注射骨水泥对骨质疏松性股骨颈的生物力学影响及有限元分析

发布时间：2018-03-23 20:01

本文选题：骨质疏松　切入点：股骨颈　出处：《兰州大学》2017年硕士论文

【摘要】：目的:骨质疏松是一种全身性骨代谢性疾病,其引起的椎体骨折、股骨颈骨折是临床常见的病理性骨折,是老年患者死亡的主要威胁因素。临床上常用经皮椎体成形术(percutaneous vertebroplasty,PVP)和经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF)。本实验旨在研究骨水泥对骨质疏松性股骨颈的生物力学影响及有限元分析,为临床防治骨质疏松性股骨颈骨折提供新的选择和思路。方法:(一)生物力学实验:健康雌性中国大白兔21只,适应性饲养2周行股骨颈骨密度测定后随机分为3组,分别为实验组、对照组、假手术组。实验组和对照组给予去势+激素注射进行骨质疏松造模,待造模成功后,实验组给予股骨颈注射骨水泥,对照组不注射骨水泥,假手术组仅行与实验组、对照组行相同的手术方式而不做其他任何处理。6周后对所有实验动物的股骨进行完整的CT扫描,随后处死所有试验动物,离取实验所需的股骨标本后,剔除附着在骨表面的肌腱及软组织,低温储存直至生物力学测量。室温自然解冻后,截取并制作生物力学测量所需的试样,并在生物力学机上按照之前的实验设计进行压缩试验,记录数据并观察试样断裂位置。(二)有限元分析:实验标本扫描数据以DICOM(Digital Imaging and Communications in Medicine)格式储存,将DICOM格式的扫描数据导入Mimics Research 17.0(Materialise's interactive medical image control system),在Mimics中利用不同组织间阈值的不同,进行分割及三维重建,导入到3-Matic之后进行网格优化和网格划分,将体网格模型导回Mimics进行材料赋值,再将赋值完成的体网格模型导入到ABAQUS 6.14进行求解分析,然后定义载荷和边界约束条件,最后提交分析处理。结果:(一)生物力学实验结果:压缩实验结果表明,实验组与对照组相比,在弹性模量、断裂点载荷、断裂点应力、载荷最大值、应力最大值等方面,差异具有统计学意义,P0.05,而和假手术组相比,差异无统计学意义,P0.05。(二)有限元分析:通过Mimics和ABAQUS我们建立了股骨颈的三维有限元模型,获得了有限元网格,实验组单元数为256559、节点数为329102,对照组单元数为222705、节点数为277455,假手术组单元数为222053、节点数为318231;通过ABAQUS求解分析发现,在同等加载条件下,实验组的刚度最大、假手术组次之、对照组最差。结论:注射骨水泥可以增加骨质疏松性股骨颈的生物力学强度,为临床防治骨质疏松性股骨颈骨折提供新的策略。
[Abstract]:Objective: osteoporosis is a systemic bone metabolic disease, which causes vertebral fracture and femoral neck fracture is a common pathological fracture in clinic. Percutaneous vertebroplasty and percutaneous kyphoplasty PKP are commonly used in the treatment of osteoporotic vertebral compression fracture of osteoporotic vertebral body compression fracture. The purpose of this study was to study the effect of percutaneous vertebroplasty and percutaneous kyphoplastic kyphoplastic kyphoplasty on the treatment of osteoporotic vertebral compression fracture. The purpose of this study was to study the effect of percutaneous vertebroplasty and kyphoplastic kyphoplasty PKP on the treatment of osteoporotic vertebral compression fracture. Biomechanical effect and finite element Analysis of Osteoporosis femoral neck, Methods (1) Biomechanical experiment: 21 healthy female Chinese rabbits were randomly divided into 3 groups after 2 weeks of adaptive feeding. The experimental group and control group were injected with ovariectomized hormone to make model of osteoporosis. After successful modeling, the experimental group was given femoral neck injection of bone cement, and the control group was not injected with bone cement. The sham-operated group was treated with the same operation as the experimental group, and the control group underwent the same operation without any other treatment. After 6 weeks of treatment, the femur of all the experimental animals were scanned by CT, then all the experimental animals were killed, and the femur specimens were removed from the experimental animals. Remove tendons and soft tissue attached to the surface of bone, store at low temperature until biomechanical measurement. After natural thawing at room temperature, intercept and make samples for biomechanical measurement. Compression tests were carried out on a biomechanical machine according to the previous experimental design. The data were recorded and observed. (2) finite element analysis. The scanning data were stored in the format of DICOM(Digital Imaging and Communications in Medicine. The scanning data in DICOM format are imported into Mimics Research 17.0(Materialise's interactive medical image control system, and the different thresholds of different tissues are used in Mimics to segment and reconstruct 3D, and then the meshes are optimized and meshed after being imported into 3-Matic. The volume mesh model is introduced back to Mimics for material assignment, and then the volume grid model is imported into ABAQUS 6.14 to solve the problem, and then the load and boundary constraints are defined. Results: compression experiment results showed that, compared with the control group, the experimental group had the following aspects: elastic modulus, fracture point load, fracture point stress, maximum load, maximum stress, and so on. The difference was statistically significant (P 0.05), but there was no significant difference compared with sham operation group (P 0.05) (2) finite element analysis: through Mimics and ABAQUS we established a three-dimensional finite element model of femoral neck and obtained finite element mesh. The experimental group had 2565559 units, 329102 nodes, the control group 222705 units, the node number 277455, the sham-operation group 222053 units, the node number 318231.The results of ABAQUS solution analysis showed that under the same loading conditions, the stiffness of the experimental group was the greatest, followed by the sham operation group. Conclusion: bone cement injection can increase the biomechanical strength of osteoporotic femoral neck and provide a new strategy for clinical prevention and treatment of osteoporotic femoral neck fracture.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R687

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