经皮椎体成形术椎间盘骨水泥渗漏对相邻椎体生物力学影响的有限元分析  

Finite element analysis of biomechanical effect of intervertebral disc cement leakage on adjacent vertebrae after percutaneous vertebroplasty

作　　者：付海军 冯毅[2] 武太勇 李健[1] FU Haijun;FENG Yi;WU Taiyong;LI Jian(Shanxi Medical University,Taiyuan 030000;Second Hospital of Shanxi Medical University,Taiyuan 030000)

机构地区：[1]山西医科大学,太原030001 [2]山西医科大学第二医院,太原030001

出　　处：《北京生物医学工程》2022年第2期140-147,共8页Beijing Biomedical Engineering

基　　金：山西省应用基础研究计划项目(201901D111373)资助。

摘　　要：目的利用3D模型及生物力学模拟分析软件进行经皮椎体成形术椎间盘骨水泥渗漏对相邻椎体的生物力学影响进行有限元分析。方法通过CT数据,运用Mimics Research 21.0、ANSYS 17.0有限元分析软件,建立骨质疏松压缩骨折PVP术后的椎体模型,通过数字化模拟制作出骨水泥渗漏至上(实验模型a)、下(实验模型b),和上下均渗漏(实验模型c)的3种模型,并进一步编辑处理模拟控制骨水泥渗出量为1 mL、1.5 mL、2 mL,相应命名为为低渗漏量组、中渗漏量组、高渗漏量组。分析相邻椎体的前皮质柱、前1/3皮质柱和品质中心柱应力分布变化情况。结果在得出的3组数据组内比较中,与对照模型相比,实验模型T_(12)、L_(2)椎体应力均增大,且差异有统计学意义(P<0.05);并且各椎体不同力柱之间应力对比,3组T_(12)椎体、L_(1)椎体前1/3柱>前皮质柱>中心柱(P<0.05);每组T_(12)椎体应力实验模型a与c显著大于实验模型b(P<0.05);L_(2)椎体应力实验模型b与c显著大于实验模型a(P<0.05)。在组与组之间的比较中,可以看出,各椎体应力变化:高渗漏量组>中渗漏量组>低渗漏量组(P<0.05)。结论PVP术中骨水泥发生椎间盘渗漏对比未发生渗漏来说,相邻椎体应力改变相对较大,发生骨折的可能性更大,而且椎体前1/3皮质柱应力变化最明显。PVP手术发生椎间盘骨水泥渗漏视作术后相邻椎体发生骨折的一个重要危险因素,骨水泥渗漏量也与相邻椎体的应力呈正相关。Objective The 3D model and biomechanical simulation software were used to analyze the biomechanical effect of intervertebral disc cement leakage on adjacent vertebrae in percutaneous vertebroplasty(PVP).Methods Based on the CT data,the vertebral body model of osteoporotic compression fracture after PVP was established by using Mimics Research 21.0,finite element analysis software ANSYS 17.0.Three models of bone cement leakage above(experimental model a),lower(experimental model b)and upper and lower(experimental model c)were made by digital simulation,and the amount of bone cement leakage was controlled by 1 mL,1.5 mL and 2 mL.It was named as low leakage group,medium leakage group and high leakage group.The changes of stress distribution in the anterior cortical column,the front 1/3 cortical column and the mass center column of the adjacent vertebrae were analyzed.Results In the comparison of the three groups of data,compared with the control model,the stress of T_(12) and L_(2) vertebrae in the experimental model was significantly higher than that in the control model(P<0.05),and the stress of T_(12) and L_(1) vertebrae in the three groups were the anterior 1/3 column>anterior cortical column>central column,and the stress in the experimental model a and c in each group was significantly larger than that in the experimental model b(P<0.05).The experimental model b and c of L_(2) vertebral body stress were significantly larger than those of the experimental model a(P<0.05).In the comparison among groups,the stress changes of each vertebral body were as follows:high leakage group>medium leakage group>low leakage group(P<0.05).Conclusions Compared with no intervertebral disc leakage during PVP,the stress change of adjacent vertebral body is relatively larger,and the possibility of fracture is greater,and the stress change of cortical 1/3 column in front of vertebral body is the most obvious.Intervertebral disc cement leakage during PVP operation is regarded as an important risk factor for fracture of adjacent verteb

关 键 词：经皮椎体成形术 骨水泥渗漏 有限元 三维模型 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]