椎体内裂隙的位置和程度影响伤椎稳定性的生物力学分析

发布时间：2018-03-02 00:18

本文关键词： 椎体内真空裂隙生物力学稳定性有限元　出处：《第三军医大学学报》2017年04期 　论文类型：期刊论文

【摘要】：目的分析椎体内真空裂隙(intravertebral vacuum cleft,IVC)的位置和程度变化对胸腰椎稳定性的影响。方法在已验证的T11~L1有限元骨质疏松模型的基础上,指定T12为伤椎,结合既往文献报道将T12椎体内部松质骨在不同位置予以不同程度的截除,模拟9种IVC的有限元模型。首先将前1/2高2 mm松质骨在偏上、中、偏下予以截除模拟轻度IVC模型(S1、C1、I1),将前1/2高4 mm松质骨截除模拟上下进展的重度IVC模型(S2、C2、I2),将高2 mm松质骨完整截除模拟前后进展的重度IVC模型(S3、C3、I3)。分别比较9种模型在各种生理活动范围时在T12皮质骨应力分布差异。结果对所有IVC模型而言,最大米塞斯应力(von Mises)主要集中在前屈活动时伤椎皮质骨前壁上下缘,其次是后伸活动时后壁上下缘。当IVC偏上或偏下时,伤椎皮质骨最大应力在前屈时显著增加(超过正常模型17%),而当IVC位于中部时最大应力仅轻微增加(约超过正常模型5%)。当IVC进展性加重时,模型的最大应力均增加,但是当IVC向前后进展加重时在各种生理活动范围下最大应力值超过轻度IVC模型最大应力8%以上,而当IVC上下进展加重时最大应力值仅超过轻度IVC模型最大应力值3%以下。结论除IVC位于中部时对伤椎稳定性影响较小外,其余大部分位置和程度的IVC对伤椎稳定性均有显著的影响,可能需要早期手术干预以稳定椎体、预防进展性严重塌陷。
[Abstract]:Objective to analyze the effect of the position and degree of intravertebral vacuum vacuum cleftCon on the stability of thoracolumbar vertebrae. Methods on the basis of the verified finite element model of Osteoporosis of T11L, T12 was designated as the injured vertebra. Combined with previous literatures, the cancellous bone in the T12 vertebra was amputated in different places to simulate 9 IVC finite element models. First, the first 1/2 high 2 mm cancellous bone was placed on the upper and middle. The model of mild IVC was amputated, the former 1/2 high 4 mm cancellous bone was amputated to simulate the progression of the upper and lower IVC, and the 2 mm high cancellous bone was completely amputated before and after the complete amputation of the developed severe IVC model (S3C3I3I3I3). The 9 models were compared respectively. The stress distribution of T12 cortical bone was different in various physiological activity ranges. Results for all IVC models, The maximum Mises stress von Mises was mainly located at the upper and lower edge of the anterior wall of the cortical bone of the injured vertebrae during flexion activity, followed by the upper and lower margin of the posterior wall during the extension activity. The maximum stress of cortical bone of injured vertebrae increased significantly at the time of anterior flexion (more than 17% of the normal model, but only slightly when IVC was located in the middle of the model) (about 5% above the normal model). The maximum stress of the model increased with the progressive aggravation of IVC. However, the maximum stress value of IVC in various physiological activities was higher than that of the mild IVC model (8% or more). The maximum stress value of IVC is only below the maximum stress value of mild IVC model when the development of IVC is higher than that of mild IVC model. Conclusion except that IVC is located in the middle of the body, it has little effect on the stability of injured vertebrae. Most of the other sites and degrees of IVC have a significant effect on the stability of the injured vertebrae. Early surgical intervention may be needed to stabilize the vertebral body and prevent severe progressive collapse.
【作者单位】：广州中医药大学第一临床医学院;广州中医药大学第一附属医院脊柱骨科;
【基金】：卫生部医药卫生科技发展研究中心资助课题(W2012ZT07,W2014ZT256) 广东省卫生厅医学科研基金(B2014175)~~
【分类号】：R681.5;R318.01

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