PDF(Pubmed)
Abstract：
BACKGROUND: Osteoporosis vertebral compression fracture (OVCF) secondary to osteoporosis is a common health problem in the elderly population. Vertebral augmentation (VA) has been widely used as a minimally invasive surgical method. The transpedicle approach is commonly used for VA puncture, but sometimes, it is limited by the anatomy of the vertebral body and can not achieve good surgical results. Therefore, we propose the treatment of OVCF with precise puncture vertebral augmentation (PPVA). This study used finite element analysis to explore the biomechanical properties of PPVA in the treatment of osteoporotic vertebral compression fractures (OVCFs) with wedge, biconcave, and collapse deformities.
METHODS: Three-dimensional finite element models of the fractured vertebral body and adjacent superior and inferior vertebral bodies were established using Computed Tomography (CT) data from patients with OVCF, both before and after surgery. Evaluate the stress changes of the wedged deformed vertebral body, biconcave deformed vertebral body, collapsed deformed vertebral body, and adjacent vertebral bodies before and after PPVA.
RESULTS: In vertebral bodies with wedge deformity and collapsed deformity, PPVA can effectively reduce the stress on the vertebral body but increases the stress on the vertebral body with biconcave deformity. PPVA significantly decreases the stress on the adjacent vertebral bodies of the wedge deformed vertebral body, and decreases the stress on the adjacent superior vertebral body of biconcave deformity and collapsed deformed vertebral bodies, but increases the stress on the adjacent inferior vertebral bodies. PPVA improves the stress distribution of the vertebral body and prevents high-stress areas from being concentrated on one side of the vertebral body.
CONCLUSIONS: PPVA has shown positive surgical outcomes in treating wedge deformed and collapsed deformed vertebral bodies. However, its effectiveness in treating biconcave vertebral body is limited. Furthermore, PPVA has demonstrated favorable results in addressing adjacent superior vertebral body in three types of fractures.
METHODS: Three-dimensional finite element models of the fractured vertebral body and adjacent superior and inferior vertebral bodies were established using Computed Tomography (CT) data from patients with OVCF, both before and after surgery. Evaluate the stress changes of the wedged deformed vertebral body, biconcave deformed vertebral body, collapsed deformed vertebral body, and adjacent vertebral bodies before and after PPVA.
RESULTS: In vertebral bodies with wedge deformity and collapsed deformity, PPVA can effectively reduce the stress on the vertebral body but increases the stress on the vertebral body with biconcave deformity. PPVA significantly decreases the stress on the adjacent vertebral bodies of the wedge deformed vertebral body, and decreases the stress on the adjacent superior vertebral body of biconcave deformity and collapsed deformed vertebral bodies, but increases the stress on the adjacent inferior vertebral bodies. PPVA improves the stress distribution of the vertebral body and prevents high-stress areas from being concentrated on one side of the vertebral body.
CONCLUSIONS: PPVA has shown positive surgical outcomes in treating wedge deformed and collapsed deformed vertebral bodies. However, its effectiveness in treating biconcave vertebral body is limited. Furthermore, PPVA has demonstrated favorable results in addressing adjacent superior vertebral body in three types of fractures.
摘要：
背景：骨质疏松性椎体压缩性骨折（OVCF）是老年人群常见的健康问题。椎体增强术(VA)作为一种微创手术方法已被广泛使用。经椎弓根入路通常用于VA穿刺，但有时候,它受到椎体解剖结构的限制，不能达到良好的手术效果。因此,我们建议通过精确穿刺椎体增强术（PPVA）治疗OVCF。本研究采用有限元分析探讨PPVA在楔形骨质疏松性椎体压缩骨折(OVCFs)治疗中的生物力学特性,双洞穴,和塌陷畸形。
方法：使用OVCF患者的计算机断层扫描（CT）数据，建立了骨折椎体和邻近的上下椎体的三维有限元模型，手术前和手术后。评估楔形变形椎体的应力变化，双凹变形椎体，塌陷的变形椎体，PPVA前后相邻椎体。
结果：在楔形畸形和塌陷畸形的椎体中，PPVA能有效降低椎体的应力，但增加了双凹畸形椎体的应力。PPVA显著降低楔形变形椎体对邻近椎体的应力，并降低双凹畸形和塌陷变形椎体对相邻上椎体的应力，但增加了相邻下椎体的应力。PPVA改善了椎体的应力分布，并防止高应力区域集中在椎体的一侧。
结论：PPVA在治疗楔形变形和塌陷变形椎体方面显示出积极的手术效果。然而,其治疗双凹椎体的有效性是有限的。此外，PPVA在解决三种类型骨折中的相邻上椎体方面已显示出良好的结果。
方法：使用OVCF患者的计算机断层扫描（CT）数据，建立了骨折椎体和邻近的上下椎体的三维有限元模型，手术前和手术后。评估楔形变形椎体的应力变化，双凹变形椎体，塌陷的变形椎体，PPVA前后相邻椎体。
结果：在楔形畸形和塌陷畸形的椎体中，PPVA能有效降低椎体的应力，但增加了双凹畸形椎体的应力。PPVA显著降低楔形变形椎体对邻近椎体的应力，并降低双凹畸形和塌陷变形椎体对相邻上椎体的应力，但增加了相邻下椎体的应力。PPVA改善了椎体的应力分布，并防止高应力区域集中在椎体的一侧。
结论：PPVA在治疗楔形变形和塌陷变形椎体方面显示出积极的手术效果。然而,其治疗双凹椎体的有效性是有限的。此外，PPVA在解决三种类型骨折中的相邻上椎体方面已显示出良好的结果。
