中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (44): 8212-8217.doi: 10.3969/j.issn.2095-4344.2012.44.009

• 数字化骨科 digital orthopedics • 上一篇    下一篇

不同植入物固定L1节段爆裂性骨折的三维有限元分析

梁 宁1，康意军2，陈 飞2   

  1. 1清华大学第一附属医院骨科，北京市 100016
    2中南大学湘雅二医院脊柱外科，湖南省长沙市 410013
  • 收稿日期:2012-02-25 修回日期:2012-04-24 出版日期:2012-10-28 发布日期:2012-10-28
  • 通讯作者: 康意军，博士，教授，主任医师，中南大学湘雅二医院脊柱外科，湖南省长沙市 410013
  • 作者简介:梁宁★，男，1984年生，湖南省邵阳市人，汉族，2009年中南大学湘雅医学院毕业，硕士，主要从事骨科方面的研究。 liangning1984@hotmail.com

Three-dimensional finite element analysis on different implant fixation for L1 segment burst fracture

Liang Ning1, Kang Yi-jun2, Chen Fei2   

  1. 1Department of Orthopedics, the First Affiliated Hospital of Tsinghua University, Beijing 100016, China
    2Department of Spine Surgery, the Second Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
  • Received:2012-02-25 Revised:2012-04-24 Online:2012-10-28 Published:2012-10-28
  • Contact: Kang Yi-jun, Doctor, Professor, Chief physician, Department of Spine Surgery, the Second Xiangya Hospital of Central South University, Changsha 410013, Hunan Province, China
  • About author:Liang Ning★, Master, Department of Orthopedics, the First Affiliated Hospital of Tsinghua University, Beijing 100016, China liangning1984@hotmail.com

PDF

499

摘要：

背景：胸腰段椎体爆裂性骨折临床十分常见，通过前路或者后路内固定重建稳定是目前常用的方法，作者未查及有关内固定应力情况的相关报道。
目的：通过三维有限元法分析在L1节段爆裂性骨折情况下前路钛网重建钉棒内固定和后路椎弓根内固定两种方式中内固定物应力的分布情况，并进行两种方式稳定性的比较。
方法：选择1名健康男性志愿者，通过CT扫描和有限元软件建立T12-L2节段的三维有限元模型。在验证有效的有限元模型上分别模拟L1节段爆裂性骨折，建立前路L1节段钛网重建钉棒内固定模型(模型A)和后路短节段椎弓根钉棒内固定模型(模型B)，在各模型上施加载荷，观察内固定应力分布情况，进行稳定性的比较。
结果与结论：建立T12-L2节段的三维有限元模型。两种内固定方式有限元模型在不同载荷实验中，模型A应力主要集中在钛网区域，模型B应力主要集中在钉棒的交接处。模型A的稳定性优于后者，模型A的T12平面的平均应力值小于模型B，差异有显著性意义(P < 0.01)。说明前路术后钛网发生沉降和后路术后钉棒处断裂均可能与局部应力集中有关。前路钛网重建钉棒内固定较后路椎弓根内固定稳定性更好。

关键词: 脊柱L1节段, 骨折, 内固定, 前路, 后路, 三维有限元, 植入体, 钛网, 螺钉, 棒, 椎弓根

Abstract:

BACKGROUND: Thoracolumbar burst fracture is a common injury in clinic. Inner fixation surgery through anterior and posterior approach is the commonly used method to rebuild the stability. The stress distribution has not been reported in literature.
OBJECTIVE: To investigate the stress distribution of internal fixation materials in titanium mesh reconstruction screw-rods system fixation and posterior approach screw-rods system fixation for the treatment of L1 segment burst fracture by three-dimensional finite element analysis, and to compare the stability of these two methods.
METHODS: One healthy male volunteer was selected to establish the T12-L2 segment three-dimensional finite element model through CT scan and finite element software. The L1 segment burst fracture was simulated on the effective finite element model to establish the anterior approach L1 segment titanium mesh reconstruction combine screw-rods system fixation (model A) and posterior approach short segment screw-rods system fixation (model B), the load was applied on the models in order to observe the stress distribution and compare the stability.
RESULTS AND CONCLUSION: A T12-L2 segment three-dimensional finite element model was established. In the loading experiment, the stress of model A was mainly in the titanium mesh area and the stress of model B was mainly concentrated in the screw-rod junction. Both model A and model B could gain valid stability in reconstruction of L1 segment burst fracture, and the former was better than later. Mean stress in T12 plane of model A was less than that of model B, and the difference was statistically significant (P < 0.01). Titanium mesh deposition after anterior approach and screw-rod fracture after posterior approach may relate with local stress concentration. The anterior approach titanium mesh reconstruction combine screw-rods system fixation has the better stability than posterior approach screw-rods system fixation.

中图分类号: