中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (3): 537-545.doi: 10.12307/2026.579

• 骨与关节有限元分析Finite element analysis of bones and joints •    下一篇

三种不同螺钉内固定治疗L1椎体严重骨折的有限元分析

尚德鹏，魏海宇，杨  帆   

  1. 大连大学附属中山医院骨科，辽宁省大连市  116001
  • 收稿日期:2024-12-11 接受日期:2025-03-14 出版日期:2026-01-28 发布日期:2025-07-01
  • 通讯作者: 杨帆，博士，主治医师，大连大学附属中山医院骨科，辽宁省大连市 116001
  • 作者简介:尚德鹏，男，1990年生，辽宁省鞍山市人，汉族，硕士，主治医师，主要从事骨科方面的研究。
  • 基金资助:
    辽宁省科技计划联合计划(2024011521-JH3/4700)，项目负责人：杨帆；大连市卫健委临床应用类项目(2111038)，
    项目负责人：杨帆；大连市科技局生命健康领域指导计划项目(大科社农(2023)243号)，项目负责人：杨帆

Finite element analysis for three different types of internal screw fixation in treatment of severe lumbar 1 vertebral body fractures

Shang Depeng, Wei Haiyu, Yang Fan   

  1. Department of Orthopedics, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning Province, China
  • Received:2024-12-11 Accepted:2025-03-14 Online:2026-01-28 Published:2025-07-01
  • Contact: Yang Fan, MD, Attending physician, Department of Orthopedics, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning Province, China
  • About author:Shang Depeng, MS, Attending physician, Department of Orthopedics, Zhongshan Hospital Affiliated to Dalian University, Dalian 116001, Liaoning Province, China
  • Supported by:
    Liaoning Provincial Science and Technology Joint Program, No. 2024011521-JH3/4700 (to YF); Clinical Application Project of Dalian Municipal Health Commission, No. 2111038 (to YF); Dalian Science and Technology Bureau Life and Health Field Guidance Program, No. DKSN(2023)243 (to YF)

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摘要：

文题释义：

腰椎骨折：是最常见的脊柱骨折之一，骨折是指骨的完整性破坏或连续性中断，当腰椎承受的力量超过自身能承受的最大强度时，就会发生骨折。高能量创伤除使骨质结构损伤外，更易伴有脊髓、马尾神经损伤，导致神经功能损伤甚至瘫痪。
有限元分析：是一种基于数值计算的方法，用于求解工程和物理学中复杂结构或系统的应力、应变、热传导、流体动力学等问题。核心思想是将一个复杂的连续体(如机械零件、建筑结构或人体骨骼)划分为许多小的、简单的、有限数量的单元(即“有限元”)，然后通过数学模型和算法对这些单元进行分析，最终得出整个系统的近似解。

摘要
背景：严重腰椎骨折的手术治疗以后路短节段固定为主，不同椎弓根螺钉内固定方式在生物力学性能上存在差异。
目的：应用三维有限的元技术模拟3种不同螺钉内固定技术治疗L1椎体严重骨折，在模拟脊柱运动过程中对比分析伤椎上下节段间盘、骨折椎体及内固定装置等的生物力学特征。
方法：建立T11-L3脊柱三维模型并模拟L1椎体重度不稳定骨折，在此基础上分别建立3种不同椎弓根螺钉固定方式：模型A，传统4钉固定(T12，L2各2钉)；模型B，通用脊柱系统4钉内固定(T12，L2各2钉)；模型C，经伤椎6钉内固定(T12、L1、L2各2钉)。对各模型施加载荷和约束，模拟脊柱在前屈、后伸、左侧弯、右侧弯、左旋转、右旋转下内固定物的最大应力及最大位移情况，以及L1椎体的位移、损伤椎体上下椎间盘的应力。
结果与结论：①模型C在前屈、后伸、左侧弯、右侧弯、左旋转、右旋转不同的运动状态下，L1椎体的最大位移及活动度最小，螺钉和连接棒的最大应力最小，邻近上下椎间盘最大应力最小；其次为模型B，而模型A的L1椎体最大位移、活动度及螺钉连接棒应力、位移最大，生物力学稳定性最差，更容易发生邻近节段退变；②提示在治疗重度腰椎骨折时，相比通用脊柱系统钉和传统4钉固定，经伤椎6钉内固定在内固定物上的应力最分散，且椎体钉棒的位移和活动度最小，更可能减少内固定失败和邻近节段间盘退变发生。


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: 严重腰椎骨折, 有限元分析, 生物力学, 椎弓根螺钉, 后路短节段, 应力, 邻近节段

Abstract: BACKGROUND: The surgical treatment of severe lumbar fractures is mainly based on posterior short-segment fixation, and different pedicle screw fixation methods have differences in biomechanical properties.
OBJECTIVE: To simulate three different screw fixation techniques in the treatment of severe L1 vertebral fractures using three-dimensional finite element technology, and to compare and analyze the biomechanical characteristics of the upper and lower intervertebral discs, fractured vertebrae, and internal fixation devices during the simulated spinal movement.
METHODS: A three-dimensional model of the T11-L3 spine was established to simulate severely unstable fracture of the lumbar 1 vertebral body using the designed three pedicle screw fixation methods: Model A with 4 traditional pedicle screws (2 in each T12 and L2), model B with 4 Universal Spine System pedicle screws (2 in each T12 and L2), and Model C were bilateral intermediate fixation with 6 pedicle screws (2 in each of T12, L1, and L2). Restraint and load were applied to simulate the maximum stress and maximum displacement of the internal fixation, the displacement of the L1 vertebral body, and stress on the intervertebral discs superior and inferior to the injured vertebra during the anterior flexion, posterior extension, left-sided bending, right-sided bending and left-right rotation of the lumbar spine. 
RESULTS AND CONCLUSION: (1) The maximum displacement and motion range of the lumbar 1 vertebra with Model C in flexion and extension, left bending, right bending, left rotation, and right rotation were lowest in the tested motion states; the maximum stress of the screws and connecting rods was the smallest; and the maximum stress of intervertebral discs superior and inferior to the injured vertebra was the smallest. This was followed by the Model B, while the maximum displacement and motion range of the lumbar 1 vertebra and the stress and displacement of the screw connecting rod in the Model A were highest, but it showed the worst biomechanical stability and was more prone to adjacent segment degeneration. (2) These results show that bilateral intermediate fixation with six pedicle screws during the treatment of severe lumbar fractures is more dispersed in internal fixator stress and exhibits the least displacement and motion range of the vertebral pedicle screws and rods compared with four universal spinal system pedicle screws and four traditional pedicle screws. Thus, it can effectively reduce the occurrence of internal fixation failure and the adjacent segment degeneration.

Key words: severe lumbar fracture, finite element analysis, biomechanics, pedicle screw, posterior short segment, stress, adjacent segment

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