中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (3): 409-414.doi: 10.3969/j.issn.2095-4344.0039

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

有限元法分析腰椎融合与非融合后的应力分布

刘 潇,刘耀升,刘蜀彬   

  1. 军事医学研究院附属医院(解放军第307医院)骨科,北京市  100071
  • 出版日期:2018-01-28 发布日期:2018-01-28
  • 通讯作者: 刘蜀彬,主任医师,硕士生导师,军事医学研究院附属医院(解放军第307医院)骨科,北京市 100071
  • 作者简介:刘潇,男,1989年生,四川省荣县人,汉族,军事医学研究院附属医院骨科在读硕士,2012年解放军第三军医大学毕业,医师,主要从事骨转移瘤临床治疗方面的研究。
  • 基金资助:

    解放军第307医院创新科研基金(JS-2014-06)

Finite element analysis of the stress distribution of spinal fusion versus non-fusion surgeries

Liu Xiao, Liu Yao-sheng, Liu Shu-bin   

  1. Department of Orthopedics, the Affiliated Hospital of Institute for Military Medicine (the 307th Hospital of Military of Chinese PLA), Beijing 100071, China
  • Online:2018-01-28 Published:2018-01-28
  • Contact: Liu Shu-bin, Chief physician, Master’s supervisor, Department of Orthopedics, the Affiliated Hospital of Institute for Military Medicine (the 307th Hospital of Military of Chinese PLA, Beijing 100071, China
  • About author:Liu Xiao, Studying for master’s degree, Physician, Department of Orthopedics, the Affiliated Hospital of Institute for Military Medicine (the 307th Hospital of Military of Chinese PLA, Beijing 100071, China
  • Supported by:

    the Innovative Research Foundation of the 307th Hospital of Military of Chinese PLA, No. JS-2014-06

摘要:

文章快速阅读:


文题释义:
腰椎融合技术:经长期实验发现,椎体融合后存在腰部活动受限和生物力学改变,腰椎融合节段丧失运动功能导致腰椎不稳、假关节形成、邻近节段加速退变,出现继发性腰椎管狭窄、椎体滑脱甚至术前症状复发。手术相邻节段椎间盘退变加速是脊椎融合后有争议的术后并发症。由于椎体融合改变了脊柱原有的结构及活动分配方式,导致脊柱屈伸、旋转及力学分配发生显著改变,相邻节段活动度代偿性增大,应力集中于相邻节段椎间盘和关节突关节,促使其发生退变。尤其对于多节段融合的患者而言风险更大。
腰椎非融合技术:这种术式的设计理念旨在保留固定节段的正常生理活动度,术中不采取植骨融合,利用动态内固定系统有效维持脊柱稳定性,以达到治疗目的的同时延缓邻近节段的退变。
 
摘要
背景:目前临床治疗腰椎退行性变仍以传统椎体融合术式为主,近年来椎体非融合手术发展迅速,两种术式对腰椎应力的影响值得进一步研究。
目的:通过有限元分析法探索退变腰椎载荷分布及腰椎退变的机制,并对比分析融合与非融合术后腰椎的应力分布及两种手术对退变腰椎的改善情况。
方法:基于CT图像分别建立正常、腰椎间盘突出退变、融合术后及非融合术后4组腰椎的有限元模型,利用workbench 17.0模拟4组模型分别处于中立位、侧屈位、屈曲位及旋转位时的受力,并进行静力学有限元分析。
结果与结论:①通过对退变腰椎有限元分析发现,椎间盘应力主要集中在纤维环后侧,当纤维环变性时在应力作用下特易变薄,从而影响腰椎稳定性;②对比4组腰椎的有限元分析结果后发现,非融合术腰椎的有限元结果更接近正常腰椎,因而采用非融合方案对退变腰椎的修复效果更佳。

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
ORCID: 0000-0003-0310-5396(刘潇)

关键词: 骨科植入物, 数字化骨科, 脊柱植入物, 腰椎, 退变模型, 融合, 非融合, 有限元分析, 生物力学, 应力, 腰椎稳定性

Abstract:

BACKGROUND: At present, traditional interbody fusion is still the main method for lumbar degeneration, and non-fusion treatment has achieved rapid development in recent years, but the effects of two kinds of methods on the lumbar biomechanics deserve a further study.

OBJECTIVE: To explore the load distribution on the degenerative lumbar vertebrae, and pathogenesis of lumbar spine degeneration through finite element analysis; and to compare the stress distribution on the lumbar vertebrae and treatment outcomes after fusion and non-fusion surgeries.
METHODS: The finite element models of four groups were established, respectively, based on the CT images, including normal lumbar spine, lumbar intervertebral disc herniation, and lumbar spine after fusion and non-fusion surgeries. The four groups were modeled in neutral position, lateral flexion, flexion and rotation by workbench 17.0, and the finite element analysis of stress and statics was conducted.
RESULTS AND CONCLUSION: (1) The finite element analysis of degenerative lumbar spine showed that the stress of intervertebral disc mainly concentrated on the posterior part of the annulus fibrosus. The degenerative annulus fibrosus easily became thin under stress, thus affecting the lumbar stability. (2) The comparative analysis results found that the finite element results of the lumbar spine after non-fusion surgery were closer to those of the normal lumbar spine. Therefore, non-fusion surgery can achieve better repair outcomes in the treatment of lumbar vertebral degeneration.

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

Key words: Lumbar Vertebrae, Spinal Fusion, Finite Element Analysis, Biomechanics, Tissue Engineering

中图分类号: