Study On Vertebral Body Vascular Abnormalities By FEM,Imaging Technique, Pathology, Clinical Application

Purpose:1) To establish the vertebral body vascular abnormalities three-dimensional finite element model; On the model, We complete the biomechanical experiments and analyze the characteristics of the vertebral body vascular abnormalities stress distribution and the fracture-risk level.2) To measure spinal hemangioma and vascular malformation and normal skin Glut-1, VEGF, Ki-67different expression, We explore the immunohistochemical features of spinal hemangioma and vascular malformation and provide to identify spinal vascular anomalies.3) Through the FEM to evaluate the fracture risk, Glut-1, VEGF, Ki-67immunohistochemical diagnosis and MRI-DWI technique, we hope to provide the best treatment strategy. Methods:1) TO select a vertebral body vascular anomaly volunteers and scan CT, We establish some models of the thoracic lumbar vertebral vascular anomaly including20%～80%vertebral anomalies of vertebral cancellous bone. We analyze the stress distribution and the fracture risk by giving600N static pressure respectively.2) Through definitely diagnosed30cases of spinal hemangioma and vascular malformation, we find the immunohistochemical features of VEGF, KI-67, Glut-1different expression.3) Combined with the FEM and immunohistochemical, MRI-DWI, we sum up26cases of spinal vascular abnormalities and hope to provide the best treatment strategy for patients with spinal vascular anomalies. Results:1) To set up the FEM of the normal vertebral bodies, the vertebral body vascular abnormalities and the filling bone cement vertebral body, The FEM is effective and can be carried out by static stress analysis.2) Confirmed by experiments, the static pressure under three models of cortical bone is no different, the biggest stress occurred in the bottom of the vertebral arch, joints and spondylolysis. When vertebral body vascular abnormalities account for20%～40%of the vertebral cancellous bone, the fracture risk of vertebral body is smaller; When vertebral body vascular abnormalities account for more than60%of the vertebral cancellous bone, the fracture risk is larger; Between40～60%of the vertebral cancellous bone, the fracture risk is changing.3) VEGF, Ki-67, Glut-1in the spinal hemangioma group were positive, Glut-1, VEGF and Ki-67can be used as hemangioma immune markers.4) Combined with FEM, VEGF, Ki-67, Glut-1immunohistochemical and DWI technique, we can receive better effect by the best treatment strategy according to the different parts of the vertebral body vascular abnormalities and different pathological types. Conclusion:1) with the aid of finite element software, the FEM is established for clinical services.2) Through the experiment, we concluded that the vertebral body vascular abnormalities account for less than40%of the vertebral cancellous bone, vertebral body fracture risk is smaller; the vertebral body vascular abnormalities account for more than60%of the vertebral cancellous bone, the fracture risk is larger; Between40～60%of the vertebral cancellous bone, the risk of fracture is changing.3) Glut-1, VEGF and Ki-67can be used as spinal hemangioma and vascular malformation immune markers in differential diagnosis.4) When b=500mm2/s, DWI is safe noninvasive to reflect the vertebral hemangioma, vascular malformation of water molecules diffuse information with providing valuable information for differential diagnosis.5) According to the different parts of the vertebral body vascular abnormalities and different pathological type, we can receive better effect by personalized treatment strategies.