中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (3): 448-454.doi: 10.12307/2025.113

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

青少年颈椎间盘突出症有限元模型建立及应力分析

赵宇昕1，亮  亮2，金  凤3，许阳阳4，康志杰1，方  源1，和雨洁1，王  星1，王海燕1，李筱贺1   

  1. 内蒙古医科大学，1基础医学院人体解剖教研室，2第一临床医学院，内蒙古自治区呼和浩特市   010010；3 内蒙古医科大学附属医院影像科，内蒙古自治区呼和浩特市   010010；4长治市人民医院康复医学科，山西省长治市   046000
  • 收稿日期:2023-11-02 接受日期:2023-12-22 出版日期:2025-01-28 发布日期:2024-06-03
  • 通讯作者: 王海燕，教授，硕士生导师，内蒙古医科大学基础医学院人体解剖学教研室，内蒙古自治区呼和浩特市 010010 李筱贺，教授，博士生导师，内蒙古医科大学基础医学院人体解剖学教研室，内蒙古自治区呼和浩特市 010010
  • 作者简介:赵宇昕，男，1992年生，内蒙古自治区巴彦淖尔市人，汉族，内蒙古医科大学在读硕士，主要从事脊柱数字医学研究。 亮亮，女，2001年生，内蒙古自治区通辽市人，蒙古族，内蒙古医科大学本科在读，主要从事数字医学研究。
  • 基金资助:
    内蒙古自治区自然科学基金项目(2021MS08086)，项目负责人：王海燕；2022年度内蒙古自治区卫生健康科技计划项目(202201188)，项目负责人：王海燕；内蒙古医科大学2020年度“成果转化”项目(YKD2020CGZH009)，项目负责人：王海燕；2021年内蒙古自治区蒙医药协同创新中心科学研究项目(MYYXTYB202104)，项目负责人：李筱贺；2021年内蒙古医科大学致远人才项目(ZY0120017)，项目负责人：李筱贺；内蒙古医科大学2021年度校级科研重点项目(YKD2021ZD001)，项目负责人：李筱贺；内蒙古教育厅高等学校创新团队发展计划(NMGIRT2227)，项目负责人：李筱贺；内蒙古自治区2023年自治区重点研发和成果转化计划(科技支撑黄河流域生态保护和高质量发展)项目(2023YFHH0003)，项目负责人：李筱贺

Establishment and stress analysis of a finite element model for adolescent cervical disc herniation

Zhao Yuxin1, Liang Liang2, Jin Feng3, Xu Yangyang4, Kang Zhijie1, Fang Yuan1, He Yujie1, Wang Xing1, Wang Haiyan1, Li Xiaohe1   

  1. 1Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 2First Clinical Medical College of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 3Department of Imaging, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China; 4Department of Rehabilitation Medicine, Changzhi People’s Hospital, Changzhi 046000, Shanxi Province, China
  • Received:2023-11-02 Accepted:2023-12-22 Online:2025-01-28 Published:2024-06-03
  • Contact: Wang Haiyan, Professor, Master’s supervisor, Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China Li Xiaohe, Professor, Doctoral supervisor, Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China
  • About author:Zhao Yuxin, Master candidate, Department of Human Anatomy, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China Liang Liang, First Clinical Medical College of Inner Mongolia Medical University, Hohhot 010010, Inner Mongolia Autonomous Region, China Zhao Yuxin and Liang Liang contributed equally to this article.
  • Supported by:
    Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2021MS08086 (to WHY); 2022 Inner Mongolia Autonomous Region Health Science and Technology Plan Project, No. 202201188 (to WHY); “Achievement Transformation” Project of Inner Mongolia Medical University in 2020, No. YKD2020CGZH009 (to WHY); 2021 Scientific Research Project of Mongolian Medicine Collaborative Innovation Center of Inner Mongolia Autonomous Region, No. MYYXTYB202104 (to LXH); 2021 Zhiyuan Talent Project of Inner Mongolia Medical University, No. ZY0120017 (to LXH); 2021 Key Campus-Level Research Project of Inner Mongolia Medical University, No. YKD2021ZD001 (to LXH); Development Plan for Innovation Teams in Higher Education Institutions of Inner Mongolia Department of Education, No. NMGIRT2227 (to LXH); 2023 Key Research & Development and Achievement Transformation Plan of Inner Mongolia Autonomous Region (Science and Technology Support for Ecological Protection and High quality Development of the Yellow River Basin) Project, No. 2023YFHH0003 (to LXH) 

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摘要：

文题释义：

青少年：是儿童向成人转变的过渡时期，在此期间青少年经历身体发育、性别认同、自我认知和自我认同等变化。
颈椎间盘突出症：是一种椎间盘退行性变的病理过程，通常是由于颈椎间盘的异常突出或损伤所引起，导致压迫或刺激周围的神经根或脊髓，临床症状表现出颈部疼痛，可放射到肩部、胳膊或手部，其他常见症状包括麻木、刺痛、肌肉无力等。

摘要
背景：颈椎间盘突出症可引起肩颈部疼痛、上肢放射性疼痛，发病率逐年上升并趋于年轻化，充分了解青少年颈椎生物力学特点，对于延缓青少年颈椎间盘突出症具有重要意义。
目的：利用有限元分析技术重建正常青少年及青少年颈椎间盘突出症患者的颈椎模型，分析C1-T1颈椎椎体活动度和纤维环、髓核、终板及小关节软骨的生物力学特征。
方法：选择正常青少年和青少年颈椎间盘突出症患者各1例，将连续扫描的颈椎CT原始影像数据以DICOM格式导入Mimics 21.0，分别重建C1-T1；随后将建立好的模型导入3-Matic软件进行椎间盘重建，将完善的模型导入Hypermesh 软件，对椎体、髓核、纤维环、韧带进行网格划分，生成有效的几何模型，赋予材料属性后将最终模型导入ABAQUS软件中。观察C1-C7各节段颈椎椎体在不同工况下的关节活动度，并分析各节段颈椎纤维环、髓核、终板及小关节软骨的生物力学特征。
结果与结论：①正常青少年与颈椎间盘突出症青少年患者颈椎模型C1在6种工况下的关节活动度均高于其他椎体，且正常青少年各节段颈椎椎体活动度均大于颈椎间盘突出症青少年患者；②正常青少年颈椎模型纤维环及髓核应力最大值在C2-3左侧屈工况(0.43 MPa，
0.17 MPa)，颈椎间盘突出症青少年患者颈椎模型应力最大值在C7-T1左侧屈工况(0.54 MPa，0.18 MPa)；③正常青少年颈椎模型终板应力最大值在C3上终板左侧屈工况(1.46 MPa)，颈椎间盘突出症青少年患者模型终板应力最大值在C7下终板左侧屈工况(1.32 MPa)；④正常青少年颈椎小关节软骨应力最大值在C2-3左旋转工况(0.98 MPa)，颈椎间盘突出青少年患者的小关节软骨在不同工况下以C1-2应力增加最明显，应力最大在左侧屈(3.50 MPa)；⑤提示与正常青少年相比，颈椎间盘突出症青少年患者颈椎曲度改变，颈椎整体关节活动度下降；颈椎间盘突出症青少年患者纤维环、髓核及终板在C7-T1节段应力明显增大；C1-2左侧小关节软骨应力明显，颈椎曲度异常可能是引起应力改变的主要因素。

https://orcid.org/0009-0007-9478-7412(赵宇昕) 

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: 青少年, 颈椎间盘突出症, 颈椎应力, 有限元分析, 生物力学

Abstract: BACKGROUND: Cervical disc herniation can cause pain in the neck and shoulder area, as well as radiating pain in the upper limbs. The incidence rate is increasing year by year and tends to affect younger individuals. Fully understanding the biomechanical characteristics of the cervical spine in adolescents is of great significance for preventing and delaying the onset of cervical disc herniation in this age group.
OBJECTIVE: To reconstruct cervical spine models for both healthy adolescents and adolescent patients with cervical disc herniation utilizing finite element analysis techniques, to analyze the motion range of the C1-T1 cervical vertebrae as well as the biomechanical characteristics of the annulus fibrosus, nucleus pulposus, endplates, and the cartilage of the small joints.
METHODS: A normal adolescent’s cervical spine and an adolescent patient with cervical disc herniation were selected in this study. The continuous scan cervical spine CT raw image data were imported into Mimics 21.0 in DICOM format. The C1-T1 vertebrae were reconstructed separately. Subsequently, the established models were imported into the 3-Matic software for disc reconstruction. The perfected models were then imported into Hypermesh software for meshing of the vertebrae, nucleus pulposus, annulus fibrosus, and ligaments, creating valid geometric models. After assigning material properties, the final models were imported into ABAQUS software to observe the joint motion range of the C1-C7 cervical vertebrae segments under different conditions, and to analyze the biomechanical characteristics of the annulus fibrosus, nucleus pulposus, endplates, and small joint cartilage of each cervical spine segment.
RESULTS AND CONCLUSION: (1) In six different conditions, the joint motion range of the C1 vertebra in the cervical spine models of both normal adolescent and adolescent patient with cervical disc herniation was higher than that of the other vertebrae. Additionally, the joint motion range of each cervical spine segment in normal adolescent was greater than that in adolescent patient with cervical disc herniation. (2) In the cervical spine model of normal adolescent, the maximum stress values in the annulus fibrosus and nucleus pulposus were found on the left side during C2-3 flexion conditions (0.43 MPa and 0.17 MPa, respectively). In the cervical spine model of adolescent patient with cervical disc herniation, the maximum stress values were found on the left side during C7-T1 flexion conditions (0.54 MPa and 0.18 MPa, respectively). (3) In the cervical spine model of normal adolescent, the maximum stress value on the endplate was found on the left side of the upper endplate of C3 during flexion conditions (1.46 MPa). In the model of adolescent patient with cervical disc herniation, the maximum stress value on the endplate was found on the left side of the lower endplate of C7 during flexion conditions (1.32 MPa). (4) In the cervical spine model of normal adolescent, the maximum stress value in the small joint cartilage was found in the C2-3 left rotation conditions (0.98 MPa). In adolescent patient with cervical disc herniation, the stress in the small joint cartilage significantly increased under different conditions, especially in C1-2, with the maximum stress found during left flexion (3.50 MPa). (5) It is concluded that compared to normal adolescent, adolescent patient with cervical disc herniation exhibits altered cervical curvature and a decrease in overall joint motion range in the cervical spine. In adolescent with cervical disc herniation, there is a significant increase in stress on the annulus fibrosus, nucleus pulposus, and endplates in the C7-T1 segment. The stress on the left articular cartilage of the C1-2 is notable. Abnormal cervical curvature may be the primary factor causing these stress changes.

Key words: adolescents, cervical disc herniation, cervical spine stress, finite element analysis, biomechanics

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