Fuzhou Second Hospital, Fuzhou, China.
Fujian Medical University Union Hospital, Fuzhou, China.
Eur J Med Res. 2022 Aug 6;27(1):142. doi: 10.1186/s40001-022-00769-x.
This study aims to explore the effects of finite element biomechanical properties of different methods in the treatment of osteoporotic thoracolumbar fractures.
Based on the ultra-thin computed tomography scan data of a volunteer's thoracolumbar spine, the finite element method was used to simulate the treatment of osteoporotic thoracolumbar fracture. Spiral computed tomography scanning was used to obtain images of the thoracolumbar region, which was then imported into Mimics software to obtain the three-dimensional geometric model. The finite element model of normal T - L segment was established by finite element software Abaqus and the validity of the model loading was verified. The finite element model of T vertebral compression fracture was established based on normal raw data. The clinical overextension reduction manipulation was simulated by different treatment methods and the changes in stress and displacement in different parts of injured vertebrae were analyzed.
An effective finite element model of T-L segment was established. The maximum stress, axial compression strength, axial compression stiffness, and transverse shear stiffness were significantly better in the percutaneous kyphoplasty and percutaneous vertebroplasty treatment group than in the conservative treatment group and open treatment group (P < 0.05). Additionally, there was no significant difference between the open treatment group and conservative treatment group, or between the PKP and PVP treatment group.
Percutaneous vertebroplasty and percutaneous kyphoplasty not only met the requirements of normal functional kinematics of thoracolumbar spine, but also restored the stability of thoracolumbar spine. They had good biomechanical properties and remarkable application effects. The application of finite element analysis can help select a scientific, reasonable, and effective treatment scheme for the clinical diagnosis and treatment of osteoporotic thoracolumbar fractures.
本研究旨在探讨不同方法治疗骨质疏松性胸腰椎骨折的有限元生物力学特性的影响。
基于志愿者胸腰椎的超薄层 CT 扫描数据，采用有限元法模拟治疗骨质疏松性胸腰椎骨折。对胸腰椎进行螺旋 CT 扫描，获得胸腰椎区域图像，然后将其导入 Mimics 软件中，获取三维几何模型。采用有限元软件 Abaqus 建立正常 T-L 节段的有限元模型，并验证模型加载的有效性。基于正常原始数据建立 T 椎体压缩性骨折的有限元模型。通过不同的治疗方法模拟临床过伸复位操作，并分析损伤椎体各部位的应力和位移变化。
建立了有效的 T-L 节段有限元模型。经皮椎体后凸成形术和经皮椎体成形术治疗组的最大应力、轴向压缩强度、轴向压缩刚度和横向剪切刚度明显优于保守治疗组和开放治疗组（P<0.05）。此外，开放治疗组与保守治疗组之间，或 PKP 与 PVP 治疗组之间无显著差异。
经皮椎体后凸成形术和经皮椎体成形术不仅满足胸腰椎正常功能运动学的要求，而且恢复了胸腰椎的稳定性。它们具有良好的生物力学特性和显著的应用效果。有限元分析的应用有助于为骨质疏松性胸腰椎骨折的临床诊断和治疗选择科学、合理、有效的治疗方案。
