骨质疏松性椎体骨折骨水泥强化术后骨水泥不同分布位置的三维有限元分析

Three-dimensional finite element analysis of different distribution of bone cement afteRbone cement augmentation of osteoporotic vertebral fracture

目的采用三维有限元分析研究骨质疏松性椎体骨折骨水泥强化术后骨水泥不同分布位置的生物力学改变。方法选择6例健康成人志愿者,将其腰椎薄层CT平扫数据导入Mimics软件中,建立L_(1)椎体骨质疏松性模型及前方、后方、右侧方填充骨水泥模型共4组。将模型导入Ansys软件中进行压力载荷模拟,记录角位移及最大压力。结果站立位、屈伸位、扭转位状态下的角位移及最大压力:填充骨水泥的3组与未填充骨水泥组比较差异均有统计学意义(P<0.05);填充骨水泥的3组间比较差异均无统计学意义(P>0.05)。结论骨质疏松性椎体骨折骨水泥强化术后均匀弥散与皮质耦合的骨水泥分布对脊柱生物力学影响最小,能预防再骨折。

Objective To study the biomechanical changes of different distribution of bone cement after bone cement augmentation of osteoporotic vertebral fractures using three-dimensional finite element analysis.Methods Six healthy adult volunteers were selected, and their thin-layer CT plain scan data of lumbar spine were imported into Mimics software to establish four groups of models, including L_(1) osteoporotic vertebra and the anterior, posterior and right bone cement filled vertebrae.The models were imported into Ansys software for stress load simulation, and the angular displacement and maximum stress were recorded.Results Under the conditions of standing, flexion-extension and torsion, there were significant differences in angular displacement and maximum stress between the three groups filled with bone cement and the non-filled bone cement group(P<0.05),but there were no significant differences among the three groups filled with bone cement(P>0.05).Conclusions After cement augmentation of osteoporotic vertebral fractures, the distribution of uniform dispersion and corticoid-coupled bone cement have minimal effect on the biomechanics of the spine, and can prevent refracture of the vertebrae.