Department of Orthopedics, The First Affiliated Hospital of Harbin Medical University, Harbin, 150001, China.
Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Harbin, 150081, China.
BMC Musculoskelet Disord. 2022 Jun 28;23(1):621. doi: 10.1186/s12891-022-05522-3.
To investigate the stress changes between different bone cement forms and injection volumes in adjacent vertebrae after percutaneous kyphoplasty (PKP) by establishing a three-dimensional finite element model of osteoporosis.
A male healthy volunteer was selected. CT of scans L1 to L3 vertebrae were imported into Mimics 21.0 software.The vertebral model of osteoporosiswas established based on previous literature reference. The models were divided into three groups: unilateral, bilateral integration and bilateral separation groups, with each group injecting 2 ml, 4,ml and 6 ml of bone cement, respectively. In all models, a vertical compressive load of 500 N, anterior flexion/posterior extension, left/right bending, and left/right rotation were applied with a moment of 7.5 N/m, of which 85% was applied to the anterior mid-column and 15% to the posterior column. The stress changes between adjacent vertebrae under different conditions were calculated.
After percutaneous kyphoplasty was applied to the L2 vertebral body, some differences can be found between the effects of different cement injection volumes and cement morphology on adjacent structures. There was no major difference between the groups when the bone cement injection volume was 2 ml. When the amount of bone cement injected was 4 ml, the bone cement morphology of the bilateral integration group (BIG) produced less stress between adjacent vertebral bodies. The minimum stress was 14.95 MPa in the L3 vertebral body in posterior extension. Whereas the stress levels on adjacent intervertebral structures, BIG shaped bone cement shows some superiority. In addition, the adjacent vertebrae and intervertebral structures are subjected to less stress during left and right rotation.
The present finite element study suggested that bilateral integration bone cement is a suitable form of cement injection, and when the injection volume is 4 ml, reduces stress on adjacent segments by approximately 15% while maintaining the stability of the injected vertebral body.
通过建立骨质疏松的三维有限元模型，研究经皮椎体后凸成形术（PKP）后不同骨水泥形态和注射体积在相邻椎骨间的应力变化。
选择一名男性健康志愿者。将 L1 至 L3 椎体的 CT 扫描导入 Mimics 21.0 软件。根据以往文献参考，建立骨质疏松椎体模型。将模型分为三组：单侧组、双侧融合组和双侧分离组，每组分别注射 2ml、4ml 和 6ml 骨水泥。在所有模型中，施加 500N 的垂直压缩载荷，前屈/后伸、左右弯曲和左右旋转，施加 7.5N/m 的弯矩，其中 85%施加在前中柱，15%施加在后柱。计算不同条件下相邻椎骨之间的应力变化。
在对 L2 椎体进行经皮椎体后凸成形术后，不同骨水泥注射量和骨水泥形态对相邻结构的影响存在一些差异。当骨水泥注射量为 2ml 时，各组之间没有明显差异。当骨水泥注射量为 4ml 时，双侧融合组（BIG）的骨水泥形态在相邻椎体之间产生的应力较小。在后伸时，L3 椎体的最小应力为 14.95MPa。而在左右旋转时，相邻椎间结构的应力水平较低。
本有限元研究表明，双侧融合骨水泥是一种合适的骨水泥注射形式，当注射量为 4ml 时，可使相邻节段的应力降低约 15%，同时保持注入椎体的稳定性。
