骨水泥弥散类型对强化椎体生物力学特性影响的有限元分析  

Finite element analysis of biomechanical effects of bone cement dispersion type on the reinforced vertebrae

作　　者：吴智华 李任 潘慧玲 范凤杰 江晓兵[3] 唐福宇 Wu Zhihua;Li Ren;Pan Huiling;Fan Fengjie;Jiang Xiaobing;Tang Fuyu(Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China;Department of Spine Surgery,Liuzhou Hospital of Traditional Chinese Medicine,Liuzhou 545000,Guangxi Zhuang Autonomous Region,China;Department of Spinal Surgery,First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405,Guangdong Province,China)

机构地区：[1]广州中医药大学,广东省广州市510405 [2]柳州市中医医院脊柱外科,广西壮族自治区柳州市545000 [3]广州中医药大学第一附属医院脊柱外科,广东省广州市510405

出　　处：《中国组织工程研究》2023年第30期4763-4768,共6页Chinese Journal of Tissue Engineering Research

基　　金：广西自然科学基金面上项目(2020GXNSFAA259082),项目负责人:唐福宇;柳州市科技计划项目(2019BE10602),项目负责人:唐福宇。

摘　　要：背景:经皮椎体强化治疗骨质疏松性椎体压缩骨折时,强化椎内骨水泥弥散类型主要为中部分离、中部融合、前部分离和不均匀分离4种,目前尚无研究对比这4种骨水泥弥散类型对强化椎体生物力学特性的影响。目的:运用三维有限元法分析骨水泥弥散类型对强化椎体生物力学特性的影响。方法:构建T_(12)骨质疏松性椎体压缩骨折三维有限元模型,然后模拟双侧椎体成形手术,其中骨水泥分中部分离、中部融合、前部分离和不均匀分离4种弥散类型,设置材料属性参数、边界条件、施加载荷(在T_(10)上终板持续施加垂直向下260 N载荷,同时分别施加前屈、后伸、左右侧屈、左右旋转10 N·m力矩),分别导入LS-DYNA软件求解。结果与结论:①在所有加载条件下,不均匀分离模型的骨水泥应力最大;左侧屈曲时,不均匀分离模型的骨水泥最大应力比中部分离模型、中部融合模型、前部分离模型分别高出4.4,8.6,4.8倍;中部分离、前部分离、不均匀分离模型左侧屈时的骨水泥最大米塞斯应力最大,中部融合模型右侧屈时的骨水泥最大米塞斯应力最大,所有模型左右旋转时的骨水泥最大米塞斯应力最小;②左右旋转时,不均匀分离模型的松质骨-水泥界面的最大米塞斯应力小于其他模型,其他工况下各模型的松质骨-水泥界面的最大米塞斯应力相似;4种模型左右侧屈时的松质骨-水泥界面的最大米塞斯应力最大;③各模型T_(12)上终板和下终板的最大米塞斯应力趋势相似,且相同工况下无明显差异;在所有加载条件下,各模型间T_(12)上终板和下终板的最大米塞斯应力无明显差异;在所有加载条件下,各模型间T_(11/12)、T_(12)/L1椎间盘最大米塞斯应力无明显差异;④当位移3.5 mm时,中部分离模型的载荷最小,为40 N;中部融合和前部分离模型的载荷为50 N;不均匀分离模型的载荷最大,是中部分离模型的2�BACKGROUND:When percutaneous vertebral augmentation is performed for osteoporotic vertebral compression fractures,the four main types of cement dispersion type on the reinforced vertebrae are central separation,central integration,anterior separation,and uneven separation.At present,no relevant biomechanical studies have been found to compare the biomechanical effects of four cement dispersion types on the reinforced vertebrae.OBJECTIVE:To analyze the effects of cement dispersion types on biomechanical characteristics of the reinforced vertebrae using the three-dimensional finite element analysis method.METHODS:A three-dimensional finite element model of the thoracolumbar segment of thoracic 12 osteoporotic vertebral compression fracture was constructed,and then four models were obtained by simulating four cement dispersion types:central separation,central integration,anterior separation and uneven separation.The material property parameters,and boundary conditions were set,and loads(a vertical downward load of 260 N continuously on the T_(10)upper-end plate,and simultaneously,10 N•m moments of flexion,extension,left and right bending,and left and right rotation)were applied,and data were imported to LS-DYNA software for a solution.RESULTS AND CONCLUSION:(1)Under all loading conditions,the stress of the uneven separation model was the largest.The maximum stress of bone cement in the uneven separation model was 4.4,8.6 and 4.8 times higher than that in the central separation model,the central integration model and the anterior separation model respectively.The maximum Von Mises stress of bone cement was the largest in the left flexion model with central separation,anterior separation and uneven separation.The maximum Von Mises stress of bone cement in the right flexion of the central integration model was the largest.The maximum Von Mises stress of bone cement was the smallest when all models were rotated left and right.(2)The maximum Von Mises stress at the cancellous bone cement interface of the uneven separat

关 键 词：骨水泥 骨质疏松 椎体压缩骨折 经皮椎体强化 有限元分析 骨水泥弥散类型 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学] R615