有限元法探究骨质疏松患者在不同内固定方式下的稳定性
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摘要
随着社会人口老龄化程度逐渐加重,骨质疏松症和骨质疏松性骨折发病率不断上升,脊柱骨折是最常见的骨质疏松性骨折,在开放手术治疗中,椎弓根螺钉固定是椎体骨质疏松性骨折患者手术的常用方法,借助三维重建有限元模型的方法进行生物力学分析,为手术方式提供了一种重要的思路,本文提出了基于CT医学图像,借助医学图像处理软件Mimics建立了骨质疏松病人T7-T9胸椎段的3D模型,并建立了相应的椎间盘及韧带等软组织,在一定的载荷和边界条件下,运用ABAQUS软件进行有限元求解.对椎弓根钉穿破椎体前部皮质骨置钉的内固定方式的稳定性采用有限元的方法加以验证,对于该种内固定方式在临床中的应用具有拓展意义和实际的指导意义.
With the aging of the social population, the incidence of osteoporosis and osteoporotic fractures continues to rise, and spinal fracture has become the most common osteoporotic fracture. In open surgical treatment, pedicle screw fixation is a common method for surgery in patients with vertebral osteoporotic fractures. The use of finite element method for biomechanical analysis of the model can provide an important idea for the surgical approach. In this paper, based on CT medical images and the medical image processing software Mimics, the 3 D model of the thoracic segment of T7-T9 in patients with osteoporosis and the corresponding soft tissues such as intervertebral disc and ligament were established. Then we used finite element analysis software Abaqus to analyze the model under certain download pressure and boundary conditions. The stability of the internal fixation of the pedicle screw in the anterior cortical bone of the pedicle screw was verified. It has significance in guiding and extending the application of the internal fixation method in clinical practice.
With the aging of the social population, the incidence of osteoporosis and osteoporotic fractures continues to rise, and spinal fracture has become the most common osteoporotic fracture. In open surgical treatment, pedicle screw fixation is a common method for surgery in patients with vertebral osteoporotic fractures. The use of finite element method for biomechanical analysis of the model can provide an important idea for the surgical approach. In this paper, based on CT medical images and the medical image processing software Mimics, the 3 D model of the thoracic segment of T7-T9 in patients with osteoporosis and the corresponding soft tissues such as intervertebral disc and ligament were established. Then we used finite element analysis software Abaqus to analyze the model under certain download pressure and boundary conditions. The stability of the internal fixation of the pedicle screw in the anterior cortical bone of the pedicle screw was verified. It has significance in guiding and extending the application of the internal fixation method in clinical practice.
引文
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[9]朴俊红,庞莲萍,刘忠厚,等.中国人口状况及原发性骨质疏松症诊断标准和发生率[J].中国骨质疏松杂志,2002,8(1):1-7.
[10]王鹏,王静成,冯新民,等.胸腰椎骨折术后伤椎上终板骨缺损的生物力学有限元分析[J].中国现代医学杂志,2017(7):72-79.
[11]吴建军.Sextant微创椎弓根螺钉内固定修复老年骨质疏松性脊柱骨折的生物相容性[J].中国组织工程研究,2016,20(31):4603-4609.
[12]王健,李凯,陈博,等.胸腰椎体压缩性骨折三维有限元模型的建立和分析[J].中国矫形外科杂志,2016,24(16):1498-1503.
[2]Seriolo B,Paolino S,Casabella A,et al.Osteoporosis in the elderly[J].Aging Clinical and Experimental Research,2013,25:27-29.
[3]陈蕃.21世纪老龄问题研究[M].北京:宇航出版社,1993.
[4]中华人民共和国国家统计局.中国统计年鉴[M].北京:中国统计出版社,2015.
[5]贺丽英,孙蕴,要文娟,等.2010-2016年中国老年人骨质疏松症患病率Meta分析[J].中国骨质疏松杂志,2016,22(12):1590-1596.
[6]邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南:骨质疏松性骨折诊断及治疗原则[J/CD].中华关节外科杂志:电子版,2015,9(6):795-798.
[7]Brasiliense L B,Lazaro B C,Reyes P M,et al.Characteristics of immediate and fatigue strength of a dual-threaded pedicle screw in cadaveric spines[J].Spine Journal,2013,13(8):947-956.
[8]Ambati D V,Wright E K,Lehman R A,et al.Bilateral pedicle screw fixation provides superior biomechanical stability in transforaminal lumbar interbody fusion:A finite element study[J].Spine Journal,2015,15(8):1812-1822.
[9]朴俊红,庞莲萍,刘忠厚,等.中国人口状况及原发性骨质疏松症诊断标准和发生率[J].中国骨质疏松杂志,2002,8(1):1-7.
[10]王鹏,王静成,冯新民,等.胸腰椎骨折术后伤椎上终板骨缺损的生物力学有限元分析[J].中国现代医学杂志,2017(7):72-79.
[11]吴建军.Sextant微创椎弓根螺钉内固定修复老年骨质疏松性脊柱骨折的生物相容性[J].中国组织工程研究,2016,20(31):4603-4609.
[12]王健,李凯,陈博,等.胸腰椎体压缩性骨折三维有限元模型的建立和分析[J].中国矫形外科杂志,2016,24(16):1498-1503.