CAJ | 학술논문

目的通过分析后凸成形术中不同容积的骨水泥填充量对相邻椎体终板应力的影响,探讨后凸成形术后相邻椎体骨折发生的可能机制. 方法建立胸腰段脊柱骨质疏松性椎体压缩骨折三维有限元模型,模拟经皮后凸成形术( percutaneous kyphoplasty,PKP)对椎体进行部分复位(80％),分别在骨折椎体内植入两种剂量(4.0 ml填充15％椎体容积,8.0 ml填充30％椎体容积)骨水泥进行填充,分析轴向压缩、前屈和后伸三种情况下相邻椎体终板应力的变化情况.结果比较PKP术中两种填充剂量下相邻椎体终板在各种情况下的应力差别,发现T11椎体下位终板与L1椎体上位终板总体应力均较术前增加,并与骨水泥充填量呈正相关,且应力主要集中在终板前部和中部. 结论 PKP术后相邻椎体终板应力的增加与骨水泥充填量呈正相关,且以终板前中部为应力集中部位.随着骨水泥填充量的增加,PKP术后相邻椎体骨折概率呈增高趋势.
목적 통과분석후철성형술중불동용적적골수니전충량대상린추체종판응력적영향,탐토후철성형술후상린추체골절발생적가능궤제. 방법 건립흉요단척주골질소송성추체압축골절삼유유한원모형,모의경피후철성형술( percutaneous kyphoplasty,PKP)대추체진행부분복위(80％),분별재골절추체내식입량충제량(4.0 ml전충15％추체용적,8.0 ml전충30％추체용적)골수니진행전충,분석축향압축、전굴화후신삼충정황하상린추체종판응력적변화정황.결과 비교PKP술중량충전충제량하상린추체종판재각충정황하적응력차별,발현T11추체하위종판여L1추체상위종판총체응력균교술전증가,병여골수니충전량정정상관,차응력주요집중재종판전부화중부. 결론 PKP술후상린추체종판응력적증가여골수니충전량정정상관,차이종판전중부위응력집중부위.수착골수니전충량적증가,PKP술후상린추체골절개솔정증고추세.
Objective To analyze the stress contribution of different cement volume to the adjacent vertebral endplates in percutaneous kyphoplasty (PKP) so as to explore the possible mechanism of adjacent vertebral fractures after PKP. Methods The three-dimensional finite element model of osteoporotic thoracolumbar vertebral compression fractures was established to simulate vertebral body partial restoration (80％) with PKP.During the process,two doses of bone cement ( polymethylmethacrylate,PMMA) were filled in the vertebral body (4.0 ml bone cement filling 15％ of the vertebral body volume and 8.0 ml bone cement filling 30％ of the vertebral body volume).Endplate stress under conditions of axial compression,flexion and extension was analyzed. Results Regarding the two filling doses in PKP,the adjacent vertebral endplate stress under the above-mentioned conditions was all increased at T11 and L1 vertebral body compared with that before operation.Meanwhile,endplate stress had positive correlation with the cement volume and the stress concentrated largely in the anterior and middle parts of endplate. Conclusions The stress of adjacent vertebral endplate is positively correlated with cement volume,with anterior and middle parts of endplate as the stress concentration.The probability of adjacent vertebral fractures shows a rising trend with the increase of cement volume in PKP.