Biomechanical effects of vertebroplasty on thoracolumbar burst fracture with transpedicular fixation: A finite element model analysis
Biomechanical effects of vertebroplasty on thoracolumbar burst fracture with transpedicular fixation: A finite element model analysis
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DOI：
10.1016/j.otsr.2014.03.016
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发表时间：
2014-06-01
影响因子：
2.3
通讯作者：
Ma, X.
中科院分区：
文献类型：
--
作者：
Xu, G.;Fu, X.;Ma, X.
目的：目的：探讨后路内固定术后骨折椎体强化的生物力学效应。方法：模拟内固定加骨水泥强化，建立8个T11-L1功能性脊柱连接的三维有限元模型。根据Denis骨折分类法建立了两种模拟不同骨折严重程度的模型。在复位后使用通用脊柱系统进行后路固定，然后使用骨水泥进行增强。这些模型假设三柱载荷配置如下：压缩、前屈、伸展、侧屈和轴向旋转。结果：对于严重骨折的模型，在垂直压缩和其他载荷条件下，加固明显降低了von Mises应力，棒降低了50%，螺钉降低了40%，T11的下终板降低了约40%，L1的上级终板降低了50%。我们应该只应用椎体成形术，以防止矫正丢失和植入物失效，这是基于这样一个事实，即当椎体严重骨折时，它可以显着降低器械和脊柱的应力。证据等级：IV级，生物力学研究。(C)2014年Elsevier Masson SAS。All rights reserved.
Objective: To investigate the biomechanical effects of augmentation of the fractured vertebrae after posterior instrumentation.Methods: By simulating internal fixation plus augmentation with cement, eight tridimensional, anatomically detailed finite element models of the T11-L1 functional spinal junction were developed. Two kinds of models for mimicking different severity of the fracture were established according to the Denis' classification. Augmentation with cement was conducted after reduction with posterior fixation using a universal spine system. These models assumed a three-column loading configuration as follows: compression, anteflexion, extension, lateroflexion and axial rotation. Stress of the implants and spine was evaluated.Results: Data showed that for severely fractured models, augmentation apparently decreased the von Mises stresses by 50% for the rods and 40% for the screws, about 40% for the inferior endplate of T11, and 50% for the superior endplate of Ll in vertical compression and other load situations.Conclusion: We should only apply vertebroplasty to prevent correction loss and implants failure based on the fact that it could significantly decrease stress of the instrumentations and spine when the vertebrae are severely fractured. Level of evidence: Level IV, biomechanical study. (C) 2014 Elsevier Masson SAS. All rights reserved.