中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (15): 3081-3088.doi: 10.12307/2025.176

• 数字化骨科Digital orthopedics •    下一篇

新型腰椎关节突关节融合装置的有限元分析

孙飞龙1，2，邱海洋2，姬宇飞2，杨意鹏2，刘大铭2，王龙超2，王  飞2，雷  伟2，张  扬2   

  1. 1西安医学院研究生处，陕西省西安市   710068；2空军军医大学附属西京医院骨科，陕西省西安市   710032
  • 收稿日期:2024-03-01 接受日期:2024-04-28 出版日期:2025-05-28 发布日期:2024-11-02
  • 通讯作者: 张扬，博士，硕士生导师，副教授，副主任医师，空军军医大学附属西京医院骨科，陕西省西安市 710032
  • 作者简介:孙飞龙，男，1996年生，陕西省渭南市人，汉族，在读硕士，主要从事脊柱外科学方面的研究。
  • 基金资助:
    陕西省重点研发计划(2023-YBSF-146)，项目负责人：张扬

Finite element analysis of a novel lumbar facet joint fusion device

Sun Feilong1, 2, Qiu Haiyang2, Ji Yufei2, Yang Yipeng2, Liu Daming2, Wang Longchao2, Wang Fei2, Lei Wei2, Zhang Yang2   

  1. 1Graduate Student Department, Xi’an Medical University, Xi’an 710068, Shaanxi Province, China; 2Department of Orthopedics, Xijing Hospital, Air Force Medical University, Xi’an 710032, Shaanxi Province, China
  • Received:2024-03-01 Accepted:2024-04-28 Online:2025-05-28 Published:2024-11-02
  • Contact: Zhang Yang, PhD, Master’s supervisor, Associate professor, Associate chief physician, Department of Orthopedics, Xijing Hospital, Air Force Medical University, Xi’an 710032, Shaanxi Province, China
  • About author:Sun Feilong, Master candidate, Graduate Student Department, Xi’an Medical University, Xi’an 710068, Shaanxi Province, China; Department of Orthopedics, Xijing Hospital, Air Force Medical University, Xi’an 710032, Shaanxi Province, China
  • Supported by:
    Key Research and Development Plan of Shaanxi Province, No. 2023-YBSF-146 (to ZY)

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摘要：


文题释义：

新型小关节突关节融合固定装置：是一种可以在脊柱小关节突关节出现退行性病变时对其进行融合，从而显著降低了由于保守治疗效果不佳引起的一系列后续临床问题的发生率，同时具有微创及操作简单等优点。
有限元分析：利用较简单的问题代替复杂问题后再求解。通过相关软件建立所需要的模型，进而对模型进行受力分析，从而得出相关数据指导临床工作。

摘要
背景：脊柱小关节骨关节炎被认为是引起老年人下腰痛的常见原因，新型脊柱小关节突关节融合装置能够在脊柱小关节骨关节炎的早期对病变的小关节突关节进行融合，明显降低了由于早期保守治疗不佳和晚期手术治疗引起的一系列并发症的发生率，但其对腰椎生物力学的影响尚未可知。 
目的：探讨新型腰椎关节突关节融合装置与传统融合装置的生物力学差异。
方法：建立完整的L3-S1腰椎三维有限元模型并进行验证。在完整模型的基础上建立3组手术模型(双侧椎弓根螺钉固定模型、双侧新型小关节突关节融合固定模型和双侧关节突螺钉固定模型)，手术节段为L4-5。在500 N载荷下，对所有腰椎模型施加7.5 Nm力矩，计算L4-5节段活动度、位移值和椎间盘应力值，以及L3-4节段和L5-S1节段应力值。
结果与结论：①与完整模型相比，各手术模型L4-5节段的活动度都降低；②新型装置在左右旋工况下L4-5节段活动度最小，在后伸工况下L4-5节段活动度最大，在其他工况下L4-5节段活动度大于双侧椎弓根螺钉固定模型；③新型装置在左右旋工况下L4-5节段的位移值最小，在其他工况下L4-5节段位移值大于双侧椎弓根螺钉固定模型；④对于新型装置在L4-5节段的应力分布，在各个工况下都是最小的；⑤对于L3-4节段新型装置在后伸和左右旋工况下的应力值最大，在其他工况下则小于双侧椎弓根螺钉固定模型；⑥与椎弓根螺钉固定相比，在L5-S1节段该新型装置的应力值都较小；⑦结果表明，与椎弓根螺钉固定相比，该新型装置通过对脊柱小关节进行融合，对腰椎的生物力学产生了一定的影响；在保留手术节段活动度的同时提供了一定的稳定性，同时也减少了手术节段及邻近节段椎间盘的应力值，从而对延缓椎间盘的退变有促进作用，进而表明该新型装置在理论上能够达到与椎弓根螺钉固定相类似的生物力学效果。

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: 腰椎, 关节突关节, 椎弓根螺钉, 融合, 有限元分析, 脊柱, 生物力学, 固定

Abstract: BACKGROUND: Facet joint osteoarthritis is acknowledged as a significant contributor to lower back pain in the geriatric population. The advent of an innovative spinal facet joint fusion device presents a therapeutic option for intervening during the initial stages of facet joint osteoarthritis, and significantly reduces the incidence of a series of complications caused by poor early conservative treatment and late surgical treatment. However, its effect on the biomechanics of the lumbar spine is unknown. 
OBJECTIVE: To investigate the biomechanical disparities between the novel lumbar zygapophyseal joint fusion device and traditional fusion devices.
METHODS: A comprehensive three-dimensional finite element model of the L3-S1 lumbar spine was established and validated. Based on this intact model, three groups of surgical models were constructed: a bilateral pedicle screw fixation model, a bilateral novel facet joint fusion fixation model, and a bilateral facet screw fixation model, with the surgical segment designated as L4-5. Under a load of 500 N, a torque of 7.5 Nm was applied to all lumbar models to calculate the range of motion, displacement values, and intervertebral disc stress values at the L4-5 segment; stress values at the L3-4 and L5-S1 segments were also measured.
RESULTS AND CONCLUSION: (1) Compared with the intact model, the range of motion at the L4-5 segment was reduced in all surgical models. (2) The novel device exhibited the smallest range of motion at the L4-5 segment under left and right rotational conditions; the greatest range of motion at the L4-5 segment under extension conditions; and a greater range of motion under other conditions than the bilateral pedicle screw fixation model. (3) The novel device demonstrated the smallest displacement values at the L4-5 segment under left and right rotational conditions; under other conditions, the displacement values at the L4-5 segment were greater than those in the bilateral pedicle screw fixation model. (4) In terms of stress distribution at the L4-5 segment, the novel device consistently exhibited the smallest values across all conditions. (5) For the L3-4 segment, the novel device showed the greatest stress values under extension and left and right rotational conditions, while under other conditions, the values were lower than those in the bilateral pedicle screw fixation model. (6) Compared with pedicle screw fixation, the novel device produced smaller stress values at the L5-S1 segment. (7) This study indicates that, compared with pedicle screw fixation, the novel device impacts the biomechanics of the lumbar spine by fusing the facet joints. It provides stability while preserving the range of motion at the surgical segment and reduces stress on the intervertebral discs of the surgical and adjacent segments, thereby potentially delaying disc degeneration. This suggests that the novel device can achieve biomechanical effects similar to those of pedicle screw fixation in theory.

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 spine, facet joints, pedicle screw, fusion, finite element analysis, spine, biomechanics, fixation

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