中国组织工程研究

中国组织工程研究 ›› 2023, Vol. 27 ›› Issue (18): 2789-2796.doi: 10.12307/2023.303

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

切除不同范围钩突后颈椎关节突的有限元对比分析

郝韵腾1，史 君2，刘宇航1，李 琨3，4，马 渊4，张少杰3，4，王超群5，陈 杰3，张志峰6，郑雷刚7，王 星3，4，李志军3，4   

  1. 内蒙古医科大学，1研究生院，2基础医学院生理学教研室，3基础医学院解剖学教研室，内蒙古自治区呼和浩特市   010110；4内蒙古医科大学数字医学中心，内蒙古自治区呼和浩特市   010059；5内蒙古医科大学附属医院影像科，内蒙古自治区呼和浩特市   010050；6内蒙古医科大学第二附属医院关节科，内蒙古自治区呼和浩特市   010000；7内蒙古自治区中医医院中医骨伤科，内蒙古自治区呼和浩特市   010020
  • 收稿日期:2022-01-29 接受日期:2022-05-21 出版日期:2023-06-28 发布日期:2022-09-14
  • 通讯作者: 李志军，教授，博士生导师，内蒙古医科大学基础医学院解剖学教研室，内蒙古自治区呼和浩特市 010110；内蒙古医科大学数字医学中心，内蒙古自治区呼和浩特市 010059 王星，博士，副教授，内蒙古医科大学基础医学院解剖学教研室，内蒙古自治区呼和浩特市 010110；内蒙古医科大学数字医学中心，内蒙古自治区呼和浩特市 010059
  • 作者简介:郝韵腾，男，1997年生，山西省吕梁市人，内蒙古医科大学在读硕士，主要从事于脊柱脊髓的数字化研究。 史君，1980年生，2018年北京中医药大学毕业，博士，副教授，主要从事从事运动生理学方面的研究。
  • 基金资助:
    国家自然科学基金资助项目(81860383)，项目负责人：李志军；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；国家自然科学基金资助项目(81860382)，项目负责人：王星；内蒙古自治区自然科学基金资助项目(2020MS03061)，项目负责人：王星；内蒙古自治区高等学校青年科技英才支持计划资助(NJYT22009)，项目负责人：王星；内蒙古自治区科技计划项目(2019GG158)，项目负责人：王星；内蒙古医科大学科研重点项目(YKD2021ZD011)，项目负责人：王星；内蒙古自治区卫生健康委医疗卫生科技计划项目(202201217)，项目负责人：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；内蒙古医科大学青年基金项目(YKD2020QNCX055)，项目负责人：李琨；内蒙古自治区自然科学基金资助项目(2019MS08139)，项目负责人：陈杰

Comparative finite element analysis of the cervical articular process after resection of different ranges of the uncinate processes

Hao Yunteng1, Shi Jun2, Liu Yuhang1, Li Kun3, 4, Ma Yuan4, Zhang Shaojie3, 4, Wang Chaoqun5, Chen Jie3, Zhang Zhifeng6, Zheng Leigang7, Wang Xing3, 4, Li Zhijun3, 4   

  1. 1Graduate School of Inner Mongolia Medical University; 2Department of Physiology, 3Department of Anatomy, School of Basic Medicine; 4Center for Digital Medicine, Inner Mongolia Medical University; 5Department of Imaging, Affiliated Hospital of Inner Mongolia Medical University; 6Department of Joint, Second Affiliated Hospital of Inner Mongolia Medical University; 7Department of Orthopedics and Traumatology, Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine
  • Received:2022-01-29 Accepted:2022-05-21 Online:2023-06-28 Published:2022-09-14
  • Contact: Li Zhijun, Professor, Doctoral supervisor, Department of Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; Center for Digital Medicine, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China Wang Xing, PhD, Associate professor, Department of Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China; Center for Digital Medicine, Inner Mongolia Medical University, Hohhot 010059, Inner Mongolia Autonomous Region, China
  • About author:Hao Yunteng, Master candidate, Graduate School of Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Shi Jun, MD, Associate professor, Department of Physiology, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Hao Yunteng and Shi Jun contributed equally to this article.
  • Supported by:
    National Natural Science Foundation of China, No. 81860383 (to LZJ); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2020LH08021 (to LZJ); National Natural Science Foundation of China, No. 81860382 (to WX); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2020MS03061 (to WX); the Support Program for Young Scientists and Technologists in Higher Education Institutions of Inner Mongolia Autonomous Region No. NJYT22009 (to WX); Science and Technology Program of Inner Mongolia Autonomous Region, No. 2019GG158 (to WX); Key Project of Scientific Research of Inner Mongolia Medical University, No. YKD2021ZD011 (to WX); Medical and Health Science and Technology Program of Inner Mongolia Autonomous Region Health and Health Commission, No. 202201217 (to WX); Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2019MS08017 (to ZSJ); Youth Fund Project of Inner Mongolia Medical University, No. YKD2020QNCX055 (to LK); the Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2019MS08139 (to CJ) 

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摘要：

文题释义：
钩椎关节(Uncovertebral Joint)：又称Luschca关节(Luschka joint)，是下颈椎的独特特征，是位于椎体后外侧呈矢状位的嵴样隆起，由颈椎椎体上侧方的骨性突起——钩突与相邻上位椎体下侧方的斜坡关节构成，具有限制椎体间侧方移位的作用。
钩突：为钩椎关节中C3-C7椎体上侧方的骨性突起，该结构的增生、骨折等病变往往会压迫神经根、椎动脉、交感神经等结构，导致相应颈椎病症状的发生，因此针对该关节的研究也比较广泛。

背景：钩突增生常导致颈椎病发生，无需内固定的钩椎关节切除术具有重要意义，但尚存诸多问题。
目的：建立全颈椎(C0-T1)三维有限元模型，切除钩突不同范围后，探究颈椎关节突的应力变化特点和规律，为临床颈椎病的手术治疗提供理论依据。
方法：对40岁男性正常成人志愿者进行全颈椎螺旋CT轴位薄层扫描来获得原始数据，应用Mimics、GeomagicStudio、Hypermesh、Abaqus等软件技术建立C0-T1全颈椎三维有限元模型，在C5椎体上构建单侧钩突切除50%、100%和双侧钩突切除100%的3种模型组，然后加载相同力矩赋予前屈、后伸、左右侧屈和左右旋转6种工况，以观测切除不同范围钩突后颈椎关节突关节在不同状态下的应力与位移变化。
结果与结论：①通过构建全颈椎正常与切除钩突不同范围后的有限元模型，加载相同力矩后发现颈椎关节突的受力集中区由正常组的C6处上移至切除不同范围钩突组的C5处，得出关节突的受力随椎序增加呈现递增趋势；②应力集中区位于C5和C6处，整体呈尖峰状，不同程度的钩突切除会降低颈椎的稳定性，降低程度随切除范围增大而增大。

https://orcid.org/0000-0001-8441-1269 (郝韵腾)；https://orcid.org/0000-0003-0059-4921 (王星) 

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: 有限元, 钩突, 全颈椎, 生物力学, 钩椎关节, 关节突, 解剖结构

Abstract: BACKGROUND: Uncinate processes hyperplasia often leads to cervical spondylosis. Uncinate process resection without internal fixation is of great significance, but there are still many problems.  
OBJECTIVE: To establish a three-dimensional finite element model of the whole cervical vertebrae (C0-T1), and to explore the characteristics and laws of stress change after excising different ranges of the uncinate process, so as to provide a theoretical basis for the surgical treatment of clinical cervical spondylosis.
METHODS:  Raw data were obtained from spiral CT thin-section scans of 40-year-old male normal adult volunteers. Mimics, GeomagicStudio, Hypermesh, Abaqus and other software technologies were used to establish (C0-T1) full cervical three-dimensional finite element model. Models of 50% unilateral uncinate processes excision, 100% unilateral uncinate processes excision and 100% bilateral uncinate processes excision were constructed on the C5 vertebral body. After loading the same torque, six working conditions of flexion, extension, lateral flexion and rotation were assigned to observe changes of stress and displacement of the cervical facet joint in different states after the resection of the uncinate process.  
RESULTS AND CONCLUSION: (1) By constructing the finite element model of the normal cervical vertebrae and the uncinate process in different ranges, after loading the same torque, the stress concentration area of the cervical articular process was now moved up from C6 in the normal group to C5 in the different ranges of uncinate process excision groups. The stress of the nodal process increased with the increase of the vertebral sequence. (2) The stress concentration areas were located at C5 and C6, and the overall shape was sharp. The degree of resection of the uncinate process reduced the stability of the cervical spine, and the degree of reduction increased with the extent of resection.

Key words: finite element, uncinate process, whole cervical spine, biomechanics, uncinate joint, articular process, anatomical structure

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