一种利用双能成像技术估计骨骼力学性能以改善椎弓根螺钉固定的新方法。

OBJECTIVE: To develop a methodology to improve the representation of the mechanical properties of a vertebral finite element model (FEM) based on a new dual-energy (DE) imaging technology to improve pedicle screw fixation. METHODS: Bone-calibrated radiographs were generated with dual-energy imaging technology in order to estimate the mechanical properties of the trabecular bone. Properties were included in regions of interest in four vertebral FEMs representing heterogeneity and homogeneity, as a realistic and reference model, respectively. Biomechanical parameters were measured during screw pull-out testing to evaluate pedicle screw fixation. RESULTS: Simulations with property distributions deduced from dual-energy imaging characterization (heterogeneous models) induced an increase in biomechanical indicators versus with a homogeneous representation, implying different behaviors for the subject-specific models. CONCLUSION: The presented methodology allows a patient-specific representation of bone quality in a FEM using new DE imaging technology. Consideration of individualized bone distribution in a spinal FEM improves the perspective of orthopedic surgical planning over otherwise underestimated results using a homogeneous representation.

目的：开发一种方法，基于新的双能（DE）成像技术来改善椎骨有限元模型（FEM）的机械性能表示，以提高椎弓根螺钉固定效果。

方法：使用双能成像技术生成骨校准射线照片，以估计松质骨的机械性能。在分别代表异质和同质的四个 FEM 中，将感兴趣区域的特性包括在内，作为现实和参考模型。在椎弓根螺钉拔出试验中测量生物力学参数，以评估椎弓根螺钉固定效果。

结果：与同质表示相比，基于双能成像特性推断的特性分布模拟（异质模型）会导致生物力学指标增加，这意味着针对特定个体的模型会有不同的行为。

结论：本研究提出的方法允许使用新的 DE 成像技术在 FEM 中实现骨骼质量的个体化表示。在脊柱 FEM 中考虑个体的骨分布可以改善骨科手术规划的角度，而不是使用同质表示会低估结果。