【摘要】 [目的]探讨经皮椎体成形术后脊柱矢状面参数变化。[方法]选取1例68岁脊柱矢状面形态为Roussouly分型Ⅱ型的L₁椎体骨质疏松性骨折的男性志愿者,全脊柱CT扫描,数据经处理建立胸腰椎和骨盆的三维模型,分别建立正常对照、轻度后凸和中度后凸的三维有限元模型,测量计算脊柱在肌力正常和肌力减小工况下各椎体的应力变化。[结果] SVA值轻度后凸模型为54.27 mm,中度后凸模型为81.37 mm。T_5～9各椎体的Mises应力均依次为:对照模型<轻度后凸模型<中度后凸模型（P<0.05）。肌力正常组,三种模型椎体Von Mises应力自T_5～9依次显著增大（P<0.05）;肌力减小组中,T₇的Von Mises应力显著大于T₅、T₆、T₈、T₉椎体（P<0.05）。肌力减小组中T₇的Von Mises应力显著大于肌力正常组（P<0.05）。L₁椎体的Mises应力显著大于L_2-5椎体的Mises应力（P<0.05）,并且中度后凸模型显著大于轻度后凸模型和对照模型（P<0.05）。肌力正常组的L_2～5椎体的Mises显著小于肌力减小组（P<0.05）。[结论]PKP术后残存的后凸畸形会导致脊柱矢状面偏移增加,引发非相邻椎体的应力集中。更多还原

【Abstract】 [Objective] To explore the variations in sagittal plane secondary to percutaneous kyphoplasty（PKP）. [Methods]A 68-year-old male who underwent PKP for Roussouly type Ⅱ osteoporotic fracture of L₁ received total spine CT scanning. After data processing, the 3 D models of thoracolumbar and pelvis were created. After that, finite element models of normal control,mild and moderate kyphosis were established respectively to measure the stress on each vertebral body under compensatory and decompensated conditions. [Results] The deviation to SVA was of 54.27 mm in the mild kyphosis, whereas 81.37 mm in the moderate kyphosis. In compensatory and decompensated conditions, the Von Mises stresses on the T₅ to T₉ ranked in sequences of the control model < the mild kyphosis < the moderate kyphosis（P<0.05）. The Von Mises stresses significantly increased from T₅ to T₉ in compensatory condition（P<0.05）, whereas were the greatest on T₇ compared with those on T₅, T₆, T₈ and T₉ vertebral bodies in decompensated condition（P<0.05）. Compared between two conditions, the Von Mises stress on T₇ was significantly greater in decompensated conditions than those in compensatory condition（P<0.05）. With respect to lumbar spine, the L₁ had significantly greater stress compared with those in the L₂ to L₅ in compensatory and decompensated conditions（P<0.05）. The stresses in moderate kyphosis were significantly greater than those in the control and mild kyphosis（P<0.05）, which also were greater in decompensated condition from L₂ to L₅ than those in compensatory condition（P<0.05）. [Conclusion] The residual kyphosis after PKP lead to the increase of deviation in sagittal plane, which cause the stress concentration on non-adjacent vertebrae.更多还原