Wang De-Guo, Li Yang, Yin Hong-Ling, Li Jun, Qu Jiao, Jiang Min-Bo, Tian Ji-Wei
Songjiang District Central Hospital, Shanghai 201600, China.
Zhongguo Gu Shang. 2021 Jan 25;34(1):26-33. doi: 10.12200/j.issn.1003-0034.2021.01.006.
To establish a three-dimensional finite element model of osteoporosis and to study the stiffness recovery of injured vertebrae and stress analysis of adjacent vertebrae after percutaneous vertebroplasty under different perfusion and distribution conditions by simulating fluid flow into the vertebral body.
A male healthy volunteer was selected. CT scans were performed from T to L. Mimics 15.0 and ABAQUS 6.11 software were used to extract CT images. The vertebral model of osteoporotic fracture was established. The flow physical field and conduction and diffusion physical field were coupled to simulate the process and parts of the injection of bone cement into the vertebral fracture model. The amount of bone cement injected into the vertebral fracture model was 2 ml, 4 ml, 6 ml respectively. The diffusion range of bone cement was simulated on the image, and the post injection model of bone cement was obtained. Vertical downward, forward and backward pressure of 300 N were applied on the surface of the model to simulate vertebral movement. The stress changes of upper and lower vertebrae and diseased vertebrae under different conditions were calculated.
(1) The VonMises stress of T inferior endplate was the largest in the three states before and after fracture.(2) The VonMises stress of the intervertebral disc and each endplate after fracture was significantly higher than before fracture. When percutaneous vertebroplasty was applied, as the amount of bone cement injection increases, the VonMises stress of the adjacent vertebral endplates increases. In the diseased vertebrae, as the amount of bone cement increases, the VonMises stress of the vertebral body endplate showed a downward trend.
Reliable biomechanical model of lumbar vertebral fracture can be established by using CT scanning data through software simulation. Vertebral fracture and vertebroplasty will cause biomechanical changes of adjacent vertebral bodies. With the increase of bone cement injection, the influence of biomechanical changes will increase significantly. Neighbouring vertebral fractures are more likely. For this experiment, percutaneous vertebroplasty has a suitable amount of cement injection of 4 ml.
建立骨质疏松三维有限元模型,通过模拟骨水泥流入椎体的不同灌注和分布情况,研究经皮椎体成形术后损伤椎体的刚度恢复及相邻椎体的应力分析。
选取一名男性健康志愿者。从胸段到腰段进行CT扫描。使用Mimics 15.0和ABAQUS 6.11软件提取CT图像。建立骨质疏松性骨折的椎体模型。将流动物理场与传导和扩散物理场耦合,模拟骨水泥注入椎体骨折模型的过程及部位。分别向椎体骨折模型注入2ml、4ml、6ml骨水泥。在图像上模拟骨水泥的扩散范围,得到骨水泥注入后模型。在模型表面施加300N的垂直向下、向前和向后压力以模拟椎体运动。计算不同条件下上下椎体及病变椎体的应力变化。
(1)骨折前后三种状态下胸段椎体下终板的VonMises应力最大。(2)骨折后椎间盘及各终板的VonMises应力明显高于骨折前。经皮椎体成形术时,随着骨水泥注入量增加,相邻椎体终板的VonMises应力增加。在病变椎体中,随着骨水泥量增加,椎体终板的VonMises应力呈下降趋势。
利用CT扫描数据通过软件模拟可建立可靠的腰椎骨折生物力学模型。椎体骨折和椎体成形术会引起相邻椎体的生物力学变化。随着骨水泥注入量增加,生物力学变化的影响将显著增加。相邻椎体骨折的可能性更大。本实验中,经皮椎体成形术合适的骨水泥注入量为4ml。