Please use this identifier to cite or link to this item: http://hdl.handle.net/11455/1902
標題: 實驗佐證脊椎運動骨節內的破裂以及崩潰現象之研究
The Study of Fracture and Failure in the Spinal Motion Segments by Experiments
作者: 洪國恩
Hong, Guo-En
關鍵字: vertebroplasty;椎體成形術;bone cement;biomechanics;骨水泥;生物力學
出版社: 機械工程學系所
引用: [1] 江林月嬌,常見的十種老人病,取自:愛網:http://www.julia4christ.org/Healthy/JHolder10.html [2] 楊雅婷譯,“梅約醫學中心:骨質疏鬆症”,天下雜誌, 2004 [3] 蔡樹濤,“骨質疏鬆症”,林郁工作室,2005: 51-52 [4] Fulmer MT, Ison IC, Hankermayer CR, Measurements of thesolubilities and dissolution rates of several hydroxyapatities. Biomaterials 2002; 23: 751-754 [5] Seeherman HJ, Bouxsien M, Kim H, Recombinant human bone morphogenetic protein-2 delivered in an injectable calcium phosphate paste accelerates osteotomy-site healing in a nonhuman primate model. J Bone Joint Surg Am 2004; 86: 1961-1972 [6] Su WY, Lin FH, Gentamicin loaded α-TCP/HAP Biphasic Calicium phosphate bone cement as drug delivery system for osteomyelitis. 2001 [7] Jensen ME, Evans AJ, Mathis JM, et al. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures:technical aspects. American society of neuroradiology. 1997; 18: 1897-1904 [8] Kopperdahl DL, Keaveny TM, Yield strain behavior of trabecular bone. J Biomech 1998; 31: 601-608 [9] Deramond H, Depriester C, Galibert P, Gars DL. Percutaneous vertebroplasty with polymethylmethacrylate. International procedures in musculoskeletal radiology. 1998; 36(3): 533-546 [10] Tohmeh A, Mathis JM, Fenton DC, Levine AM, Bekloff SM. Biomechanical efficacy of unipedicular versus bipedicular vertebroplasty for management of osteoporotic compression fractures. Spine 1999; 24(17): 1772-1776 [11] Martin JB, Jean B, Sugiu K, Point M, Murphy K, Muster M. Vertebroplasty : Clinical experience and follow-up results. Bone 1999; 25(2), 11s-15s [12] Cyteval C, Sarrabere PB, Roux O, et al. Acute osteoporotic vertebral collapse: open study on percutaneous injection of acrylic surgical cement in 20 patients. American Roentgen Ray Society . 1999: 1685-1690 [13] Barr JD, Barr MS, Lemley TJ, Percutaneous vertebroplasty for pain relief and spinal stabilization. Spine 2000; 25(8): 623-928 [14] Belkoff SM, Mathis JM, Jasper LE, Deramomd H. The effect of cement volume on mechanical behavior. Spine 2001; 26(14): 1537-1541 [15] Lieberman IH, Dudeney S, Reinhardt MK, Bell G, Initial outcome and efficacy of Kyphoplasty in the treatment of painful osteoporotic vertebral compression fractures. Spine 2001; 26(14): 1631-1638 [16] Garfin SR, Yuan HA, Reiley MA. Kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures. Spine 2001; 26(14): 1511-1515 [17] Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty. Spine 2001; 26(14): 1547-1554 [18] Berlemann U, Ferguson SJ, Nolte LP, Heini PF. Adjacent vertebral failure after vertebroplasty. A biomechanical investigation. Journal of Bone & Joint Surgery – British Volume 2002 Jul; 84(5): 748-52 [19] Theodorou DJ, Theodorou SJ, Duncan TD, Garfin SR, Wong WH, Percutaneous balloon kyphoplasty for the correction of spinal deformity in painful vertebral body compression fractures. Clinical Imaging 2002; 26(1):1-5 [20] Verlaan JJ, Oner FC, Verbout AJ, Dhert JA, Temperature Elevation after Vertebroplasty with Polymethyl-Methacrylate in the Goat Spine. Journal of Biomedical Materials Research - Part B Applied Biomaterials 2003; 67(1): 581-585 [21] Chen ZL, Chen TY, Comparison of effect of vetebroplasty assisted with different volume of autosetting calcium phosphate cement. Journal of Medical Sciences 2004; 31(3): 263-266 [22] Komemushi A, Tanigawa N, Kariya S, Kojima H, Shomura Y, Sawada S, Percutaneous vertebroplasty for compression fracture: Analysis of vertebral body volume by CT volumetry 2005; 46(3): 276-279 [23] Baroud G, Vant C, Wilcox R, Long-term effects of vertebroplasty: Adjacent vertebral fractures. Journal of Long-Term Effects of Medical Implants 2006; 16(4): 265-280 [24] Jonsson K, Kyphoplasty and vertebroplasty. Acta Radiologica 2006; 47(8): 759 [25] Koh YH, Han D, Cha JH, Seong CK, Kim J, Choi YH, Vertebroplasty: Magnetic resonance findings related to cement leakage risk. Acta Radiologica 2007; 48(3): 315-320 [26] Lewis G, Percutaneous vertebroplasty and kyphoplasty for the stand-alone augmentation of osteoporosis-induced vertebral compression fractures: Present status and future directions. Journal of Biomedical Materials Research - Part B Applied Biomaterials 2007; 81(2): 371-386 [27] Cinotti G, Rocca CD, Romeo S, Vittur F, Toffanin R, Trasimeni G. Degeneration changes of porcine intervertebral disc include by vertebral endplate injuries. Spine 2005; 30(2): 174-180 [28] Marieb EN, Mallatt J. Human anatomy 2nd edition, Benjamin and Cummings. 1996 [29] Radin EL, Simon SR, Rose RM, Paul LL. Practical Biomechanics for the Orthopaedic Surgeon. New York: Wiley & Sons, Inc., 1978. [30] Kieth L. Moore, Arthur F. Dalley, “Clinical oriented Anatomy 4th edition”, 1999 [31] Kieth L. Moore, Anne M. R. Agur, “Essential clinical anatomy”, Williams & Wilkins 1998 [32] Holmes AD and Hukins DWL, Analysis of load-relaxation in compressed segments of lumbar spine. Medical Engineer & Physics 1996; 18(2): 99-104 [33] Gerard JT, “Principle of Human Anatomy”, Harper Collins College Publishers 2000: 137 [34] Hall SJ, “Basic biomechanics 2nd edition”, Brown and Benchma. 1995 [35] Margareta Nordin, Victor H. Frankel, “Basic biomechanics of the Musculoskeletal System 3rd edition”, 2001 [36] Stoke IAF, “Mechanical function of facet joints in the lumbar spine” Clin Biomech 1988; 3(2): 101-105 [37] Botsford DJ, Esses SI, Ogilivie-Harris DJ,“In-vivo diurnal variation in intervertebral disc volume and morphology”, Spine 1994; 19(8): 935-940 [38] Riggs BL, Melton LJ, “Osteoporosis: Etiology, Diagnosis, Management 2nd edition”, Lippincott-Raven. 1997:99-103, 214-219 [39] Gartland JJ, “Fundamentals of Orthopaedics”, 1994: 364-365 [40] Cooper C, Atkinson EJ, O’Fallon WM, Melton LJ Ⅲ. Incidence of clinically diagnosed vertebral fractures: a population based study in Rochester, Minnesota, 1985-1989. J Bone Miner Res 1992; 7: 221-227 [41] Riggs BL. Osteoporosis: In: Wyngaarden JB, Smith LH Jr., eds. Cecil Textbook of medicine .18th edition. Philadelphia: WB Saunders; 1988: 1510-1515 [42] Jensen GF, Christiansen C, Boesen J, Hegedus V, Transbl I. Epidemiology of postmenopausal spinal and long bone fractures: a unifying approach to postmenopausal osteoporosis. Clin Orthop 1982; 166: 75-81 [43] Ettinger B, Black DM, Nevitt MC, Rundle AC, Cauley JA, Cummings SR, Genant HK, The study of Osteoporotic Fractures Research Group. Contribution of vertebral deformities to chronic back pain and disability. J Bone Miner Res 1992; 7: 449-456 [44] Santavirta S, Konttinen YT, Heliovaara M, Knekt P, Luthje P, Aromaa A. Determinants of osteoporotic thoracic vertebral fractures. Acta Ortho Scand 1992; 63: 198-202 [45] Tumbleson ME., “Swine in biomedical research”, New York :Plenum Press, 1986; v1: 3-4 [46] Zutphen LFM , Baumans V, Beynen AC, “Principles of laboratory animal science :a contribution to the humane use and care of animals and to the quality of experimental results”, Elsevier, 2001; 7-8 [47] Dirk L, Chris JS, Ldsart K, Japp H, In vitro Torsion-induced stress distribution changes in porcine intervertebral discs. Spine 2001 [48] Lu WW, Luk KDK, Ruan DK, Fei ZU, Leong JCY, Stability of the whole lumbar spine after multilevel fenestration and discectomy. Spine 1999; 24: 1277-1282
摘要: 
本研究主要是透過實驗的方式探討脊椎運動骨節內破裂以及崩潰的現象。對於脊椎傷害的問題與形成的機制,經由實驗模擬的方式做進一步的了解,並且討論椎體成形術對於壓迫性骨折椎體的效益與術後對鄰近椎體的影響。
實驗主要從脊椎骨折的角度切入並使用豬脊椎作為試樣,分做兩個階段進行實驗,主要針對單節椎體和多節椎體兩個項目進行壓縮實試,並以人工的方式加工缺口以模擬脊椎骨折的狀況,注入不同的骨水泥量進行修補,進行壓縮以比較出最適合的骨水泥注入量。
實驗結果顯示,若僅僅討論單節椎體,約需4ml ~ 6ml的骨水泥注入,可使椎體恢復;多節試體項目則顯示4ml ~ 5ml的骨水泥量,就可以使整體運動元達到較佳的狀態。因此骨水泥的注入量以少量為佳,過多的骨水泥只會增加溢出的危險性,且提高鄰近椎體發生椎體壓迫性骨折的機率。

Fracture and failure in the spinal motion segments are studied in this research by experiments. The aim of this study is to discuss the problem of the spinal injuries and the formation processes by the simulation experiments and to investigate the difference between adjacent vertebral bodies after vertebroplasty.
In the experiments, we enter the subject in light of vertebral compression fracture and use swinish vertebras as samples. Compression experiments are divided into two stages, single vertebras and three vertebras. In order to simulate the situation of fracture and failure, several chips were cut in the vertebral body. Inside the vertebral body, the different volume of bone cement were injected into the vertebral body to compare with the relatively fit bone cement infusion quantity after experiments.
The results showed that vertebroplasty is an effective method in increasing biomechanical strength of vertebral body. According to our experiments, the volume of 4ml~6ml of bone cement can make a near recover in single vertebral body. In the part of three motion segments, infusion of 4ml~5ml of PMMA per specimen provide sufficient strength. Although the volume of bone cement is depend on the fracture and failure in the vertebral body, the result suggest that injecting lower bone cement into the vertebral body during the vertebroplasty.
URI: http://hdl.handle.net/11455/1902
其他識別: U0005-2408200710390800
Appears in Collections:機械工程學系所

Show full item record
 

Google ScholarTM

Check


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.