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新型手术方法替代椎体后凸成形术改善椎体力学行为的生物力学评估:微观有限元研究

Biomechanical assessment of new surgical method instead of kyphoplasty to improve the mechanical behavior of the vertebra: Micro finite element study.

作者信息

Faradonbeh Seyed Aref Hosseini, Jamshidi Nima

机构信息

Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan 81746-73441, Iran.

出版信息

World J Orthop. 2017 Nov 18;8(11):829-835. doi: 10.5312/wjo.v8.i11.829.

Abstract

AIM

To reduce post treatments of kyphoplasty, as a common treatment for osteoporotic vertebrae.

METHODS

This study suggests a new method for treating vertebrae by setting the hexagonal porous structure instead of the rigid bone cement mass in the kyphoplasty (KP). The KP procedure was performed on the fresh ovine vertebra of the level L1. Micro finite element modeling was performed based on micro computed tomography of ovine trabecular cube. The hexagonal porous structure was set on one cube instead of the bone cement mass. For the implant designing, two geometrical parameters were considered: Spacing diameter and thickness.

RESULTS

The results of micro finite element analyses indicated the improvement in the mechanical behavior of the vertebra treated by the hexagonal porous structures, as compared to those treated by vertebroplasty (VP) and KP under static loading. The improvement in the mechanical behavior of the vertebra, was observed as 54% decrease in the amount of maximum Von Misses stress (improvement of stress distribution), in trabecular cube with embedded hexagonal structure, as compared to VP and KP. This is comparable to the results of the experimental study already performed; it was shown that the improvement of mechanical behavior of the vertebra was observed as: 83% increase in the range of displacements before getting to the ultimate strength (increasing the toughness) after setting hexagonal pearls inside vertebrae. Both the material and geometry of implant influenced the amount of Von Mises stress in the structure.

CONCLUSION

The new proposed method can be offered as a substitute for the KP. The implant geometry had a more obvious effect on the amount of Von Mises stress, as compared to the implant material.

摘要

目的

作为骨质疏松性椎体的常见治疗方法,减少椎体后凸成形术的后续治疗。

方法

本研究提出一种治疗椎体的新方法,即在椎体后凸成形术(KP)中设置六边形多孔结构而非刚性骨水泥块。在新鲜的L1节段绵羊椎体上进行KP手术。基于绵羊小梁骨立方体的微观计算机断层扫描进行微观有限元建模。在一个立方体上设置六边形多孔结构而非骨水泥块。在植入物设计方面,考虑了两个几何参数:间距直径和厚度。

结果

微观有限元分析结果表明,与经椎体成形术(VP)和KP治疗的椎体相比,在静态载荷下,经六边形多孔结构治疗的椎体力学行为有所改善。与VP和KP相比,在嵌入六边形结构的小梁骨立方体中,观察到椎体力学行为的改善表现为最大冯·米塞斯应力降低54%(应力分布改善)。这与已进行的实验研究结果相当;研究表明,在椎体内部设置六边形珠粒后,椎体力学行为的改善表现为:在达到极限强度之前位移范围增加83%(韧性增加)。植入物的材料和几何形状均影响结构中的冯·米塞斯应力大小。

结论

新提出的方法可作为KP的替代方法。与植入物材料相比,植入物几何形状对冯·米塞斯应力大小的影响更为明显。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0411/5696610/a65747254a3a/WJO-8-829-g001.jpg

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