CAJ | 학술논문

目的采用有限元法分析一种新型偏心球囊扩张器的生物力学性质,为其临床应用提供依据. 方法基于健康成年男性T12-L1-L2节段CT图像建立胸腰段骨质疏松性椎体压缩性骨折(OVCF)有限元模型.模拟经皮椎体后凸成形术过程,分别建立常规球囊扩张器双侧椎弓根穿刺模型(M1)、常规球囊扩张器单侧椎弓根穿刺模型(M2)及新型偏心球囊扩张器单侧椎弓根穿刺模型(M3).对模型施加260 N的预载荷,附加力为8N·M,在压缩、前屈、后伸、左右侧弯及左右旋转7种工况下计算手术椎体、相邻节段终板和椎间盘、后部结构的应力变化情况. 结果模型M3手术椎体的应力峰值在压缩、后伸、左右旋载荷下较模型M1分别减少20.1％、8.7％、47.1％、41.8％,在前屈、左右侧弯载荷下较模型M1分别增加15.6％、8.1％、4.4％;在压缩、后伸、前屈、左右侧弯载荷下较模型M2增加显著,但在左、右旋载荷下较模型M2减少2.0％、6.8％.3种模型都可以增加相邻节段椎间盘和相邻终板的局部应力,并可使相邻椎体的应力峰值明显增加,模型M3对相邻节段椎间盘及终板的影响介于模型M1、M2之间. 结论新型偏心球囊扩张器较之以往的常规球囊扩张器单侧穿刺能有效恢复骨折椎体的部分生物力学性质,并可能降低对相邻节段的影响,可以作为OVCF治疗的一种选择.
목적 채용유한원법분석일충신형편심구낭확장기적생물역학성질,위기림상응용제공의거. 방법 기우건강성년남성T12-L1-L2절단CT도상건립흉요단골질소송성추체압축성골절(OVCF)유한원모형.모의경피추체후철성형술과정,분별건립상규구낭확장기쌍측추궁근천자모형(M1)、상규구낭확장기단측추궁근천자모형(M2)급신형편심구낭확장기단측추궁근천자모형(M3).대모형시가260 N적예재하,부가력위8N·M,재압축、전굴、후신、좌우측만급좌우선전7충공황하계산수술추체、상린절단종판화추간반、후부결구적응력변화정황. 결과 모형M3수술추체적응력봉치재압축、후신、좌우선재하하교모형M1분별감소20.1％、8.7％、47.1％、41.8％,재전굴、좌우측만재하하교모형M1분별증가15.6％、8.1％、4.4％;재압축、후신、전굴、좌우측만재하하교모형M2증가현저,단재좌、우선재하하교모형M2감소2.0％、6.8％.3충모형도가이증가상린절단추간반화상린종판적국부응력,병가사상린추체적응력봉치명현증가,모형M3대상린절단추간반급종판적영향개우모형M1、M2지간. 결론 신형편심구낭확장기교지이왕적상규구낭확장기단측천자능유효회복골절추체적부분생물역학성질,병가능강저대상린절단적영향,가이작위OVCF치료적일충선택.
Objectives To study the biomechanical performance of a self-designed eccentric balloon dilator used in percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fracture (OVCF) by finite element analysis.Methods We created a three-dimensional finite element model of OVCF (T12-L1-L2) in which bilateral PKP with a normal balloon dilator (M1),unilateral PKP with a normal balloon dilator (M2) and unilateral PKP with a self-designed eccentric balloon dilator (M3) were respectively simulated.The 8 N · m moment with a compressive preload of 260 N was respectively imposed on the superior surface of the T12 vertebral body when it was at flexion,extension,left rotation,right rotation,left lateral bending and right lateral bending.Then the changes in stresses at the operated vertebra,endplate and intervertebral disk of the adjacent segment,and posterior structure were analyzed and compared.Results Compared with M1,the peak stresses of the operated vertebra at compression,extension,left rotation and right rotation in M3 were decreased by respectively 20.1％,8.7％,47.1％ and 41.8％,but increased by15.6％,8.1％ and 4.4％ at flexion,left lateral bending and right lateral bending; compared with M2,the peak stresses of the operated vertebra at compression,extension,flexion,left lateral bending and right lateral bending in M3 were increased significantly,but decreased by 2.0％ and 6.8％ at flexion,left rotation and right rotation.All models increased the local stress at the endplate and intervertebral disk of the adjacent segment,and obviously enhanced the peak stresses at adjacent vertebrae.The effects of M3 on the endplate and intervertebral disk of the adjacent vertebrae were between those of M 1 and M2.Conclusions The self-designed eccentric balloon dilator may have better biomechanical performance than a conventional balloon dilator.It may be an option used in treatment of OVCF in that it can effectively restore partial biomechanical performance of the fractured vertebra and reduce the influence on adjacent segments.