| Project/Area Number |
18K10774
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 59010:Rehabilitation science-related
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| Research Institution | Saitama Medical University (2020)
The University of Tokyo (2018-2019) |
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Principal Investigator |
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| Co-Investigator(Kenkyū-buntansha) |
小林 寛 東京大学, 医学部附属病院, 講師 (20407951)
田中 健之 東京大学, 医学部附属病院, 助教 (00583121)
別所 雅彦 国際医療福祉大学, 医学部, 講師 (50451810)
芳賀 信彦 東京大学, 医学部附属病院, 教授 (80251263)
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| Project Period (FY) |
2018-04-01 – 2021-03-31
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| Project Status |
Completed (Fiscal Year 2020)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2019: ¥780,000 (Direct Cost: ¥600,000、Indirect Cost: ¥180,000)
Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 骨転移 / 骨盤 / 骨折 / 有限要素法 / 転移性骨腫瘍 / QOL / ADL |
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| Outline of Final Research Achievements |
CT data of pelvis with metastatic tumors were taken into finite element analysis software, and a normal pelvic model was created from the healthy side. The ligament components of the sacroiliac joint and the pubic symphysis were set with the material property values, the sacrum and pubic symphysis were restrained in all directions except the horizontal direction, and the sacrum was restrained only in the vertical direction. The load direction of the hip joint to the acetabulum was set at an angle of 30 degrees from the plane composed of the upper edge of the pubic symphysis and that of the sacral spine. As a result, fractures occurred in sacrum, upper and lower branches of the pubis, which were frequent sites for fragile fracture. Next, a bone defect model that imitates bone metastasis was created and the risk of fracture was evaluated. Fractures are likely to occur if there is a defect in the anterior margin of the acetabulum to the superior pubic branch, or the ischial notch.
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| Academic Significance and Societal Importance of the Research Achievements |
骨盤骨転移の治療の目的は病的骨折を予防してADLを維持することである。骨盤転移の骨折リスクを評価する指標が必要であるが、これまで骨盤転移による骨折リスクや手術適応の指標が存在していなかった。 そこで、我々は有限要素法を用いて、腫瘍部位や大きさによる骨折リスクの違いを明らかにし、実際の症例における骨折リスクを予測するシステムを作成することを目標とした。現時点では、仮想骨転移モデルで、臼蓋前縁から恥骨上枝、坐骨切痕部に欠損があると骨折を生じやすいことを明らかにしたので、今後実症例で検証を行い、スコアリングシステムを確立する。
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