傳統上對於脊椎壓迫性骨折之手術方式為使用椎體成形術式來處理，並且使用脊椎後側固定術式以確保足夠之穩定度。使用氣球或椎體支撐系統擴張無法回復原本之椎體高度，文獻指出約有20.5~29.8%的椎體高度喪失。研究指出使用鈦合金椎體矯正支撐系統對於椎體高度之重建效果優於傳統之氣球擴張術，但是，對於不同椎體高度重建目前並無相關的力學研究。因此，本研究之目的為使用有限元素法比較椎體三節骨折後，在椎體高度完整重建下，使用骨水泥加上鈦合金椎體矯正支撐系統或單純骨水泥兩種椎體固定方式，搭配不同脊椎後側融合術式(傳統融合固定與動態穩定)，對於在椎體高度不完整重建下，使用骨水泥搭配不同脊椎後側融合術式(傳統融合固定與動態穩定)之生物力學效應亦在本研究中一併探討。
本研究先建立一完整之腰椎實體模型，並在第三節腰椎作為植入節，參考Wedge骨折術後修復高度100%及70%建立壓迫性骨折修復後模型，搭配單純骨水泥或SpineJack加骨水泥搭配傳統融合固定與動態穩定之不同脊椎後側融合術式。本研究探討之負載包含400N之軸向負載模擬體重、10Nm之彎曲負載模擬前屈後仰、側彎及旋轉動作，計算每一節椎間盤之運動範圍、最大位移量與應力分佈及後側骨元件之應力分佈做為結構穩定度之指標。
結果顯示骨水泥或SpineJack加骨水泥於植入節支撐骨折椎體與正常腰椎在相同的附載條件有類似的結果。當植入節高度未完全修復時，於後仰運動時骨折椎體上方椎間盤纖維環基質的最大應力值增加了238%;纖維環基質之正常腰椎應力0.93MPa與未完全修復高度腰椎應力2.4MPa。當使用脊椎後側融合術式後可以降低固定節數之運動範圍。在研究中，建議在椎體成形術中盡可能完全修復高度，作為治療腰椎骨折指標。

Traditional surgical approach for vertebral compression fractures uses vertebroplasty along with the posterior fixation to ensure adequate stability. After surgery, the vertebral height in general cannot be fully restored by a balloon or vertebral augmentation system (SpineJack system) by kyphoplasty. Literatures indicated that about 20% to 30% of the vertebral height is lost. Clinical study has shown that using the SpineJack system for the reconstruction of vertebral body height is better than using balloon kyphoplasty. However, for incomplete vertebral body height reconstructions, there is no relevant mechanical research. The purpose of this study was to compare the biomechanical effects, with finite element simulation, on the third lumbar vertebral compression fracture with complete and incomplete height restorations. Different augmentation approaches were considered: with bone cement alone and bone cement with the SpineJack, also two posterior fixations, ReBorn System and Bioflex system, were evaluated.
In this study, a intact complete, first to fifth, lumbar computer model was created. A wedge (compression) fracture was then induced at the third lumbar to generated the fractured model. Models with complete, 100%, and incomplete, 70%, restorations of the fractured vertebral body height were then created by various augmentation approaches. For the fractured vertebral body restorations two approaches were simulated: bone cement alone and bone cement with SpineJack. For posterior fixation, three approaches were modeled: without posterior fixation, ReBorn System and the Bioflex system. A pressure load of 400N to simulate body weight was applied to the most superior surface of this lumbar spine. Moment load of 10 N-m in four directions, flexion, extension, lateral bending, and axial rotation, were applied to the lumbar spine. The range of motion of vertical, deformation and stress of intervertebral disc and stress on the posterior element were obtained as indices for evaluation.
The results showed that restoration height was the key factor, whether the bone cement alone or with a SpineJack was used in the restored body. A fully restored body height would have a similar mechanical results with the intact lumbar, compared to the insufficient restored spine. This was most obvious at the second intervertebral disc in which the maximum equivalent stress of intact lumbar ground substance was 0.93MPa, under extension, while the maximum equivalent stress of incompletely restoration ground substance was 2.4MPa, a 238% increasing. When the posterior instrumentation was applied the range of motion was reduced as expected.
In summary, better spinal stability was identified in vertebral body with fully restored height. And this might be the lumbar curvature change due to insufficient body height restoration.

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