Biomechanical analysis of a novel height-adjustable nano-hydroxyapatite/polyamide-66 vertebral body: a finite element study
Biomechanical analysis of a novel height-adjustable nano-hydroxyapatite/polyamide-66 vertebral body: a finite element study
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DOI：
10.1186/s13018-019-1432-2
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发表时间：
2019-11-14
影响因子：
2.6
通讯作者：
Liu, Tielong
中科院分区：
文献类型：
--
作者：
Chen, Guanghui;Xin, Baoquan;Liu, Tielong
目的比较新型高度可调纳米羟基磷灰石/聚酰胺66椎体（HAVB）与钛网笼（TMC）、人工椎体（AVB）的生物力学性能，评价其重建脊柱稳定性的生物力学效果。方法建立完整L1骶骨的三维非线性有限元模型并进行验证。建立了三个有限元模型，分别植入HAVB、TMC和AVB进行手术模拟。在3D运动中对三个FE模型施加7.5 Nm的纯力矩和400 N的预载荷。记录每个假体和界面终板上的峰值von Mises应力用于分析。此外，研究了每个模型的整体和节段间活动范围（ROM），以评估每个模型在脊柱稳定性重建中的有效性。结果AVB在所有运动中的应力集中最大，是TMC和HAVB的25.6-101.8倍，是TMC的0.8-8.1倍。HAVB的峰值应力为TMC的3.1-10.3%，AVB的1.6-3.9%。三种FE模型之间L2尾侧和L4颅侧终板上的最大应力值不同：在HAVB、TMC和AVB中，L2尾侧终板是完整模型的0.9-1.9、1.3-12.1和31.3-117.9倍，L4颅侧终板是完整模型的0.9-3.5、7.2-31.5和10.3-56.4倍，而三种模型的整体和节段ROM减少相似，AVB在所有载荷条件下提供了相对较高的ROM减少（整体ROM为完整模型的88.1-84.7%，L1/2为69.5-82.1%，L2/4为87.0-91.7%，L4/5为71.1-87.2%）。结论HAVB重建脊柱稳定性的生物力学效果与TMC和AVB相似。HAVB所用材料和解剖设计有助于避免应力集中和应力遮挡效应，从而大大减少植入相关并发症。HAVB表现出一些优于TMC和AVB的生物力学特性，可能被证明是脊柱稳定性重建的潜在可行选择。进一步的体内和体外研究仍然需要验证我们的发现和结论。
Background To compare the biomechanical properties of a novel height-adjustable nano-hydroxyapatite/polyamide-66 vertebral body (HAVB) with the titanium mesh cage (TMC) and artificial vertebral body (AVB), and evaluate its biomechanical efficacy in spinal stability reconstruction. Methods A 3D nonliner FE model of the intact L1-sacrum was established and validated. Three FE models which instrumented HAVB, TMC, and AVB were constructed for surgical simulation. A pure moment of 7.5 Nm and a 400-N preload were applied to the three FE models in 3D motion. The peak von Mises stress upon each prosthesis and the interfaced endplate was recorded for analysis. In addition, the overall and intersegmental range of motion (ROM) of each model was investigated to assess the efficacy of each model in spinal stability reconstruction. Results AVB had the greatest stress concentration compared with TMC and HAVB in all motions (25.6-101.8 times of HAVB, 0.8-8.1 times of TMC). The peak stress on HAVB was 3.1-10.3% of TMC and 1.6-3.9% of AVB. The maximum stress values on L2 caudal and L4 cranial endplates are different between the three FE models: 0.9-1.9, 1.3-12.1, and 31.3-117.9 times of the intact model on L2 caudal endplates and 0.9-3.5, 7.2-31.5, and 10.3-56.4 times of the intact model on L4 cranial endplates in HAVB, TMC, and AVB, respectively, while the overall and segmental ROM reduction was similar between the three models, with AVB providing a relatively higher ROM reduction in all loading conditions (88.1-84.7% of intact model for overall ROM and 69.5-82.1% for L1/2, 87.0-91.7% for L2/4, and 71.1-87.2% for L4/5, respectively). Conclusions HAVB had similar biomechanical efficacy in spinal stability reconstruction as compared with TMC and AVB. The material used and the anatomic design of HAVB can help avoid stress concentration and the stress shielding effect, thus greatly reducing the implant-associated complications. HAVB exhibited some advantageous biomechanical properties over TMC and AVB and may prove to be a potentially viable option for spinal stability reconstruction. Further in vivo and vitro studies are still required to validate our findings and conclusions.