Nakashima Daisuke, Kanchiku Tsukasa, Nishida Norihiro, Ito Saki, Ohgi Junji, Suzuki Hidenori, Imajo Yasuaki, Funaba Masahiro, Chen Xian, Taguchi Toshihiko
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.
Department of Mechanical Engineering, Yamaguchi University, Ube, Yamaguchi 755-8611, Japan.
Exp Ther Med. 2018 Apr;15(4):3225-3230. doi: 10.3892/etm.2018.5848. Epub 2018 Feb 7.
Vertebral fractures commonly occur at the thoracolumbar junction. These fractures can be treated with mild residual deformity in many cases, but are reportedly associated with increased risk of secondary vertebral fractures. In the present study, a three-dimensional (3D) whole spine model was constructed using the finite element method to explore the mechanism of development of compression fractures. The 3D model of the whole spine, from the cervical spine to the pelvis, was constructed from computed tomography (CT) images of an adult male. Using a normal spine model and spine models with compression fractures at the T11, T12 or L1 vertebrae, the distribution of strain was analyzed in the vertebrae after load application. The normal spine model demonstrated greater strain around the thoracolumbar junction and the middle thoracic spine, while the compression fracture models indicated focused strain at the fracture site and adjacent vertebrae. Increased load time resulted in the extension of the strain region up to the middle thoracic spine. The present findings, that secondary vertebral fractures commonly occur around the fracture site, and may also affect the thoracic vertebrae, are consistent with previous clinical and experimental results. These results suggest that follow-up examinations of compression fractures at the thoracolumbar junction should include the thoracic spine and adjacent vertebrae. The current data also demonstrate that models created from CT images can be used for various analyses.
椎体骨折常见于胸腰段交界处。在许多情况下，这些骨折可伴有轻度残余畸形，但据报道其与继发椎体骨折风险增加有关。在本研究中，采用有限元方法构建了三维（3D）全脊柱模型，以探究压缩性骨折的发生机制。从一名成年男性的计算机断层扫描（CT）图像构建了从颈椎到骨盆的全脊柱3D模型。使用正常脊柱模型以及T11、T12或L1椎体发生压缩性骨折的脊柱模型，在施加负荷后分析椎体中的应变分布。正常脊柱模型在胸腰段交界处和胸椎中部周围显示出更大的应变，而压缩性骨折模型则表明在骨折部位和相邻椎体处存在集中应变。负荷时间增加导致应变区域扩展至胸椎中部。本研究结果表明继发椎体骨折通常发生在骨折部位周围，并且可能还会影响胸椎，这与先前的临床和实验结果一致。这些结果表明，对胸腰段交界处压缩性骨折的随访检查应包括胸椎和相邻椎体。当前数据还表明，由CT图像创建的模型可用于各种分析。
