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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:

期数:

2024年04期

页码:

243-250

栏目:

综述

出版日期:

2024-08-05

文章信息/Info

Title:

Biomechanical characteristics of lumbar trabecular bone and its application in the treatment of osteoporotic fractures

作者:

李彦霖1; 2; 3; 4; 王海程2; 3; 4; 权元元2; 3; 4; 5; 张一凡2; 3; 4; 陈伟2; 3; 4

300450 天津市，天津市滨海新区中医医院康复科1；050001 石家庄，河北省骨科研究所2；河北省骨科生物力学重点实验室3，河北医科大学第三医院创伤急救中心4；041000 临汾，临汾职业技术学院医学系5

Author(s):

Li Yanlin1;  2;  3;  4;  Wang Haicheng2;  3;  4;  Quan Yuanyuan2;  3;  4;  5;  Zhang Yifan2;  3;  4;  Chen Wei2;  3;  4.

1Department of Rehabilitation, Binhai New Area Hospital of Traditional Chinese Medicine, Tianjin 300450, China; 2Orthopedic Research Institution of Hebei Province, 3Key Laboratory of Biomechanics of Hebei Province, 4Department of Orthopaedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang 050051, China; 5Department of Medicine, Linfen Vocational and Technical College, Linfen 041000, China

关键词:

骨小梁;  松质骨;  微结构;  骨质疏松骨折;  生物力学

Keywords:

Bone trabeculae;  Cancellous bone;  Microstructure;  Osteoporosis fractures;  Biomechanics

DOI:

10.3877/cma.j.issn.2096-0263.2024.04.008

文献标志码:

A

摘要:

伴随中国社会的进步及人口老龄化加剧，骨质疏松性骨折快速增多。文章详细探讨了骨小梁生物力学及其在椎体骨质疏松骨折治疗中的应用。椎体是骨质疏松骨折最常见的部位，其主要由松质骨构成。文章首先介绍了椎体松质骨的宏观结构和生物力学特性。而后介绍了骨小梁的微结构参数对骨小梁的形态特征及力学性质的重要作用。重点介绍了常用于定量描述骨小梁微结构的三维形态学参数，及骨小梁异质性、在空间上的连接方向、年龄增长、性别对其力学性质的影响。继而介绍骨质疏松性腰椎压缩骨折的传统诊断及创新诊断方式。在治疗方面，文章概述了现如今应用于临床的多种治疗骨质疏松性骨折术式的优缺点，包括椎体成形术、椎体融合术和经皮椎弓根钉内固定术等。最后介绍了新兴技术3D打印在脊柱手术中的创新应用，如使用3D打印多孔金属内植物和仿生内固定物。未来将3D打印技术与传统治疗方法相结合，可以达到更好的治疗效果和提高生活质量。

Abstract:

With the progress of Chinese society and the intensification of population aging, osteoporotic fractures are rapidly increasing. The article discusses in detail the biomechanics of trabeculae and its application in the treatment of vertebral osteoporotic fractures. The vertebral body is the most common site of osteoporotic fractures, mainly composed of trabecular bone. The article first introduces the macroscopic structure and biomechanical properties of vertebral trabecular bone. Then, the important role of microstructure parameters of bone trabeculae in the morphological characteristics and mechanical properties of bone trabeculae was introduced. The focus is on the three-dimensional morphological parameters commonly used to quantitatively describe the microstructure of bone trabeculae, as well as the effects of bone trabecular heterogeneity, spatial connectivity direction, age growth, and gender on their mechanical properties. Subsequently, traditional and innovative diagnostic methods for osteoporotic lumbar vertebral compression fractures will be introduced. In terms of treatment, the article provides an overview of the advantages and disadvantages of various clinical treatments for osteoporotic fractures, including vertebroplasty, vertebral fusion, and percutaneous pedicle screw fixation. Finally, the innovative application of emerging technology 3D printing in spinal surgery was introduced, such as the use of 3D printing porous metal implants and biomimetic internal fixation devices. Combining 3D printing technology with traditional treatment methods can achieve better therapeutic effects and improve quality of life.

备注/Memo

备注/Memo:

基金项目：国家自然科学基金面上项目（82072447）；河北省自然科学基金杰出青年项目（H2021206329）

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更新日期/Last Update: 2024-10-12