机械负荷对颈椎全椎间盘置换术中异位骨化的影响:三维有限元分析
Effect of mechanical loading on heterotopic ossification in cervical total disc replacement: a three-dimensional finite element analysis.
作者信息
Ganbat Danaa, Kim Yoon Hyuk, Kim Kyungsoo, Jin Yong Jun, Park Won Man
机构信息
Department of Mechanical Engineering, Kyung Hee University, 1 Seocheon-dong, Giheung-gu, Yongin-si, Gyeonggi-do, 446-701, Korea.
Department of Technical Mechanics, Mongolian University of Science and Technology, Ulaanbaatar, Mongolia.
出版信息
Biomech Model Mechanobiol. 2016 Oct;15(5):1191-9. doi: 10.1007/s10237-015-0752-3. Epub 2015 Dec 23.
The development of heterotopic ossification (HO) is considered one of the major complications following cervical total disc replacement (TDR). Even though previous studies have identified clinical and biomechanical conditions that may stimulate HO, the mechanism of HO formation has not been fully elucidated. The objective of this study is to investigate whether mechanical loading is a biomechanical condition that plays a substantial role to decide the HO formation. A finite element model of TDR on the C5-C6 was developed, and HO formation was predicted by simulating a bone adaptation process under various physiological mechanical loadings. The distributions of strain energy on vertebrae were assessed after HO formation. For the compressive force, most of the HO formation occurred on the vertebral endplates uncovered by the implant footplate which was similar to the Type 1 HO. For the anteriorly directed shear force, the HO was predominantly formed in the anterior parts of both the upper and lower vertebrae as the Type 2 HO. For both the flexion and extension moments, the HO shapes were similar to those for the shear force. The total strain energy was reduced after HO formation for all loading conditions. Two distinct types of HO were predicted based on mechanically induced bone adaptation processes, and our findings were consistent with those of previous clinical studies. HO formation might have a role in compensating for the non-uniform strain energy distribution which is one of the mechanical parameters related to the bone remodeling after cervical TDR.
异位骨化(HO)的发生被认为是颈椎全椎间盘置换术(TDR)后的主要并发症之一。尽管先前的研究已经确定了可能刺激HO的临床和生物力学条件,但HO形成的机制尚未完全阐明。本研究的目的是调查机械负荷是否是决定HO形成的一个起重要作用的生物力学条件。建立了C5-C6节段TDR的有限元模型,并通过模拟各种生理机械负荷下的骨适应过程来预测HO的形成。在HO形成后评估椎体上应变能的分布。对于压缩力,大部分HO形成于植入物脚板未覆盖的椎体终板上,这与1型HO相似。对于向前的剪切力,HO主要形成于上下椎体的前部,为2型HO。对于屈曲和伸展力矩,HO的形状与剪切力的相似。在所有负荷条件下,HO形成后总应变能均降低。基于机械诱导的骨适应过程预测了两种不同类型的HO,我们的发现与先前的临床研究结果一致。HO的形成可能在补偿不均匀应变能分布方面发挥作用,这是颈椎TDR后与骨重塑相关的机械参数之一。