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[骨水泥渗漏至椎间盘的经皮椎体后凸成形术对相邻椎体的生物力学影响:胸腰椎骨质疏松性椎体压缩骨折的有限元分析]

[Biomechanical effect on adjacent vertebra after percutaneous kyphoplasty with cement leakage into disc: a finite element analysis of thoracolumbar osteoporotic vertebral compression fracture].

作者信息

Fei Qi, Li Qiu-Jun, Li Dong, Yang Yong, Tang Hai, Li Jin-Jun, Wang Bing-Qiang, Wang Yi-Peng

机构信息

Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2011 Jan 4;91(1):51-5.

Abstract

OBJECTIVE

To explore the biomechanical effects on adjacent vertebra of thoracolumbar osteoporotic vertebral compression fracture (OVCF) after percutaneous kyphoplasty (PKP) with cement leakage into the disc by using finite element analysis.

METHODS

T10-L2 segment data were obtained from computed tomography (CT) scans of an elder female with single T12 OVCF undergoing a cement leakage into the T12-L1 disc after PKP. A three-dimensional finite element Model of thoracolumbar spine (T10-L2) was built in the Mimics and the ABAQUS software. The stress on annulus fiber, nucleus pulposus, endplate and facet joints under axial pressure (0.3, 1.0, 4.0 MPa) were analyzed.

RESULTS

The 3D finite element after percutaneous kyphoplasty (PKP) with cement leakage into the disc may be strongly related with the changes of biomechanical effects on adjacent vertebra of thoracolumbar OVCF. Models of thoracolumbar OVCF before and after PVP with a cement leakage into the T12-L1 disc were successfully established. The stresses increased with a rising axial pressure in the model of cement leakage into the disc after PVP, the stress augmentation scope on adjacent end plates(T11 low plate & L1 top plate) and intervertebral disc (T11-12 & T12-L1) increased. The maximal Von Mises stress on adjacent vertebra (T11 & L1) increased while but the maximal Von Mises stress on end vertebra (T10 & L2) decreased.

CONCLUSION

Postoperative adjacent vertebral fracture.

摘要

目的

通过有限元分析探讨经皮椎体后凸成形术(PKP)治疗胸腰椎骨质疏松性椎体压缩骨折(OVCF)且骨水泥渗漏至椎间盘时对相邻椎体的生物力学影响。

方法

从一名老年女性的计算机断层扫描(CT)数据中获取T10-L2节段数据,该女性患有单一T12 OVCF,PKP术后骨水泥渗漏至T12-L1椎间盘。在Mimics和ABAQUS软件中建立胸腰椎(T10-L2)三维有限元模型。分析轴向压力(0.3、1.0、4.0 MPa)下椎间盘纤维环、髓核、终板和小关节的应力。

结果

经皮椎体后凸成形术(PKP)且骨水泥渗漏至椎间盘后的三维有限元分析可能与胸腰椎OVCF相邻椎体生物力学效应的变化密切相关。成功建立了PVP前后骨水泥渗漏至T12-L1椎间盘的胸腰椎OVCF模型。在PVP后骨水泥渗漏至椎间盘的模型中,应力随轴向压力增加而增加,相邻终板(T11下终板和L1上终板)和椎间盘(T11-12和T12-L1)的应力增加范围增大。相邻椎体(T11和L1)的最大冯·米塞斯应力增加,而终末椎体(T10和L2)的最大冯·米塞斯应力降低。

结论

术后相邻椎体骨折。

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