中国组织工程研究

中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (12): 1866-1871.doi: 10.12307/2022.509

• 骨科植入物Orthopedic implants • 上一篇    下一篇

儿童经颈前路置入内固定系统的三维有限元分析

李  琨1，2 ，王  星1，2，李志军1，2，高  尚1，孙  昊3，熊  峰2，王  鹏2   

  1. 内蒙古医科大学，1人体解剖学教研室，2数字医学中心，3学生管理处，内蒙古自治区呼和浩特市   010000
  • 收稿日期:2021-03-22 修回日期:2021-03-24 接受日期:2021-04-30 出版日期:2022-04-28 发布日期:2021-12-14
  • 通讯作者: 李志军，教授，博士生导师，内蒙古医科大学人体解剖学教研室，数字医学中心，内蒙古自治区呼和浩特市 010000 高尚，副教授，硕士生导师，内蒙古医科大学人体解剖学教研室，内蒙古自治区呼和浩特市 010000
  • 作者简介:李琨，女，1988年生，汉族，内蒙古自治区呼和浩特市人，硕士，主要从事脊柱与脊髓的数字化研究。 王星，男，1979年生，汉族，内蒙古自治区呼和浩特市人，博士，主要从事脊柱与脊髓的数字化研究。
  • 基金资助:
    国家自然科学基金资助项目(81860382)，项目负责人：王星；国家自然科学基金资助项目(81860383)，项目负责人：李志军；内蒙古医科大学青年基金项目(YKD2020QNCX055)，项目负责人：李琨；内蒙古医科大学英才培育项目(YCPY20200090)，项目负责人：李琨；内蒙古医科大学英才培育项目(YCPY20200002)，项目负责人：李琨；内蒙古医科大学实验室开放项目(2020ZN48)，项目负责人：李琨；内蒙古医科大学大学生创新创业项目(202010132001)，项目负责人：熊峰；内蒙古自治区自然科学基金资助项目(2020LH08021)，项目负责人：李志军；内蒙古自治区自然科学基金资助项目(2020MS03061)，项目参与人：王星；内蒙古自治区自然科学基金资助项目(2019MS08017)，项目负责人：张少杰；内蒙古医科大学科技百万项目(YKD2017KJBW015)，项目负责人：高尚

Three-dimensional finite element analysis of anterior cervical fixation system in children

Li Kun1, 2, Wang Xing1, 2, Li Zhijun1, 2, Gao Shang1, Sun Hao3, Xiong Feng2, Wang Peng2    

  1. 1Department of Human Anatomy, 2Digital Medical Center, 3Student Administration Office, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
  • Received:2021-03-22 Revised:2021-03-24 Accepted:2021-04-30 Online:2022-04-28 Published:2021-12-14
  • Contact: Li Zhijun, Professor, Doctoral supervisor, Department of Human Anatomy, and Digital Medical Center, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China Gao Shang, Associate professor, Master’s supervisor, Department of Human Anatomy, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
  • About author:Li Kun, Master, Department of Human Anatomy, and Digital Medical Center, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China Wang Xing, MD, Department of Human Anatomy, and Digital Medical Center, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China Li Kun and Wang Xing contributed equally to this article.
  • Supported by:
    National Natural Science Foundation of China, No. 81860382 (to WX); National Natural Science Foundation of China, No. 81860383 (to LZJ); Youth Fund Project of Inner Mongolia Medical University, No. YKD2020QNCX055 (to LK); Talent Cultivation Project of Inner Mongolia Medical University, No. YCPY20200090 (to LK); Talent Cultivation Project of Inner Mongolia Medical University, No. YCPY20200002 (to LK); Laboratory Open Project of Inner Mongolia Medical University, No. 2020ZN48 (to LK); Undergraduate Innovation and Entrepreneurship Project of Inner Mongolia Medical University, No. 202010132001 (to XF); Natural Science Foundation Project of Inner Mongolia Autonomous Region, No. 2020LH08021 (to LZJ); Natural Science Foundation Project of Inner Mongolia Autonomous Region, No. 2020MS03061 (to WX); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2019MS08017 (to ZSJ); Science and Technology Million Project of Inner Mongolia Medical University, No. YKD2017KJBW015 (to GS)

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摘要：

文题释义：
枕-寰-枢复合体：由C0-C2的寰枕关节、寰枢正中(寰齿关节)和外侧关节及周围关节软骨、韧带等软组织构成，其作为连接颅脑与上颈椎的重要力学结构，结构特殊且功能复杂，可满足头颈部多维运动并提供必要的力学支撑以保护生命中枢脑干及周围血管、神经等重要结构。
有限元分析：通过计算机模拟人体解剖结构及各种不同状态下几何重建及设定，经过验证后，对椎体和软组织内部结构，包括肌肉、韧带等结缔组织的压力、张力、载荷和形变方面进行模拟。

背景：儿童枕-寰-枢关节在形态发育、生理特性等方面有自身的特征，临床损伤较常见。枕寰枢内固定装置是一种可以维持寰枢椎稳定性的方法，其生物力学特点与传统融合术之间的差异有待进一步研究。
目的：运用三维有限元分析法对新型儿童枕颈前路内固定装置进行生物力学评价。
方法：在建立的正常C0-C2关节三维有限元模型基础上删除横韧带及关节囊，模拟建立枕颈损伤模型，在该模型上置入新型儿童枕颈前路内固定装置构建其内固定有限元模型，运用有限元法对各模型的活动度及应力进行对比分析。
结果与结论：儿童枕颈钛板-螺钉内固定有限元模型与正常儿童有限元模型相比，屈伸、侧屈、旋转运动都明显限制了枕寰枢活动度，说明此种枕颈内固定系统可取得较好的稳定性。枕寰枢骨性结构在前屈、后伸、侧屈及旋转时，应力主要集中在钛板与斜坡接触处、枢椎椎体处、螺钉与骨面接触处。最大应力均来源于螺钉与钛板接触处，说明枕颈内固定系统应力较分散，降低了螺钉-钛板断裂的风险。

https://orcid.org/0000-0002-8329-3368 (李琨) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 枕寰枢, 内固定, 有限元, 儿童, 活动度, 应力

Abstract: BACKGROUND: Occipito-atlanto-axial joint has its own characteristics in morphological development and physiological characteristics, and clinical injuries are common in children. The differences between the biomechanical characteristics of occipito-atlantoaxial internal fixation (a way to maintain the stability of the atlantoaxial spine) and conventional fusion need further study.  
OBJECTIVE: To evaluate the biomechanics of a new occipitocervical anterior internal fixation device in children by three-dimensional finite element analysis.
METHODS:  The transverse ligament and joint capsule were deleted on the basis of the established three-dimensional finite element model of the normal C0-C2 joint, and the occipitocervical injury model was simulated. A new type of anterior occipitocervical internal fixation device was placed on the model to construct the finite element model of internal fixation. The motion range and stress of each model were compared and analyzed by the finite element method.  
RESULTS AND CONCLUSION: Compared with the normal children’s finite element model of occipitocervical titanium plate-screw internal fixation, the occipitocervical and atlantoaxial motion was significantly limited in flexion and extension, lateral flexion and rotation, indicating that this occipitocervical internal fixation system could achieve better stability. During the flexion, extension, lateral flexion and rotation of the occipito-atlantoaxial structure, the stress mainly concentrated on the contact between the titanium plate and the slope, the axial vertebral body, and the contact between the screw and the bone surface. The maximum stress originated from the contact between the screw and the titanium plate, indicating that the stress of the occipitocervical internal fixation system was relatively dispersed, which reduced the risk of screw-titanium plate fracture.

Key words: occipito-atlantoaxial, internal fixation, finite element, children, motion range, stress

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