中国组织工程研究

中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (18): 2812-2816.doi: 10.12307/2022.686

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

矫形力加载肋骨施力区对胸椎段位移及旋转角度影响的有限元分析

任  东1，朱  晔1，雷  蕾1，王玉任2   

  1. 1大连交通大学机械工程学院，辽宁省大连市   116028；2大连铭洋科技实业有限公司，辽宁省大连市   116028
  • 收稿日期:2021-08-20 接受日期:2021-10-11 出版日期:2022-06-28 发布日期:2022-01-29
  • 通讯作者: 朱晔，博士，讲师，大连交通大学机械工程学院，辽宁省大连市 116028
  • 作者简介:任东，男，1996年生，辽宁省昌图县人，汉族，大连交通大学在读硕士，主要从事先进运动机构与康复机构的设计理论与技术研究。

Orthopedic force applied to the rib influences the displacement and rotation angle of thoracic vertebrae: a finite element analysis

Ren Dong1, Zhu Ye1, Lei Lei1, Wang Yuren2   

  1. 1School of Mechanical Engineering, Dalian Jiaotong University, Dalian 116028, Liaoning Province, China; 2Dalian Mingyang Technology Industrial Co., Ltd., Dalian 116028, Liaoning Province, China
  • Received:2021-08-20 Accepted:2021-10-11 Online:2022-06-28 Published:2022-01-29
  • Contact: Zhu Ye, MD, Lecturer, School of Mechanical Engineering, Dalian Jiaotong University, Dalian 116028, Liaoning Province, China
  • About author:Ren Dong, Master candidate, School of Mechanical Engineering, Dalian Jiaotong University, Dalian 116028, Liaoning Province, China

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摘要：

文题释义：
三维矫形理论：根据椎体生物力学原理，通过固定、旋转、压缩等手段使脊柱在三维层面上达到矫形的目的。
Cobb 角：测量脊柱标准全长的正位相X射线片，确定侧弯的端椎。上、下端椎是指侧弯中向脊柱侧弯凹侧倾斜度最大的椎体。脊柱侧弯凸侧的椎间隙较宽，而在凹侧椎间隙开始变宽的第一个椎体被认为不属于该弯曲的一部分，因此其相邻的一个椎体被认为是该弯曲的端椎。在上端椎的椎体上缘划一横线，同样在下端椎椎体的下缘划一横线。对此两横线各做一垂直线，二垂直线的交角就是 Cobb 角。

背景：脊柱侧弯不但使椎体在冠状面上发生偏移，还会带来椎体的旋转。人们对脊柱侧弯的矫形很少考虑到对椎体旋转的影响，使得矫形效果不佳。
目的：建立有限元模型，在矫形力加载情况，三维层面分析规范施力区、释放区、矫形力大小及施力面积等要素。
方法：基于1例14岁青少年特发性脊柱侧弯患者的CT数据，建立胸椎段椎体与顶椎凸侧上下3条肋骨的有限元模型，分别在肋骨的背部区域、侧身区域、前侧区域施加不同面积的20，40，60，100 N的均布矫形力，在椎体上选取参考点记录不同工况下的位移及旋转角度。
结果与结论：①在侧身区域施加矫形力对于侧弯矫形效果最明显；②在小面积60 N的矫形力加载下，Cobb角从29°矫正到了19°，在冠状面矫形了4.5 mm；③背部区域施力对于椎体的旋转矫形效果最为明显，大面积施加力使得相邻椎体旋转的矫形更加平缓，在背部大面积施加100 N矫形力时，顶椎旋转矫形了76.9%，而前侧区域施力会加重椎体的旋转畸变；④结果说明，对于冠状面的矫形宜采用小面积施加，对于椎体旋转的矫形宜采用大面积施加；冠状面的矫形施力区域宜选择侧身区域；对于凸侧背部区域施力有助于椎体旋转的矫形，前侧区域不利于椎体旋转的矫正且对椎体旋转影响较小；因此胸椎段的三维矫形，可将凸侧侧身与背部区域、凹侧前侧区域设为施力区，其余区域宜设为释放区。

https://orcid.org/0000-0002-7095-5254 (任东) 

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: ">CT图像, 椎体旋转, 逆向工程, 生物力学, 矫形力, 特发性脊柱侧弯, 三维矫形, 有限元

Abstract: BACKGROUND: Scoliosis not only causes a shift of the vertebral body in the coronal plane, but also causes vertebral rotation. Vertebral rotation is rarely considered in the correction of scoliosis, which weakens the correction effect.  
OBJECTIVE: To analyze the loading condition of the orthopedic force, and standardize the force application zone, release zone, orthopedic force magnitude and force area at the three-dimensional level through a finite element model.
METHODS:  Based on the CT data of a 14-year-old adolescent with idiopathic scoliosis, a finite element model of the upper and lower ribs of the thoracic vertebra and the convex side of the parietal vertebra was established, and uniform orthopedic forces of 20, 40, 60, and 100 N were applied to the dorsal region, lateral region and anterior region of the ribs, respectively. Reference points were selected on the vertebral body to record displacement and rotation angle under different working conditions.  
RESULTS AND CONCLUSION: Applying orthopedic force to the lateral area had the most obvious effect on scoliosis correction. The Cobb angle was corrected from 29° to 19° under 60 N to a small area, and the coronal plane was corrected by 4.5 mm. Applying force to the dorsal area had the most obvious effect on the rotation and correction of the vertebral body. Applying force to a large area could relatively gently rotate the adjacent vertebral body. When applying 100 N force to a large dorsal area, the rotation of the apex vertebral body was corrected by 76.9%, while applying force to the anterior area aggravated the rotational distortion of the vertebral body. All these findings indicate that applying force to a small area should be selected for coronal plane correction and applying a force to a large area should be selected for vertebral rotation correction. The lateral area should be selected for coronal orthopedic force. The force applied to the convex dorsal region is beneficial to the correction of vertebral rotation, while the force applied to the anterior region is unfavorable to the correction of vertebral rotation and had little effect on vertebral rotation. Therefore, in the three-dimensional thoracic orthopedic surgery, the lateral side of the convex, the dorsal area, and the anterior area of the concave should be set as the area that the force is applied, and the other areas should be set as the release area.

Key words: CT images, vertebral rotation, reverse engineering, biomechanics, orthopedic force, idiopathic scoliosis, three-dimensional orthosis, finite element

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