Abstract
Background: While cement distributes sufficiently in the fractured area and relatively symmetrically around the fractured area, three types of cement mass location in the vertebral body are commonly seen when performing bipedicular percutaneous vertebral augmentation (PVA) for osteoporotic vertebral compression fractures (OVCFs), including anterolateral (AL), anteromedial (AM) and posterolateral (PL). However, little is known about differences of biomechanical behaviors among these three types of cement distribution so far. The present study aimed to investigate biomechanical effects of AL, AM and PL in the fractured area on OVCFs.Methods: Three dimentional finite element methods were utilized to construct OVCF model and simulate AL, AM and PL in the fractured area for OVCFs treated with PVA. Distributions and magnitudes of von Mises stress in cortical and cancellous bone and maximum displacement of the four models were compared.Results: Compared with the OVCF model, Distribution of von Mises stress in cortical bone was unchanged while that in cancellous bone was transferred to be concentrated symmetrically at cancellous bone surrounding cement after PVA. Maximum displacement and maximum von Mises stress in cortical bone in AL decreased the most significantly, while AM created the lowest maximum von Mises stress in cancellous bone.Conclusions: Cement distribution between AL and AM may balance stress in cortical and cancellous bone, better restoring vertebral strength, meanwhile, providing sufficient vertebral stability.
Comparison the clinical outcomes and complications of high-viscosity versus low-viscosity in osteoporotic vertebral compression fractures
