有限元分析在骨质疏松性椎体压缩骨折脊柱力学动态变化中的应用
|
摘要
骨质疏松性椎体压缩骨折常常发生在脊柱胸腰段,是脊柱骨折中最常见的类型,约占所有脊柱骨折的90%,该损伤常伴有神经功能的损害,给家庭和社会造成很大的负担。此类骨折被认为是椎体负荷应力超过本身结构强度时发生的力学变化。对于骨质疏松性椎体压缩骨折,了解和熟悉其脊柱力学环境的动态变化过程与机制是防止骨质疏松性骨折的发生重要环节。利用有限元技术能够很好地模拟骨质疏松性椎体压缩骨折脊柱力学环境变化状况,分析其作用机制,验证实验假说,为临床预防与诊疗方法的选择作出定性、定量的最佳治疗方案,为临床预防与诊疗方法的基础研究提供有效的研究方法。通过回顾近年骨质疏松性椎体压缩骨折的有限元研究与分析,探讨不同治疗方法对脊柱力学动态变化的影响,进一步明确骨质疏松性胸腰椎压缩骨折早期预防、诊治措施,从而避免做超出椎体负荷安全范围的活动,预防与治疗椎体骨折连锁反应的发生。
Occurring in the thoracolumbar segment of the spine, the osteoporotic vertebral compression fractures, which accounts for about 90 percent of all spinal fractures, are the most common type of spinal fracture. It has become an important issue for spinal surgery that how to prevent and treat these diseases in a timely and effective manner and improve the quality of the patients' life. This type of fracture is considered as a mechanical change when the stress of the vertebral body exceeds its structural strength. Understanding and familiarizing with the dynamic changes of the spinal mechanical environment is an important step to the osteoporotic fracture. The use of finite element technique can simulate the dynamic changes of the vertebral column in osteoporotic vertebral compression fracture, analyze its mechanism, verify the experimental hypothesis, and provide effective research methods for the basic research of clinical prevention and diagnosis and treatment. By reviewing the latest researches about the finite element analysis of osteoporotic vertebral compression fracture, the effects of different treatment methods in dynamic changes of spinal mechanics were discussed to further clarify the early prevention, diagnosis and treatment of osteoporotic thoracolumbar compression fractures, so as to avoid doing activities beyond the safe range of vertebral load and prevent and treat the occurrence of linkage reaction of vertebral fracture.
Occurring in the thoracolumbar segment of the spine, the osteoporotic vertebral compression fractures, which accounts for about 90 percent of all spinal fractures, are the most common type of spinal fracture. It has become an important issue for spinal surgery that how to prevent and treat these diseases in a timely and effective manner and improve the quality of the patients' life. This type of fracture is considered as a mechanical change when the stress of the vertebral body exceeds its structural strength. Understanding and familiarizing with the dynamic changes of the spinal mechanical environment is an important step to the osteoporotic fracture. The use of finite element technique can simulate the dynamic changes of the vertebral column in osteoporotic vertebral compression fracture, analyze its mechanism, verify the experimental hypothesis, and provide effective research methods for the basic research of clinical prevention and diagnosis and treatment. By reviewing the latest researches about the finite element analysis of osteoporotic vertebral compression fracture, the effects of different treatment methods in dynamic changes of spinal mechanics were discussed to further clarify the early prevention, diagnosis and treatment of osteoporotic thoracolumbar compression fractures, so as to avoid doing activities beyond the safe range of vertebral load and prevent and treat the occurrence of linkage reaction of vertebral fracture.
引文
[1]Svensson H K,Olofsson E H,Karlsson J,et al.A painful, never ending story:older women’s experiences of living with an osteoporotic vertebral compression fracture.Osteoporos Int,2016,27(5):1729-1736
[2]Cosman F,De Beur S J,Leboff M S,et al.Clinician’s guide to prevention and treatment of osteoporosis.Osteoporos Int,2014,5(10):2359-2381
[3]张晓刚,赵希云,宋敏,等.骨质疏松性椎体压缩骨折的生物力学研究进展.医用生物力学,2017,32(2):199-204
[4]杨惠林,刘昊,殷国勇,等.我国经皮椎体后凸成形术治疗骨质疏松性椎体骨折现状与创新.中华骨质疏松和骨矿盐疾病杂志,2017,10(1):12-19
[5]邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南(骨质疏松性骨折诊断及治疗原则).中华骨与关节外科杂志,2015,8(5):371-374
[6]中华医学会骨科学分会骨质疏松学组,中华医学会骨质疏松和骨矿盐疾病分会.骨质疏松性骨折患者抗骨质疏松治疗与管理专家共识.中华骨质疏松和骨矿盐疾病杂志,2015,8(3):189-195
[7]Nguyen N D,Ahlborg H D,Center J R,et al.Residual lifetime risk of fractures in women and men.J Bone Miner Res,2007,22(6):781-788
[8]Si L,Winzenberg T M,Jiang Q,et al.Projection of osteoporosis related fractures and costs in China:2010-2050.Osteoporos Int,2015,26:1929-1937
[9]Panjabi M M.Cervical spine models for biomechanical research.Spine,1998, 23(24):2684-2700
[10]黄宇峰,潘福敏,赵卫东.关于腰椎三维有限元模型的建模及有效性验证.生物骨科材料与临床研究,2015,12(5):16-19
[11]王志鹏,张晓刚,赵文韬,等.有限元分析在腰椎手法治疗中的生物力学研究进展.医用生物力学,2017,32(3):293-298
[12]胡勇,谢辉,杨述华.三维有限元分析在脊柱生物力学中应用研究.医用生物力学,2006,21(3):246-250
[13]Zhang Q H,Teo E C,NG H W,et al.Finite element analysis of moment-rotation relationships for human cervical spine.J Biomech,2006,39(1):189-193
[14]Baruch M,Bar Itzhack I Y.Optimal weighted orthogonalization of measured modes.AIAA Journal,1979,17(8):927-928
[15]张敏,仇永贵,邵煜,等.有限元方法在胸腰椎损伤中的应用.法医学杂志,2015,31(2):132-134,139
[16]Belytschko T,Kulak R F,Schultz A B,et al.Finite element stress analysis of an intervertebral disc.J Biomech,1974,7(3):277-285
[17]Liu Y K,Ray G,Hirsch C.The resistance of the lumbar spine to direct shear.Orthop Clin North Am,1975,6(1):33-49
[18]Lin H S,Liu Y K,Adams K H.Mechanical response of the lumbar intervertebral joint under physiological(complex)loading.J Bone Joint Surg Am,1978,60(1):41-55
[19]Hakim N S,King A I.A three dimensional finite element dynamic response analysis of a vertebra with experimental verification.J Biomech,1979,12(4):277-292
[20]Goel V K,Kim Y E,Lim T H,et al.An analytical investigation of the mechanics of spinal instrumentation.Spine,1988,13(9):1003-1011
[21]Natali A N.A hyperelastic and almost incompressible material model as an approach to intervertebral disc analysis.J Biomed Eng,1991,13(2):163-168
[22]RAO A A,DUMAS G A.Influence of material properties on the mechanical behaviour of the L5-S1 intervertebral disc in compression:A nonlinear finite element study.J Biomed Eng,1991,13(2):139-151
[23]Shirazi-Adl A.Nonlinear stress analysis of the whole lumbar spine in torsion-mechanics of facet articulation.Spine,1994,27(3):289-299
[24] Zander T,Rohlmann A,Burra N K,et al.Estimation of muscle forces in the lumbar spine during upper-body inclination.Clin Biomech,2001,16(1):73-80
[25]Rohlmann A,Bauer L,Zander T,et al.Determination of trunk muscle forces for flexion and extension by using a validated finite element model of the lumbar spine and measured in vivo data.J Biomech,2006,39(6):981-989
[26]徐海涛,徐达传,张美超,等.坐位旋转手法时L4-5变形和位移的研究.中国临床解剖学杂志,2008,26(3):321-324
[27]李孝林.基于CT图像应用Mimics软件快速构建人体胸腰段骨骼有限元模型.中国组织工程研究与临床康复,2009,13(39):7619-7622
[28]李孝林.基于CT精细扫描构建人体胸腰段脊柱三维有限元模型的方法及意义.山东医药,2009,49(14):8-10
[29]徐海涛,张美超,李义凯,等.坐位旋转手法对正常腰椎间盘内在应力和位移的实时监测的实验研究.中国康复医学杂志, 2005,20(6):563-565
[30]万磊,李义凯.有限元方法在腰椎研究中的应用.中国骨与关节损伤杂志,2006,21(2):158-160
[31]闫广奎,叶君健.有限元分析法在腰椎生物力学研究中的应用.中国组织工程研究,2012,16(22):4117-4120
[32]付帅,黄菊英.腰椎有限元分析及其临床意义.医疗卫生装备,2012,33(10):76-78
[33]秦计生,王昱,彭雄奇,等.全腰椎三维有限元模型的建立及其有效性验证.医用生物力学,2013,28(3):321-325
[34]项嫔,都承斐,赵美雅,等.全腰椎有限元模态分析.医用生物力学,2014,29(2):154-160
[35]秦大平,张晓刚,聂文忠,等.不同运动状态下模拟人体腰椎结构特征变化的有限元分析.医用生物力学,2017,32(4):355-362
[36]张晓刚,秦大平,宋敏.等,拔伸按压手法对退变腰椎节段应力分布影响的有限元分析.中华中医药杂志,2013,28(10):3108-3114
[37]张爱平,陈日齐,黄昱,等.人类腰段脊柱三维有限元模型的建立.中国组织工程研究,2002,6(12):1734-1735
[38]苏文珍,林永杰,孙立民,等.体外冲击波与传统方法治疗腰椎间盘突出症疗效比较.医学与哲学,2014,35(5B):30-32
[39]Robin S,Skalli W,Lavaste F.Influence of geometrical factors on the behavior of lumbar spine segments:a finite element analysis.Eur Spine J,1994,3(2):84-90
[40]Voo L M,Kumaresan S,Yoganandan N,et al.Finite element analysis of cervical facetectomy.Spine,1997,22(9):964-969
[41]苏晋,赵文志,陈秉智,等.建立全腰椎有限元接触模型.医用生物力学,2010,25(3):200-205
[42]关海山,杨惠林,冯皓宇.有限元分析肌肉力对胸腰椎运动节段椎间盘压力的影响.苏州大学学报(医学版),2007,27(2):209-213,221
[43]聂文忠.脊柱胸腰部的生物力学建模与应用研究—中国力学虚拟人的基本问题初探.上海:上海交通大学,2009
[44]徐浩,张秋林,唐昊,等.腰椎L3~L5三维有限元模型的有效性验证.中国组织工程研究,2013,17(35):6261-6266
[45]王宏卫,刘新宇,万熠.人体腰椎L4~L5段有限元模型建立及力学有效性验证.医学与哲学,2017,38(5B):50-53
[46]张磊,林松青,杨曾静,等.脊柱胸腰段及其压缩骨折有限元模型的建立及意义.中国中医骨伤科杂志,2015,23(2):21-23
[47]刘勇,田青,李国庆,等.骨质疏松腰椎三维有限元模型的建立.中华实验外科杂志,2013,30(1):161-162
[48]仰嘉轩,郭海玲,毛敦,等.骨质疏松症患者腰椎有限元模型的建立与骨强度分析.中国中医骨伤科杂志,2017,25(5):13-17
[49]Anne P,Lutz P N,Stephen J Ferguson.Simulated influence of osteoporosis and disc degeneration on the load transfer in a lumbar functional spinal unit.Biomechanics,2004,37:1061-1069
[50]Imai K,Ohnishi I,Yamamoto S,et al.In vivo assessment of lumbar vertebral strength in elderly women using computed tomographybased nonlinear finite element model.Spine,2008,33(1):27-32
[51]Mc Donald K,Little J,Pearcy M,et al.Development of a multiscale finite element model of the osteoporotic lumbar vertebral body for the investigation of apparent level vertebra mechanics and micro-level trabecular mechanics.Med Eng Phys,2010,32(6):653-661
[52]Kopperdahl D L,Aspelund T,Hoffmann P F,et al.Assessment of incident spine and hip fractures in women and men using finite element analysis of CT scans.J Bone Miner Res,2014,29(3):570-580
[53]卢昌怀,刘志军,张宏波,等.骨水泥量及分布对椎体成形术后相邻椎体生物力学影响的三维有限元分析.中国骨质疏松杂志,2015,21(1):29-33
[54]Imai K,Ohnishi I,Bessho M,et al.Nonlinear finite element model predicts vertebral bone strength and fracture site.Spine,2006,31(16):1789-1794
[55]Hengsbe Rger S,Ammann P,Legros B,et al.Intrinsic bone tissue properties in adult rat vertebrae:Mod-ulation by dietary protein.Bone,2005,36:134-141
[56]Rubin C D.Emerging concepts in osteoporosis and bone strength.Curr Med Res Opin,2005,21(7):1049-1056
[57]周双珍,张雄,马红磊.不同骨密度下人体脊柱着陆冲击响应的数值模拟.医用生物力学,2013,28(6):591-595
[58]Erdem I,Truumees E,VAN Der Meulen M C H.Simulation of the behaviour of the L1 vertebra for different material properties and loading conditions.Comput Methods Biomech Biomed Engin,2013,16(7):736-746
[59]曾至立,程黎明,朱睿,等.胸腰椎三维非线性有限元模型的建立.中华医学杂志,2011,91(31):2176-2180
[60]Yan Y B,Qi W,Wu Z X,et al.Finite element study of the mechanical response in spinal cord during the thoracolumbar burst fracture.PLo S One,2012,7(9):e41397
[61]Zysset P K,Dall’ara E,Varga P,et al.Finite element analysis for prediction of bone strength.Bonekey Rep,2013,2:386
[62]Kuijer P P F,Verbeek J H,Visser B,et al.An evidence-based multidisciplinary practice guideline to reduce the workload due to lifting for preventing work-related low back pain.Ann Occup Environ Med,2014,26(2):16-18
[63]Pand A,Das C J,Baruah U.Imaging of vertebral fractures.Indian J Endocrinol Metab,2014,18(3):295-303
[64]Grifftth J F.Identifying osteoporotic vertebral fracture.Quant Imaging Med Surg,2015,5(4):592-602
[65]Briggs A M,Wrigley T V,Van Dien J H,et al.The effect of osteoporotic vertebral fracture on predicted spinal loads in vivo.Eur Spine J,2006,15(12):1785-1795
[66]Tzermiadianos M N,Renner S M,Phillips F M,et al.Altered disc pressure profile after an osteoporotic vertebral fracture is a risk factor for adjacent vertebral body fracture.Eur Spine J,2008,17(11):1522-1530
[67]秦大平,张晓刚,宋敏.等,老年骨质疏松性胸腰椎压缩骨折治疗研究进展.中华中医药杂志,2017,32(2):679-684
[2]Cosman F,De Beur S J,Leboff M S,et al.Clinician’s guide to prevention and treatment of osteoporosis.Osteoporos Int,2014,5(10):2359-2381
[3]张晓刚,赵希云,宋敏,等.骨质疏松性椎体压缩骨折的生物力学研究进展.医用生物力学,2017,32(2):199-204
[4]杨惠林,刘昊,殷国勇,等.我国经皮椎体后凸成形术治疗骨质疏松性椎体骨折现状与创新.中华骨质疏松和骨矿盐疾病杂志,2017,10(1):12-19
[5]邱贵兴,裴福兴,胡侦明,等.中国骨质疏松性骨折诊疗指南(骨质疏松性骨折诊断及治疗原则).中华骨与关节外科杂志,2015,8(5):371-374
[6]中华医学会骨科学分会骨质疏松学组,中华医学会骨质疏松和骨矿盐疾病分会.骨质疏松性骨折患者抗骨质疏松治疗与管理专家共识.中华骨质疏松和骨矿盐疾病杂志,2015,8(3):189-195
[7]Nguyen N D,Ahlborg H D,Center J R,et al.Residual lifetime risk of fractures in women and men.J Bone Miner Res,2007,22(6):781-788
[8]Si L,Winzenberg T M,Jiang Q,et al.Projection of osteoporosis related fractures and costs in China:2010-2050.Osteoporos Int,2015,26:1929-1937
[9]Panjabi M M.Cervical spine models for biomechanical research.Spine,1998, 23(24):2684-2700
[10]黄宇峰,潘福敏,赵卫东.关于腰椎三维有限元模型的建模及有效性验证.生物骨科材料与临床研究,2015,12(5):16-19
[11]王志鹏,张晓刚,赵文韬,等.有限元分析在腰椎手法治疗中的生物力学研究进展.医用生物力学,2017,32(3):293-298
[12]胡勇,谢辉,杨述华.三维有限元分析在脊柱生物力学中应用研究.医用生物力学,2006,21(3):246-250
[13]Zhang Q H,Teo E C,NG H W,et al.Finite element analysis of moment-rotation relationships for human cervical spine.J Biomech,2006,39(1):189-193
[14]Baruch M,Bar Itzhack I Y.Optimal weighted orthogonalization of measured modes.AIAA Journal,1979,17(8):927-928
[15]张敏,仇永贵,邵煜,等.有限元方法在胸腰椎损伤中的应用.法医学杂志,2015,31(2):132-134,139
[16]Belytschko T,Kulak R F,Schultz A B,et al.Finite element stress analysis of an intervertebral disc.J Biomech,1974,7(3):277-285
[17]Liu Y K,Ray G,Hirsch C.The resistance of the lumbar spine to direct shear.Orthop Clin North Am,1975,6(1):33-49
[18]Lin H S,Liu Y K,Adams K H.Mechanical response of the lumbar intervertebral joint under physiological(complex)loading.J Bone Joint Surg Am,1978,60(1):41-55
[19]Hakim N S,King A I.A three dimensional finite element dynamic response analysis of a vertebra with experimental verification.J Biomech,1979,12(4):277-292
[20]Goel V K,Kim Y E,Lim T H,et al.An analytical investigation of the mechanics of spinal instrumentation.Spine,1988,13(9):1003-1011
[21]Natali A N.A hyperelastic and almost incompressible material model as an approach to intervertebral disc analysis.J Biomed Eng,1991,13(2):163-168
[22]RAO A A,DUMAS G A.Influence of material properties on the mechanical behaviour of the L5-S1 intervertebral disc in compression:A nonlinear finite element study.J Biomed Eng,1991,13(2):139-151
[23]Shirazi-Adl A.Nonlinear stress analysis of the whole lumbar spine in torsion-mechanics of facet articulation.Spine,1994,27(3):289-299
[24] Zander T,Rohlmann A,Burra N K,et al.Estimation of muscle forces in the lumbar spine during upper-body inclination.Clin Biomech,2001,16(1):73-80
[25]Rohlmann A,Bauer L,Zander T,et al.Determination of trunk muscle forces for flexion and extension by using a validated finite element model of the lumbar spine and measured in vivo data.J Biomech,2006,39(6):981-989
[26]徐海涛,徐达传,张美超,等.坐位旋转手法时L4-5变形和位移的研究.中国临床解剖学杂志,2008,26(3):321-324
[27]李孝林.基于CT图像应用Mimics软件快速构建人体胸腰段骨骼有限元模型.中国组织工程研究与临床康复,2009,13(39):7619-7622
[28]李孝林.基于CT精细扫描构建人体胸腰段脊柱三维有限元模型的方法及意义.山东医药,2009,49(14):8-10
[29]徐海涛,张美超,李义凯,等.坐位旋转手法对正常腰椎间盘内在应力和位移的实时监测的实验研究.中国康复医学杂志, 2005,20(6):563-565
[30]万磊,李义凯.有限元方法在腰椎研究中的应用.中国骨与关节损伤杂志,2006,21(2):158-160
[31]闫广奎,叶君健.有限元分析法在腰椎生物力学研究中的应用.中国组织工程研究,2012,16(22):4117-4120
[32]付帅,黄菊英.腰椎有限元分析及其临床意义.医疗卫生装备,2012,33(10):76-78
[33]秦计生,王昱,彭雄奇,等.全腰椎三维有限元模型的建立及其有效性验证.医用生物力学,2013,28(3):321-325
[34]项嫔,都承斐,赵美雅,等.全腰椎有限元模态分析.医用生物力学,2014,29(2):154-160
[35]秦大平,张晓刚,聂文忠,等.不同运动状态下模拟人体腰椎结构特征变化的有限元分析.医用生物力学,2017,32(4):355-362
[36]张晓刚,秦大平,宋敏.等,拔伸按压手法对退变腰椎节段应力分布影响的有限元分析.中华中医药杂志,2013,28(10):3108-3114
[37]张爱平,陈日齐,黄昱,等.人类腰段脊柱三维有限元模型的建立.中国组织工程研究,2002,6(12):1734-1735
[38]苏文珍,林永杰,孙立民,等.体外冲击波与传统方法治疗腰椎间盘突出症疗效比较.医学与哲学,2014,35(5B):30-32
[39]Robin S,Skalli W,Lavaste F.Influence of geometrical factors on the behavior of lumbar spine segments:a finite element analysis.Eur Spine J,1994,3(2):84-90
[40]Voo L M,Kumaresan S,Yoganandan N,et al.Finite element analysis of cervical facetectomy.Spine,1997,22(9):964-969
[41]苏晋,赵文志,陈秉智,等.建立全腰椎有限元接触模型.医用生物力学,2010,25(3):200-205
[42]关海山,杨惠林,冯皓宇.有限元分析肌肉力对胸腰椎运动节段椎间盘压力的影响.苏州大学学报(医学版),2007,27(2):209-213,221
[43]聂文忠.脊柱胸腰部的生物力学建模与应用研究—中国力学虚拟人的基本问题初探.上海:上海交通大学,2009
[44]徐浩,张秋林,唐昊,等.腰椎L3~L5三维有限元模型的有效性验证.中国组织工程研究,2013,17(35):6261-6266
[45]王宏卫,刘新宇,万熠.人体腰椎L4~L5段有限元模型建立及力学有效性验证.医学与哲学,2017,38(5B):50-53
[46]张磊,林松青,杨曾静,等.脊柱胸腰段及其压缩骨折有限元模型的建立及意义.中国中医骨伤科杂志,2015,23(2):21-23
[47]刘勇,田青,李国庆,等.骨质疏松腰椎三维有限元模型的建立.中华实验外科杂志,2013,30(1):161-162
[48]仰嘉轩,郭海玲,毛敦,等.骨质疏松症患者腰椎有限元模型的建立与骨强度分析.中国中医骨伤科杂志,2017,25(5):13-17
[49]Anne P,Lutz P N,Stephen J Ferguson.Simulated influence of osteoporosis and disc degeneration on the load transfer in a lumbar functional spinal unit.Biomechanics,2004,37:1061-1069
[50]Imai K,Ohnishi I,Yamamoto S,et al.In vivo assessment of lumbar vertebral strength in elderly women using computed tomographybased nonlinear finite element model.Spine,2008,33(1):27-32
[51]Mc Donald K,Little J,Pearcy M,et al.Development of a multiscale finite element model of the osteoporotic lumbar vertebral body for the investigation of apparent level vertebra mechanics and micro-level trabecular mechanics.Med Eng Phys,2010,32(6):653-661
[52]Kopperdahl D L,Aspelund T,Hoffmann P F,et al.Assessment of incident spine and hip fractures in women and men using finite element analysis of CT scans.J Bone Miner Res,2014,29(3):570-580
[53]卢昌怀,刘志军,张宏波,等.骨水泥量及分布对椎体成形术后相邻椎体生物力学影响的三维有限元分析.中国骨质疏松杂志,2015,21(1):29-33
[54]Imai K,Ohnishi I,Bessho M,et al.Nonlinear finite element model predicts vertebral bone strength and fracture site.Spine,2006,31(16):1789-1794
[55]Hengsbe Rger S,Ammann P,Legros B,et al.Intrinsic bone tissue properties in adult rat vertebrae:Mod-ulation by dietary protein.Bone,2005,36:134-141
[56]Rubin C D.Emerging concepts in osteoporosis and bone strength.Curr Med Res Opin,2005,21(7):1049-1056
[57]周双珍,张雄,马红磊.不同骨密度下人体脊柱着陆冲击响应的数值模拟.医用生物力学,2013,28(6):591-595
[58]Erdem I,Truumees E,VAN Der Meulen M C H.Simulation of the behaviour of the L1 vertebra for different material properties and loading conditions.Comput Methods Biomech Biomed Engin,2013,16(7):736-746
[59]曾至立,程黎明,朱睿,等.胸腰椎三维非线性有限元模型的建立.中华医学杂志,2011,91(31):2176-2180
[60]Yan Y B,Qi W,Wu Z X,et al.Finite element study of the mechanical response in spinal cord during the thoracolumbar burst fracture.PLo S One,2012,7(9):e41397
[61]Zysset P K,Dall’ara E,Varga P,et al.Finite element analysis for prediction of bone strength.Bonekey Rep,2013,2:386
[62]Kuijer P P F,Verbeek J H,Visser B,et al.An evidence-based multidisciplinary practice guideline to reduce the workload due to lifting for preventing work-related low back pain.Ann Occup Environ Med,2014,26(2):16-18
[63]Pand A,Das C J,Baruah U.Imaging of vertebral fractures.Indian J Endocrinol Metab,2014,18(3):295-303
[64]Grifftth J F.Identifying osteoporotic vertebral fracture.Quant Imaging Med Surg,2015,5(4):592-602
[65]Briggs A M,Wrigley T V,Van Dien J H,et al.The effect of osteoporotic vertebral fracture on predicted spinal loads in vivo.Eur Spine J,2006,15(12):1785-1795
[66]Tzermiadianos M N,Renner S M,Phillips F M,et al.Altered disc pressure profile after an osteoporotic vertebral fracture is a risk factor for adjacent vertebral body fracture.Eur Spine J,2008,17(11):1522-1530
[67]秦大平,张晓刚,宋敏.等,老年骨质疏松性胸腰椎压缩骨折治疗研究进展.中华中医药杂志,2017,32(2):679-684
© 2004-2018 中国地质图书馆版权所有 京ICP备05064691号 京公网安备11010802017129号 地址：北京市海淀区学院路29号 邮编：100083 电话：办公室：(+86 10)66554848；文献借阅、咨询服务、科技查新：66554700 |