在正常和骨质疏松条件下对不同变形形腰椎体融合结构的生物力学评估:有限元分析
Chen Liu1, Mengmeng Zhao2, Wencan Zhang1
1Department of Orthopedics, Qilu Hospital of Shandong University, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250012, P.R. China.
概括
对于经历腰部融合的骨质疏松症患者,混合皮质骨轨迹 (CBT-TT) 螺丝固定提供了比传统方法更好的强度. 这种方法提高了稳定性,并减少了骨质疏松性骨的压力,为脊柱手术提供了可行的替代方案.
科学领域:
- 脊柱外科手术 脊柱外科手术
- 生物机械分析分析
- 骨质疏松症的研究研究.
背景情况:
- 骨质疏松症在腰部手术中是一个重大挑战,原因是骨质不佳,导致融合和内部固定稳定性受到损害.
- 老年患者经常患有骨质疏松症,因此手术耐受性降低,进一步复杂化脊柱手术.
研究的目的:
- 为了在不同的骨矿物密度条件下比较传统轨迹 (TT-TT),皮质骨轨迹 (CBT-CBT) 和混合CBT-TT螺丝结构的固定强度.
- 在模拟骨质疏松性腰椎模型中评估不同螺丝固定方法的生物力学性能.
主要方法:
- 用有限元分析 (FE) 建模了一个健康的成年腰椎.
- 在正常和骨质疏松性骨条件下,创建了三种跨腰椎体融合 (TLIF) 模型 (TT-TT,CBT-CBT,CBT-TT).
- 模拟生理负载 (压缩,扭矩) 被应用来评估运动范围 (ROM),相邻的磁盘应力,子应力和后部固定应力.
主要成果:
- 骨质疏松症增加了ROM,相邻的磁盘应力,子应力和后部固定应力,与正常骨状况相比.
- 在正常骨密度下,TT-TT固定显示了最低的ROM和应力.
- 在骨质疏松症条件下,CBT-CBT和CBT-TT结构与TT-TT相比显示出更高的固定强度和较低的子和固定系统压力.
结论:
- 虽然TTTT固定在正常骨中提供最佳的生物力学稳定性,但CBT-CBT和CBT-TT结构在骨质疏松性骨中提供了优越的固定强度.
- 混合CBT-TT结构呈现了一个有前途的替代固定方法,在骨质疏松患者中平衡最小的创伤与增强的固定强度.
- 这项研究支持在骨质疏松症患者的TLIF手术中使用混合CBT-TT结构的临床应用.
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