中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (3): 553-560.doi: 10.12307/2025.870

• 骨与关节有限元分析Finite element analysis of bones and joints • 上一篇    下一篇

腰椎融合与人工椎间盘置换比较的有限元分析

赵金港，刘利平，陈建伟   

  1. 1华北理工大学人工智能学院，河北省唐山市   063210；2上海电子信息职业技术学院机械与能源工程学院，上海市   201411；3上海交通大学医学院附属仁济医院宝山分院骨科，上海市   200044；4上海交通大学医学院附属仁济医院骨科，脊柱外科，上海市   200127
  • 收稿日期:2024-10-22 接受日期:2025-01-06 出版日期:2026-01-28 发布日期:2025-07-03
  • 通讯作者: 刘利平，博士，教授，上海电子信息职业技术学院机械与能源工程学院，上海市 201411
  • 作者简介:赵金港，男，1995年生，河南省周口市人，汉族，华北理工大学在读硕士，主要从事腰椎重建及力学分析。

Finite element analysis comparing lumbar fusion and artificial intervertebral disc replacement

Zhao Jingang, Liu Liping, Chen Jianwei   

  1. 1School of Artificial Intelligence, North China University of Science and Technology, Tangshan 063210, Hebei Province, China; 2School of Mechanical and Energy Engineering, Shanghai Electronic Information Vocational and Technical College, Shanghai 201411, China; 3Department of Orthopedics, Baoshan Branch of Renji Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200044, China; 4Department of Orthopedics, Spine Surgery, Renji Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2024-10-22 Accepted:2025-01-06 Online:2026-01-28 Published:2025-07-03
  • Contact: Liu Liping, MD, Professor, School of Mechanical and Energy Engineering, Shanghai Electronic Information Vocational and Technical College, Shanghai 201411, China
  • About author:Zhao Jingang, Master candidate, School of Artificial Intelligence, North China University of Science and Technology, Tangshan 063210, Hebei Province, China

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摘要：

文题释义：

远端位移：可以同时进行位移和角度旋转的加载。此次研究在腰椎融合模型的L2上表面施加此边界条件，以达到术前活动度，用来模拟腰椎融合后高负荷与重体力劳动迫使邻近椎间盘对融合节段的补偿行为。
机械式人工椎间盘与黏弹性人工椎间盘：机械式人工椎间盘主要包括2个金属终板和1个核心，这种类型的人工椎间盘强调耐久性和稳定性。黏弹性人工椎间盘使用柔软、具有弹性的聚合材料，这些材料在机械特性上更接近人体的椎间盘，能更好地模拟天然椎间盘的压缩和弹性行为。

摘要
背景：腰椎退行性疾病是一种主要影响椎间结构的肌肉骨骼系统疾病，其治疗方法有腰椎融合和椎间盘置换。
目的：对比分析腰椎融合、机械式腰椎间盘假体置换和黏弹性腰椎间盘假体置换之间的差异性。
方法：根据1名健康成人腰椎的计算机断层扫描图像，使用Mimic、Geomagic及Ansys等软件构建L2-L5正常腰椎的有限元模型。使用建模软件构建出腰椎融合和腰椎置换所需的器材，依据腰椎融合与椎间盘置换的手术要求对L3-L4节段腰椎进行处理，构建相应的有限元模型。施加特定的边界条件，提取腰椎各个节段的活动度、手术邻近椎间盘应力及假体内衬应力。
结果与结论：①相较于术前，腰椎融合术后若保持原有活动度，上邻近椎间盘最大应力在前屈和侧弯状态下增加了64.09%和39.79%，下邻近椎间盘最大应力在前屈和侧弯状态下增加了24.39%和20.98%，表明在重体力劳动时，上邻近椎间盘比下邻近椎间盘将遭受到更大的应力变化；②椎间盘置换的邻近椎间盘应力并未表现出显著变化，其中机械式假体置换略微降低邻近椎间盘的应力，而黏弹性假体置换更符合椎间盘的生物特性，且其邻近椎间盘最大应力与术前相近；③在稳定性方面，机械式假体置换节段侧弯状态活动度增加了51.67%，后伸活动度增加了53.27%，而黏弹性假体能更好地维持置换节段的活动度；④另外，机械式假体内衬的应力主要集中在边缘区域，这种应力分布可能导致边缘磨损进而影响假体使用寿命。

关键词: 腰椎融合, 椎间盘置换, 人工椎间盘, 邻近椎间盘, 有限元分析, 生物力学

Abstract: BACKGROUND: Lumbar degenerative disease is a disease of the musculoskeletal system that primarily affects the intervertebral structures, and the disease is treated with lumbar fusion and disc replacement.
OBJECTIVE: To conduct comparative analysis of the differences between lumbar fusion, mechanical lumbar disc prosthesis replacement, and viscoelastic lumbar disc prosthesis replacement.
METHODS: The computerized tomography images of a healthy adult were used to construct a finite element model of the L2-L5 normal lumbar spine with Mimic, Geomagic, and Ansys software. The equipment required for lumbar fusion and lumbar spine replacement was constructed using modeling software, and the L3-L4 segment of the lumbar spine was processed according to the surgical requirements for lumbar fusion and intervertebral disc replacement, creating the corresponding finite element model. Specific boundary conditions were applied to extract the mobility of each lumbar spine segment, the stresses on the neighboring intervertebral discs, and the stresses on the prosthesis lining.
RESULTS AND CONCLUSION: (1) Compared with the preoperative period, the maximum stress in the upper neighboring discs increased by 64.09% and 39.79% in the forward flexion and lateral bending states if the original mobility was maintained after lumbar fusion surgery. The maximum stress in the lower neighboring discs increased by 24.39% and 20.98% in forward flexion and lateral bending. This suggested that the upper adjacent discs would suffer greater stress changes than the lower adjacent discs during heavy physical labor. (2) Disc replacement did not show significant changes in adjacent disc stress, with mechanical prosthesis replacement slightly reducing adjacent disc stress, while viscoelastic prosthesis replacement was more in line with the biological properties of the disc, with maximum adjacent disc stress similar to that of the preoperative period. (3) In terms of stability, the mechanical prosthesis replacement segment showed a 51.67% increase in range of motion in the lateral bending state and a 53.27% increase in range of motion in the posterior extension state, whereas the viscoelastic prosthesis was better able to maintain mobility in the replacement segment. (4) In addition, the stresses in the liner of the mechanical prosthesis were mainly concentrated in the edge region, and this stress distribution may lead to edge wear and thus affect the service life of the prosthesis.

Key words: lumbar fusion, lumbar disc replacement, artificial disc, adjacent disk, finite element analysis, biomechanics

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