https://scholars.lib.ntu.edu.tw/handle/123456789/464273
標題: | Mechanism of fractures of adjacent and augmented vertebrae following simulated vertebroplasty | 作者: | Wang, J.-L. Chiang, C.-K. Kuo, Y.-W. Chou, W.-K. Yang, B.-D. JAW-LIN WANG |
關鍵字: | Fatigue loading; PMMA bone cement; Vertebral fracture; Vertebroplasty | 公開日期: | 2012 | 卷: | 45 | 期: | 8 | 起(迄)頁: | 1372-1378 | 來源出版物: | Journal of Biomechanics | 摘要: | Percutaneous vertebroplasty (VP) is a minimally invasive procedure that is used to treat osteoporosis-induced vertebral compression fractures (OVCFs). Frequently observed complications are fractures of adjacent and augmented vertebrae. In the present work, mechanisms for these fractures are presented. Fresh 4-level osteoporotic thoracic motion segments were tested. Both ends of the specimen were mounted. The lower level of the free vertebra was compressively fractured and followed by an injection of a 3.5. mL of a PMMA bone cement. Three steps of fatigue loading (5. Hz for 5. h) were incrementally and vertically applied on the specimens from 650. N to 950. N to 1150. N. Specimens of intact, compressively fractured, cement augmented and post-fatigued loading were radiographed for the measurement of deformations of the vertebra, the canal, and the foramen. At the end of fatigue loading, the vertebrae were sliced for micro morphologic analysis. The largest height loss after fatigue loading was at the posterior region of the augmented vertebra. In the augmented vertebra, fissures were found along the bone-cement interface. These fissures split the cement and the trabeculae and propagated into the vertebrae and the endplates. The compactness ratio of the trabeculae region of the adjacent cranial vertebra was higher than that for intact and adjacent caudal ones. We attribute the fracture of the augmented vertebra, following simulated VP, to the initiation of fissures along the cement-bone interface, which, in turn, may be due to uneven deformation of the vertebra. Fracture of the adjacent cranial vertebra is attributed to collapse of its trabeculae. ? 2012 Elsevier Ltd. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/464273 | DOI: | 10.1016/j.jbiomech.2012.03.003 | SDG/關鍵字: | 4-level; Bone-cement interface; Endplates; Fatigue loadings; Minimally invasive; Morphologic analysis; Motion segments; Osteoporotic; Percutaneous vertebroplasty; PMMA bone cement; Vertebral compression; Vertebral fractures; Vertebroplasty; Bone cement; Cements; Deformation; Fracture; Loading; Musculoskeletal system; bone cement; adult; aged; article; compression fracture; controlled study; disease activity; fatigue; female; human; loading test; male; micromorphology; morphological trait; nerve ending; osteoporosis; percutaneous vertebroplasty; priority journal; trabecular bone; vertebra body; vertebra fracture; Adult; Aged; Aged, 80 and over; Elastic Modulus; Female; Humans; Male; Middle Aged; Osteoporotic Fractures; Tensile Strength; Thoracic Vertebrae; Vertebroplasty; Weight-Bearing |
顯示於: | 醫學工程學研究所 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。