中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (31): 4970-4974.doi: 10.3969/j.issn.2095-4344.0362

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

有限元法分析寰-枢椎椎弓根螺钉内固定的生物力学变化

陈树金1,2,马向阳1,杨进城1,尹庆水1,杨 敏1,邹小宝1   

  1. 1广州军区广州总医院骨科,广东省广州市 510010;2广州中医药大学研究生院,广东省广州市 510405
  • 出版日期:2018-11-08 发布日期:2018-11-08
  • 通讯作者: 马向阳,教授,主任医师,硕士生导师,博士后,广州军区广州总医院骨科,广东省广州市 510010
  • 作者简介:陈树金,男,1989年生,广州中医药大学在读硕士,主要从事脊柱外科方面的研究。
  • 基金资助:

    国家自然科学基金(81672232);广东省省级科技计划项目(2015B020233013)

Biomechanical changes of atlantoaxial pedicle screw-rod fixation: a finite element analysis  

Chen Shu-jin1, 2, Ma Xiang-yang1, Yang Jin-cheng1, Yin Qing-shui1, Yang Min1, Zou Xiao-bao1   

  1. 1Department of Orthopedics, General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China; 2Graduate School of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Online:2018-11-08 Published:2018-11-08
  • Contact: Ma Xiang-yang, Professor, Chief physician, Master’s supervisor, Department of Orthopedics, General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China
  • About author:Chen Shu-jin, Master candidate, Department of Orthopedics, General Hospital of Guangzhou Military Command, Guangzhou 510010, Guangdong Province, China; Graduate School of Guangzhou University of Chinese Medicine, Guangzhou 510405, Guangdong Province, China
  • Supported by:

    the National Natural Science Foundation of China, No. 81672232; the Science and Technology Program of Guangdong Province, No. 2015B020233013

摘要:

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文题释义:
椎弓根螺钉:寰椎椎弓根螺钉于2002年首先报道,该技术相较侧块螺钉可避开上颈椎后方静脉丛及C2神经根,减少术中出血及对C2神经根骚扰;枢椎椎弓根螺钉于1994年首次提出,术中可探查并根据椎弓根走向置入螺钉,安全有效。椎弓根螺钉把持力较侧块螺钉及椎板螺钉均强,抗拔出效果更佳。
寰-枢椎椎弓根螺钉内固定系统:已广泛应用于临床,尤其对于上颈椎病变同时伴有骨质疏松症患者,更加牢固可靠,但现阶段对于其生物力学方面的研究相对较少。
 
摘要
背景:寰-枢椎椎弓根螺钉内固定系统已广泛应用于临床,尤其对于上颈椎病变同时伴有骨质疏松症患者,更加牢固可靠,但现阶段对于其生物力学方面的研究相对较少。
目的:建立寰-枢椎椎弓根螺钉钉棒内固定三维有限元分析模型,分析其生物力学特性。
方法:通过CT扫描获取一健康成年人枕骨、寰枢椎图像信息,构建寰-枢椎椎弓根螺钉钉棒内固定三维有限元分析模型,利用Abaqus加载前屈、后伸、左右侧弯、左右旋转等6种载荷,分析不同运动状态下内固定系统的应力变化。
结果与结论:①寰-枢椎椎弓根螺钉钉棒内固定系统明显减少了上颈椎运动幅度,不同运动状态下,螺钉应力均主要集中在螺钉的钉-骨交界处及钉棒连接处;②前屈、左右侧弯、左右旋转状态下,枢椎椎弓根螺钉根部承受最大应力;③后伸状态下,寰椎椎弓根螺钉根部承受最大应力;④旋转状态下,螺钉与连接棒均存在明显的高应力区,螺钉及连接棒所承受应力最大值明显高于其他运动状态;⑤提示寰-枢椎椎弓根螺钉钉棒内固定安全可靠,螺钉进钉点根部周围易出现应力集中,旋转状态下,螺钉所受的应力明显增加。

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: 0000-0001-5088-6477(陈树金)

关键词: 寰椎, 枢椎, 椎弓根螺钉, 有限元, 生物力学, 国家自然科学基金

Abstract:

BACKGROUND: Atlantoaxial pedicle screw-rod fixation has been extensively applied in clinic, especially for upper cervical lesions with osteoporosis. But there are few biomechanical studies.

OBJECTIVE: To investigate the biomechanical features of atlantoaxial pedicle screw-rod fixation by three-dimensional finite element analysis.
METHODS: CT data of occipital bone and atlantoaxial vertebrae were obtained from a healthy adult volunteer, and the three-dimensional finite element analysis model of atlantoaxial pedicle screw-rod fixation was established. The changes of von Mises Stress of the internal fixation system under different loads (flexion, extension, left and right lateral bending, as well as left and right axial rotation by Abaqus) were analyzed.
RESULTS AND CONCLUSION: (1) Atlantoaxial pedicle screw-rod fixation significantly reduced the motion range of upper cervical vertebra. (2) The stress concentrated on the bone-screw interface and screw-rod interface under different postures. The maximum stress located at the root of axoid pedicle screws under flexion, left and right lateral bending, as well as left and right axial rotation. (3) The maximum stress located at the root of atlas pedicle screws under extension. (4) Mises stress was obviously increased under rotation. (5) Atlantoaxial pedicle screw-rod fixation is safe and reliable. Stress concentration always appears at the root of screw and the Mises stress is increased obviously under rotation. 

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: Axis, Finite Element Analysis, Biomechanics, Tissue Engineering

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