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骨质疏松症在腰椎体间融合后人体脊柱振动特性中的生物力学作用。

Biomechanical role of osteoporosis in the vibration characteristics of human spine after lumbar interbody fusion.

机构信息

School of Mechanical Engineering and Automation, Northeastern University, Shenyang, China.

出版信息

Int J Numer Method Biomed Eng. 2020 Dec;36(12):e3402. doi: 10.1002/cnm.3402. Epub 2020 Oct 16.

Abstract

Lumbar vertebrae osteoporosis is the most common challenge for lumbar interbody fusion, and this challenge has been widely concerned by scholars for many years. However, under whole-body vibration, osteoporosis how to affect the vibration characteristics of the fusion lumbar spine, complications, and fusion outcomes is urgent to know. The L1-L5 finite element model of lumbar spine was modified to simulate the transforaminal lumbar interbody fusion model with the bilateral pedicle screw fixator at L4-L5 level. A 5 Hz, 40 N sinusoidal vertical load supplemented with a 400 N preload was used to simulate the vertical vibration of human body. The results showed that under whole-body vibration, osteoporosis of fused vertebrae may cause the adjacent segments more unstable and increase the risk of adjacent segment diseases, subsidence, cage failure, rod failure, and lumbar instability. Osteoporosis of the fused vertebrae may cause the vertebral cells an unstable, inhibited growth and lead to poorer fusion outcomes. The findings may assist us in understanding the effect of osteoporosis on the vibration characteristics of lumbar spine fusion and provide references to clinical treatments for lumbar interbody fusion and lumbar vertebrae osteoporosis.

摘要

腰椎骨质疏松症是腰椎体间融合最常见的挑战,多年来一直受到学者们的广泛关注。然而,在全身振动下,骨质疏松症如何影响融合腰椎的振动特性、并发症和融合结果,这是迫切需要了解的。对 L1-L5 腰椎的有限元模型进行了修正,以模拟 L4-L5 水平双侧椎弓根螺钉固定器的经椎间孔腰椎体间融合模型。使用 5 Hz、40 N 的正弦垂直载荷补充 400 N 的预载来模拟人体的垂直振动。结果表明,在全身振动下,融合椎体的骨质疏松症可能导致相邻节段更加不稳定,并增加相邻节段疾病、下沉、笼失败、棒失败和腰椎不稳定的风险。融合椎体的骨质疏松症可能导致椎体细胞不稳定,抑制生长,导致融合结果较差。这些发现可能有助于我们了解骨质疏松症对腰椎融合振动特性的影响,并为腰椎体间融合和腰椎骨质疏松症的临床治疗提供参考。

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