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的有限元评估

被引:6
作者
吴立军 [1 ]
杨国敬 [2 ]
张力成 [2 ]
余斌峰 [2 ]
机构
[1] 温州医学院数字化医学研究所
[2] 温州医学院附属第三医院骨科
基金
广东省自然科学基金;
关键词
功能脊柱单元; 骨质疏松; 骨移植增强; 后凸成形术; 有限元分析; 力学相容性; 生物相容性;
D O I
10.16156/j.1004-7220.2010.02.013
中图分类号
R687.3 [骨骼手术]; R318.01 [生物力学];
学科分类号
100103 [病原生物学]; 100220 [骨科学];
摘要
目的研究松质骨粒移植增强和骨水泥增强对椎体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椎体中心注入骨水泥,模拟经皮骨移植(Optimesh)在L2椎体中心置入松质骨粒,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。结果与骨质疏松模型相比,松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;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骨折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。
引用
收藏
页码:79 / 88
页数:10
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