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新型脊柱保护装置预防和治疗骨质疏松性椎体压缩性骨折的有限元分析。

Finite Element Analysis of a New Type of Spinal Protection Device for the Prevention and Treatment of Osteoporotic Vertebral Compression Fractures.

机构信息

Department of Spinal Surgery, The First Hospital of Jilin University, Changchun, China.

Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, China.

出版信息

Orthop Surg. 2022 Mar;14(3):577-586. doi: 10.1111/os.13220. Epub 2022 Feb 11.

Abstract

OBJECTIVE

To study the effectiveness of a new spinal protection device for preventing and treating osteoporotic vertebral compression fractures (OVCFs) by finite element analysis (FEA).

METHODS

One healthy volunteer and one patient with 1-segment lumbar vertebral compression fractures were included in this experimental study. The DICOM files of two different lumbar spiral computed tomography (CT) scans were converted into STL files, and 3D finite element models of the lumbar spine were generated for normal and L1 vertebral fracture spines. A new type of spinal protection device was applied to reduce the stress on the anterior vertebral edge and direct the center of gravity posteriorly. The stress distribution characteristics of different finite element models of the lumbar spine were analyzed, revealing the characteristics of the stress distributed along the spine under the action of the new spinal protection device.

RESULTS

Under normal conditions, the stress was mainly distributed in the middle and posterior columns of the spine. When the anterior border of the L1 vertebral body was fractured and collapsed, the stress distribution shifted toward the anterior column due to the center of gravity being directed forward. According to finite element analysis of the spine with the new protection device, the stress in the middle and posterior columns tended to increase, and that in the anterior column decreased. After the new type of spinal fixation device was applied, the stress at the L1 and L2 vertebral endplates decreased to a certain extent, especially that at the L1 vertebral body. The maximum stress on the L1 vertebral body decreased by 20% after the auxiliary device was applied.

CONCLUSIONS

According to the FEA results, the new spinal protection device can effectively prevent and treat osteoporotic vertebral compression fractures (OVCFs), and can alter the stress distribution in the spine and reduce the stress in the anterior column of the vertebral body, especially in vertebral compression fractures.

摘要

目的

通过有限元分析(FEA)研究一种新型脊柱保护装置预防和治疗骨质疏松性椎体压缩性骨折(OVCFs)的效果。

方法

本实验研究纳入了 1 名健康志愿者和 1 名 1 个节段腰椎压缩性骨折患者。将两名不同腰椎螺旋 CT 扫描的 DICOM 文件转换为 STL 文件,并生成正常和 L1 椎体骨折脊柱的 3D 有限元模型。应用新型脊柱保护装置可减少前椎体边缘的压力,并使重心向后转移。分析不同腰椎脊柱有限元模型的应力分布特征,揭示新型脊柱保护装置作用下脊柱沿脊柱分布的应力特征。

结果

在正常情况下,应力主要分布在脊柱的中柱和后柱。当 L1 椎体前缘骨折塌陷时,由于重心向前转移,应力分布向脊柱前柱转移。根据带有新型保护装置的脊柱有限元分析,中柱和后柱的应力趋于增加,前柱的应力减少。新型脊柱固定装置应用后,L1 和 L2 椎体终板处的应力在一定程度上降低,尤其是 L1 椎体。辅助装置应用后,L1 椎体的最大应力降低了 20%。

结论

根据 FEA 结果,新型脊柱保护装置可有效预防和治疗骨质疏松性椎体压缩性骨折(OVCFs),并可改变脊柱的应力分布,减少椎体前柱的应力,尤其是在椎体压缩性骨折中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7837/8926982/2611b77debb0/OS-14-577-g001.jpg

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