中国组织工程研究

中国组织工程研究 ›› 2024, Vol. 28 ›› Issue (18): 2901-2905.doi: 10.12307/2024.072

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

最佳Halo重力牵引治疗Lenke3型脊柱侧凸的生物力学分析

富荣昌，杨骁峥，李现政   

  1. 新疆大学，智能制造现代产业学院，新疆维吾尔自治区乌鲁木齐市   830017
  • 收稿日期:2023-04-08 接受日期:2023-06-01 出版日期:2024-06-28 发布日期:2023-08-26
  • 通讯作者: 富荣昌，硕士，副教授，硕士生导师，新疆大学，智能制造现代产业学院，新疆维吾尔自治区乌鲁木齐市 830017
  • 作者简介:富荣昌，1965年生，2007年瑞士日内瓦大学毕业，硕士，副教授，硕士生导师，主要从事生物力学和机器人动力学研究。
  • 基金资助:
    国家自然科学基金项目(32260235)，项目负责人：富荣昌

Biomechanical analysis of optimal Halo gravity traction in treatment of Lenke 3 scoliosis

Fu Rongchang, Yang Xiaozheng, Li Xianzheng   

  1. College of Intelligent Manufacturing Modern Industry, Xinjiang University, Urumqi 830017, Xinjiang Uygur Autonomous Region, China
  • Received:2023-04-08 Accepted:2023-06-01 Online:2024-06-28 Published:2023-08-26
  • Contact: Fu Rongchang, Master, Associate professor, Master’s supervisor, College of Intelligent Manufacturing Modern Industry, Xinjiang University, Urumqi 830017, Xinjiang Uygur Autonomous Region, China
  • About author:Fu Rongchang, Master, Associate professor, Master’s supervisor, College of Intelligent Manufacturing Modern Industry, Xinjiang University, Urumqi 830017, Xinjiang Uygur Autonomous Region, China
  • Supported by:
    National Natural Science Foundation of China, No. 32260235 (to FRC)

PDF

97

摘要：


文题释义：

Halo重力牵引：可以加强患者脊柱的柔韧度，使手术时获得更好的矫正效果，同时减少手术中神经疾病发生的风险。
Von Mises应力：是一种等效应力，它用应力等值线来表示模型内部的应力分布情况，它可以清晰描述出一种结果在整个模型中的变化，从而使分析人员可以快速地确定模型中的最危险区域。


背景：Halo重力牵引是许多学者认可的术前牵引方法，但大部分为临床观察，缺乏有限元的相关分析。

目的：运用有限元法探究Halo重力牵引对Lenke3型脊柱侧凸的最佳牵引力，从生物力学角度为临床提供理论依据。
方法：对脊柱侧凸患者扫描的CT图像进行逆向建模处理并建立有限元模型，并取正常节段(T1-T4椎体)对模型的有效性进行验证。对腰胸椎侧凸模型设置5组不同的受力条件，模拟患者在不同牵引力作用下的矫正情况。5组皆将L5下表面完全约束，在T1上表面施加沿Z轴正方向(重力的反方向)不同大小的牵引力，分别为50，100，150，200，250 N。对比不同牵引力下侧凸脊柱的位移、主弯曲的Cobb角变化情况、脊柱的伸长量以及Von Mises应力。

结果与结论：①当Halo重力牵引力为150-200 N时，主弯曲的Cobb角缩小量为最大缩小量的69.4%-88.9%，Z轴的伸长量是最大伸长量69.4%-85.9%，受到的应力为最大应力的63.6%-82.9%；②牵引力大于200 N，Cobb角的减少量和Z轴的伸长量变化不明显，但应力值急剧增长，且此时的T6、T7、T8椎体质心到L5中垂线的减小距离最为明显；③当Halo重力牵引力为150-200 N时，对此类型患者的矫正效果最佳——Cobb角缩小量与Z轴伸长量效果较佳的同时不会有应力的急剧增长。上述结果可为临床矫正提供一定的理论支持，可在较大程度矫正侧凸时保证患者安全。

https://orcid.org/0000-0002-7045-7597 (富荣昌) 

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: 脊椎侧凸, Halo重力牵引, Cobb角, 有限元

Abstract: BACKGROUND: Halo gravity traction is a pre-operative traction method recognized by many scholars, but most of them rely on clinical observation and lack finite element analysis.
OBJECTIVE: To explore the best traction force of Halo gravity traction on Lenke 3 scoliosis by finite element method and to provide a theoretical basis for clinics from a biomechanical point of view.
METHODS: The CT images scanned by patients with scoliosis were processed by reverse modeling, and a finite element model was established. The validity of the model was verified by taking normal segments (T1-T4 vertebral bodies). Five groups of different stress conditions were set on the lumbar-thoracic scoliosis model to simulate the correction of patients under different traction forces. In all five groups, the lower surface of L5 was completely restrained, and different traction forces were applied to the upper surface of T1 along the positive direction of the Z axis (the opposite direction of gravity), which were 50, 100, 150, 200, and 250 N, respectively. The displacement of the scoliosis spine, Cobb angle change of the main bending, elongation of the spine, and Von Mises stress were compared under different traction forces.
RESULTS AND CONCLUSION: (1) When the Halo gravity traction force was 150 N to 200 N, the reduction of the Cobb angle of the main bending was 69.4% to 88.9% of the maximum reduction; the elongation of the Z axis was 69.4% to 85.9%, and the stress was 63.6% to 82.9% of the maximum stress. (2) When the traction force was greater than 200 N, the reduction of the Cobb angle and the elongation of the Z axis did not change obviously, but the stress value increased sharply. At this time, the distance from the centroids of T6, T7, and T8 to the vertical line of L5 was the most obvious. (3) When the Halo gravity traction force was 150 N to 200 N, the correction effect on this type of patient was the best—the reduction of Cobb angle and the elongation of the Z axis were better without the sharp increase in stress. (4) It has certain theoretical support for clinical correction and can ensure the safety of patients when scoliosis is corrected to a large extent.

Key words: spinal scoliosis, Halo gravity traction, Cobb angle, finite element

中图分类号: