摘要
目的应用有限元分析法探讨定量骨水泥在椎体内的不同分布对改善骨质疏松椎体整体刚度的影响。方法选取成年女性脊柱标本1具,建立L1椎体骨质疏松有限元模型。模拟椎体强化技术在L1椎体中注入骨水泥,根据骨水泥量及分布分为5组:A组(4.5 m L):骨水泥局限于椎体一侧;B组(4.5 m L):骨水泥集中于椎体中央,对称分布于椎体双侧的1/4;C组(4.5 m L):骨水泥位于椎体中间,对称弥散分布于椎体双侧的1/2;D组(4.5 m L):骨水泥位于椎体中间,对称弥散分布于椎体双侧的3/4;E组(9 m L):双侧骨水泥强化。分析轴向压缩加载状态下骨水泥填充前后椎体整体刚度的变化,并比较不同组别整体刚度的差异。结果各组椎体骨水泥强化后的整体刚度均显著高于骨水泥强化前(P<0.05)。E组椎体整体刚度显著高于A、C和D组(P<0.05),而B组和E组的整体刚度差异无统计学意义(P>0.05);B组椎体整体刚度值分别比A、C和D组高出33.9%、27.2%和34.1%(P<0.05);而A、C和D组之间的整体刚度值差异无统计学意义(P>0.05)。结论当骨水泥量固定时,集中于椎体中央的骨水泥分布比局限于单侧椎体或均衡弥散于两侧对骨质疏松椎体整体刚度的改善程度更强。
Objective To evaluate the effect of different distributions of quantitative bone cement on improving total stiffness of osteoporotic vertebrae after bone cement augmentation by finite element （FE） analysis. Methods We choose a female cadaver and then three-dimensional FE models of the osteoporotic L1 vertebral body （VB） were built. Bone cement augmentation of L1 was simulated in this numerical study. VBs were divided into five groups based on the volume and distribution of bone cement： Group A （4.5 mL）, the cement augmentation was limited to hemivertebral bodies; Group B （4.5 mL）, the cement augmentation was located in the middle and symmetrically reached one quarter of both sides of the VB; Group C （4.5 mL）, the bone cement was located in the middle and symmetrically reached half of both sides of the VB; Group D （4.5 mL）, the cement augmentation was located in the middle and symmetrically reached three quarters of both sides of the VB; Group E （9 mL）, bi-pedicular bone cement augmentation. Changes of total stiffness in all models with cement augmentation were compared with those in the corresponding unaugmented models, and the differences of total stiffness among the different groups were evaluated under axial compression loads. Results The total stiffness of VBs of each group was markedly increased compared with the osteoporotic, untreated model （P 〈 0.05）. The total stiffness of group E was significantly higher than group A, C and D, respectively （P 〈0.05）, and there was no significant difference between group B and E （P 〉0.05）. Moreover, the total stiffness of group B was 33.9%, 27.2% and 34.1% higher than group A, C and D, respectively （P 〈0.05）, and there were no significant differences among group A, C and D （P 〉0.05）. Conclusion When bone cement is being quantified, the total stiffness of osteoporotic VB improved by cement distribution in the middle of the VB is superior to uni-pedicular or symmetrically diffused cement distribution.
出处
《中国骨科临床与基础研究杂志》
2015年第3期162-168,共7页
Chinese Orthopaedic Journal of Clinical and Basic Research
基金
广东省科技计划资助项目(2011B031300019)
AOSpine China Research Project Grant[AOSCN(R)2014-03]
关键词
骨质疏松
脊柱
骨黏合剂
穿刺术
有限元分析
刚度
Osteoporosis
Spine
Bone cements
Punctures
Finite element analysis
Stiffness
