青少年特发性脊柱侧凸与骨质疏松的生物力学分析

Biomechanical Analysis of Adolescent Idiopathic Scoliosis and Osteoporosis

摘要: 研究目标：本研究旨在揭示骨质疏松(Osteoporosis, OP)性青少年特发性脊柱侧凸(Adolescent Idiopathic Scoliosis, AIS)患者的腰骶部在重力载荷作用下的生物力学特性。研究方法：以正常青少年及AIS患者脊柱CT图像为基础，构建L3-S1节段的椎体三维模型。通过调整模型的杨氏模量，模拟正常骨质与骨质疏松。运用有限元分析技术，对比这四种模型：正常模型、OP模型、AIS模型以及OP性AIS模型，从而评估各模型内部应力分布及位移情况。结果：在重力作用下：1) 患OP的腰骶部椎体位移会减小，但应力会增大；2) AIS患者腰骶部位移及应力均大于正常青少年；3) AIS患者腰骶部应力集中在脊柱侧凸的凹侧。结论：与正常青少年相比，患有OP的AIS患者的腰骶部椎体更加不稳定。OP会显著提高AIS腰骶部的应力水平，加剧椎体的不均匀应力分布，使得在高负荷条件下，OP的椎体更易发生骨折风险。

Abstract: Research objective: This study aims to reveal the biomechanical properties of the lumbar and sacral regions of adolescent idiopathic scoliosis (AIS) patients with osteoporosis (OP) under gravity loading. Research method: Based on CT images of the spine in normal adolescents and AIS patients, a three-dimensional model of the L3-S1 segment vertebral body was constructed. By adjusting the Young’s modulus of the models to simulate normal bone quality and osteoporosis, we employed finite element analysis technology to compare four models: the normal model, the OP model, the AIS model, and the OP based AIS model, thereby assessing the internal stress distribution and displacement of each model. Result: Under the action of gravity, 1) the displacement of the lumbar sacral vertebrae with OP will decrease, but the stress will increase; 2) AIS patients have greater lumbar sacral displacement and stress than normal adolescents; 3) AIS patients experience stress concentration in the lumbar and sacral regions on the concave side of scoliosis. Conclusion: Compared with normal adolescents, AIS patients with OP have more unstable lumbar and sacral vertebrae. OP significantly increases the stress level in the lumbar and sacral regions of AIS, exacerbating the uneven stress distribution in the vertebral bodies, making the vertebral bodies of OP more susceptible to fracture risk under high load conditions.