and percutaneous vertebroplasty combined with percutaneous pediculoplasty in treatment of Kummell’s disease with three-dimensional finite element method.METHODS:The collected CT data in Kummell’s disease patients were imported into Mimics image processing sotiware to read the images.A three-segment three-dimensional finite element model of T12,L1,and L2 vertebrae was established(L1 was the diseased segment),and a novel cement screw model was reconstructed with Creo sotiware.The three-dimensional finite element model of Kummell’s disease was repaired and treated with five options:novel unilateral cement screw placement,novel bilateral cement screw placement,percutaneous vertebroplasty combined with unilateral percutaneous pediculoplasty,and percutaneous vertebroplasty combined with bilateral percutaneous pediculoplasty,and pure percutaneous vertebroplasty.Maximum equivalent stress of T12 inferior endplate,maximum Von-Mises of bone cement,relative displacement of bone cement,and stability of bone cement under flexion,extension,leti flexion,right flexion,and rotation conditions were analyzed.RESULTS AND CONCLUSION:(1)There was litile change in the stress distribution of the inferior endplate of T12 under different schemes,and the maximum Von-Mises of inferior endplate of T12 of percutaneous vertebroplasty combined with unilateral and bilateral percutaneous pediculoplasty group was larger under different working conditions.The maximum Von-Mises of inferior endplate of T12 of other groups was smaller.(2)The maximum Von-Mises of bone cement of percutaneous vertebroplasty group was obviously larger than that of the other four schemes,and its stress distribution was not uniform.(3)The bone cement displacement of percutaneous vertebroplasty group wa

关 键 词:Kummell病 新型骨水泥螺钉 胸腰椎 有限元分析 内固定 生物力学 

分 类 号:R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]

 

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