中国医学装备2025，Vol.22Issue(3)：29-36,42,9.DOI:10.3969/j.issn.1672-8270.2025.03.006
胸椎骨质疏松性压缩骨折经皮椎体成形术中骨水泥渗漏致邻椎骨折风险的有限元分析
FEA on the risk of adjacent vertebral fractures caused by leakage of bone cement in PKP for thoracic vertebra OVCF
摘要
Abstract
Objective:To research the change of adjacent vertebral stress and the risk of adjacent vertebral fracture after the front upper bone cement of vertebra occurred leakage when patients with osteoporotic vertebral compression fracture(OVCF)on thoracic vertebra underwent percutaneous kyphoplasty(PKP)by using finite element analysis(FEA).Methods:The data of a 82 years old female patient with OVCK on thoracic vertebra who admitted to the Affiliated Hospital of Jinan Central Hospital Affiliated to Shandong First Medical University from May to September 2023 were collected.The patient occurred fracture at the thoracic 10(T10)vertebra.During the progress of PKP treatment,the front upper bone cement occurred leakage,followed by a subsequent fracture occurred at the adjacent T9 vertebra,and the magnetic resonance imaging(MRI)revealed abnormal signals at the front lower region of T9,which closed to the leakage site of bone cement.The pre-and postoperative computed tomography(CT)images were respectively used to construct three groups of models by using Mimics 21.0,Geomagic Studio 2014 and HyperMesh 14.0 software,which were preoperative model group,postoperative model group with leakage of bone cement,and postoperative model group without leakage of bone cement.The three groups of models were optimized by using MSC.Patran 2019 and MSC.Nastran 2019 software.The suffered stresses of adjacent vertebra of fracture and the relevant vertebras with the leakage of bone cement,and the difference of them under 7 kinds of situations,which included upright,forward bending,backward extension,left and right lateral bending,and left and right rotation,were compared and analyzed.Results:The overall stresses on adjacent vertebra of the fixed forming segment by bone cement,endplates and intervertebral discs of PKP postoperative model group with leakage of bone cement were all higher than those of postoperative model group without leakage of bone cement,and were higher than PKP preoperative model group.The increased amount of stress in PKP postoperative model group with leakage of bone cement were respectively 29.61%-110.81%,7.11%-166.01%,and 51.49%-123.88%on T9,T10 and T11 vertebras,which were significantly higher than those of postoperative model group without leakage of bone cement.Among of them,the increased amount of the stress of T9 vertebra under forward bending,backward extension,left and right rotation,and that of the stress of T10 vertebra under left and right rotation,and that of the stress of T11 vertebra under forward bending,left lateral bending,and left and right rotation were significant.The increased amount of the stress of the corresponding adjacent endplates and adjacent intervertebral discs in postoperative model group with leakage of bone cement were significantly higher than those in postoperative model group without leakage of bone cement.Among of them,the increased amount of T9 lower endplate under upright,forward bending,backward extension,and left and right rotation,T10 upper endplate under left lateral bending,and left and right rotation,T10 lower endplate under right rotation,T9-T10 intervertebral discs under forward bending,and left and right rotation,T10-T11 intervertebral discs under upright,left lateral bending,and right rotation were more obviously.Conclusion:The leakage of front upper bone cement during PKP can lead to the change of the adjacent vertebra on biomechanics,and the change of suffered stress,which might increase the risk of occurring fracture on adjacent vertebra.In clinical PKP surgery,it is important to reduce incidence of the leakage of bone cement.关键词
胸椎骨质疏松性压缩骨折/经皮穿刺脊柱后凸成形术/骨水泥渗漏/有限元分析Key words
Osteoporotic vertebral compression fracture(OVCF)of thoracic vertebra/Percutaneous kyphoplasty(PKP)/Leakage of bone cement/Finite element analysis(FEA)分类
医药卫生引用本文复制引用
张高翔,张庆国..胸椎骨质疏松性压缩骨折经皮椎体成形术中骨水泥渗漏致邻椎骨折风险的有限元分析[J].中国医学装备,2025,22(3):29-36,42,9.基金项目
国家自然科学基金面上项目(82274553) （82274553）
山东省医药卫生科技发展计划(202104070847) National Natural Science Foundation of China(82274553) （202104070847）
Shandong Provincial Medical and Health Science and Technology Development Program(202104070847) （202104070847）
