骨移植与骨水泥增强对治疗骨质疏松椎体的生物力学相容性有限 元评估
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国家自然科学基金项目(30970702);浙江省温州医学院重大科研专项(QTJ06012);广东省自然科学基金项目(5300714)


Biomechanical compatibility of osteoporotic vertebral augmentation with cancellous bone granules and bone cement: a finite element evaluation
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    目的 研究松质骨粒移植增强和骨水泥增强对治疗节段和相邻非治疗节段的生物力学相容性 影响,探讨椎体重建前后的荷载传导机制。方法 选取正常男性青壮年脊柱L1-L2节段标本进行薄层 CT扫描,构建正常的和骨折复位后疏松的功能脊柱单元三维有限元模型,模拟经皮穿刺椎体后凸 成形术(PKP)在L2椎体核心注入骨水泥,模拟经皮骨移植(Optimesh)在L2椎体核心置入松质骨粒,按 照脊柱三柱理论施加轴向压缩、前屈和后伸荷载进行有限元分析。结果 质骨粒移植增强或骨水泥增强后相邻节段椎体应力应变的变化甚微;但是,治疗节段增强区域的应力应变明显改变。另外,骨质疏松、松质骨粒移植增强、骨水泥增强对脊柱三柱轴向压缩位移和椎间盘平均内压没有影响。结论 松质骨粒移植增强和骨水泥增强均能恢复疏松椎体的总体刚度和强 度,有利于椎体功能重建;但从椎体与增强材料间的力学相容性和生物相容性的观点看,松质骨粒 移植增强优于骨水泥增强。

    Abstract:

    Objective The goal of this study was to investigate the biomechanical compatibility effects of cancellous bone granule(CBG) augmentation of Optimesh and polymethylmethacrylate (PMMA) augmentation of Kyphoplasty on treated andadjacent non-treated vertebral bodies. Methods Three-dimensional, anatomically detailed finite element (FE) models of the L1–L2functional spinal unit (FSU) were developed on the basis of cadaver computed tomography (CT) scans. The material properties and plug forms of the L2 centrum were adapted to simulate osteoporosis, CBG and PMMA augmentation. The models assumed a three-column loading configuration as the following types: compression, ?exion and extension. Results Compared with the osteoporotic model, changes in stress and strain at adjacent levels both of CBG and PMMA augmentation models were minimal, but stresses/strains within the two reinforcement material plugs were modified distinctly and differently. In addition, osteoporosis, CBG and PMMA augmentation had little effect on either the axial compressive displacement of the three columns or the average disc internal pressure in all models. Conclusion Both morcelized cancellous bone and PMMA augmentation restore the total strength and stiffness level of treated vertebral bodies and benefit the reconstruction of vertebral function. Regarding the biomechanical compatibility and the biocompatibility of the treated vertebral body and reinforcement material, however, the morcelized cancellous bone is better than PMMA augmentation.

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吴立军,杨国敬,张力成,余斌峰.骨移植与骨水泥增强对治疗骨质疏松椎体的生物力学相容性有限 元评估[J].医用生物力学,2010,25(2):79-88

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  • 收稿日期:2009-11-04
  • 最后修改日期:2010-03-20
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