Three-dimensional finite element analysis of Daogaijinbei manipulation on lumbar intervertebral disc biomechanics

doi:10.12307/2022.055

Abstract

Abstract: BACKGROUND: The South Shaolin technique uses the essence of martial arts in bone and tendon and massage techniques to form a unique Chinese bone injury treatment technique. Research has found that the South Shaolin tendon and chiropractic technique has a significant effect on the treatment of lumbar disc herniation.
OBJECTIVE: To analyze the biomechanical effects of Daogaijinbei manipulation on the lumbar intervertebral disc by using the three-dimensional finite element method.
METHODS: A healthy young male volunteer was selected to construct a three-dimensional finite element model of the lumbar spine (L1-L5) based on the CT scan results. The stress distribution and variation of lumbar intervertebral disc under different jacking heights were calculated by simulating loading Daogaijinbei manipulation on the validated lumbar spine model.
RESULTS AND CONCLUSION: (1) The maximum average stress of each lumbar intervertebral disc was about 9.2 MPa after being pushed by a total displacement of 10 cm in L3, and there was stress concentration in some units of the L4-5 intervertebral disc. (2) With the increase of the jacking height, the stress of each intervertebral disc presented an approximate linear growth trend. The stress values of each intervertebral disc were: 1.36-7.36 MPa in L1-2 intervertebral disc, 1.64-7.82 MPa in L2-3 intervertebral disc, 1.52-9.20 MPa in L3-4 intervertebral disc, and 1.25-8.71 MPa in L4-5 intervertebral disc. The stress distribution was: L3-4 > L4-5 > L2-3 > L1-2. (3) The stress variation of lumbar intervertebral disc increased from nucleus pulposus to the edge, and the maximum stress was in the anterior side of annulus fibrosus. (4) During Daogaijinbei manipulation, the overall stress distribution of the lumbar intervertebral disc is consistent and gradually increasing, which suggests that manipulation should be done little by little to ensure patients’ safety.

Key words: Daogaijinbei manipulation, lumbar intervertebral disc, biomechanics, three-dimensional finite element, lumbar model, spinal hyperextension, normal lumbar spine, stress

CLC Number:

Li Yanting, Chen Jian, Liu Menglan, Ren Manman, Zhong Weihong, Chen Changxing. Three-dimensional finite element analysis of Daogaijinbei manipulation on lumbar intervertebral disc biomechanics[J]. Chinese Journal of Tissue Engineering Research, 2022, 26(3): 340-343.

Figures/Tables 2

References

[1] 李民,董竑麟,汪桂珍,等.有限元分析不同牵伸时长相邻腰椎节段和椎间盘应力及位移的变化[J].中国组织工程研究,2020,24(21):3281-3286.
[2] ZHU QQ, GAO X, LEVENE HB, et al. Influences of Nutrition Supply and Pathways on the Degenerative Patterns in Human Intervertebral Disc. Spine (Phila Pa 1976). 2016;41(7):568-576.
[3] 王和鸣,王诗忠.南少林理筋整脊手法图谱[M].北京:中国中医药出版社,2015:1-2.
[4] 陈福建,李永军,苏丽君.南少林整脊手法治疗腰椎间盘突出症的疗效观察[J].深圳中西医结合杂志,2019,29(12):43-45.
[5] 刘发元,翁霞萍,吴超雄,等.南少林理筋整脊手法治疗腰椎间盘突出症89例临床观察[J].风湿病与关节炎,2019,8(10):28-31.
[6] 张大勇,张凌岚.功夫整脊[M].福州:福建科学技术出版社,2011:31.
[7] MASNI-AZIAN, MASAO T. Biomechanical investigation on the influence of the regional material degeneration of an intervertebral disc in a lower lumbar spinal unit: A finite element study. Comput Biol Med. 2018;98:26-38.
[8] SHEN H, FOGEL GR, ZHU J, et al. Biomechanical analysis of different lumbar interspinous process devices: A finite element study. World Neurosurg. 2019;127:1112-1119.
[9] 张瑜,李忠海.三维有限元法在脊柱生物力学中的应用现状[J].中国骨与关节杂志,2020,9(3):220-224.
[10] XU M, YANG J, LIEBERMAN I, et al. Stress distribution in vertebral bone and pedicle screw and screw-bone load transfers among various fixation methods for lumbar spine surgical alignment: A finite element study. Med Eng Phys. 2019;63:26-32.
[11] SPINA NT, MORENO GS, BRODKE DS, et al. Biomechanical effects of laminectomies in the human lumbar spine: a finite element study. Spine J. 2021;21(1):150-159.
[12] 苏晋.腰椎有限元模型的建立与生物力学分析[D].大连:大连医科大学,2016.
[13] 邓海峰.腰骶椎三维有限元建模及三种内固定方式生物力学分析[D].沈阳:中国医科大学,2011.
[14] 沈永乐.新型腰椎后路动态内固定系统固定腰椎滑脱有限元分析[D].沈阳:中国医科大学,2012.
[15] LO CC, TSAI KJ, ZHONG ZC, et al. Biomechanical differences of Coflex-F and pedicle screw fixation combined with TLIF or ALIF--a finite element study. Comput Methods Biomech Biomed Engin. 2011;14(11):947 -956.
[16] PANJABI MM, OXLAND TR, YAMAMOTO I, et al. Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load-displacement curves. J Bone Joint Surg Am. 1994;76(3):413-424.
[17] XIAO ZT, WANG LY, GONG H, et al. Biomechanical evaluation of three surgical scenarios of posterior lumbar interbody fusion by finite element analysis. Biomed Eng Online. 2012;11(1):1-11.
[18] Robertson DGE, Caldwell GE, Hamill J, et al. Research Methods in Biomechanics. 2013:69.
[19] 吕立红,金叶道,郑如云,等.不同作用方向的整复手法治疗腰椎间盘突出症临床疗效观察[J].中国骨伤,2009,22(4):257.
[20] 王强,孙波.整骨类手法治疗腰椎间盘突出症研究概况[J].按摩与康复医学,2014(11):25-27.
[21] 尚永,张人文,莫灼锚,等.腰椎退变影响拔伸按压手法生物力学作用的有限元研究[J].山东中医药大学学报,2019,43(2):151-154.
[22] 庞胤,尹帅,赵长义,等.脊柱腰段三维有限元模型的构建与椎间盘应力分析[J].河北医科大学学报, 2019,40(12):1368-1371.
[23] 田强,钟侨霖,赵家友,等.提拉旋转斜扳法操作时腰椎椎间盘应力及应变的有限元研究[J].中国临床解剖学杂志,2019,37(1):83-86.
[24] 陈忻,于杰,冯敏山,等.坐位旋转手法治疗退行性腰椎滑脱的椎间盘力学分析[J].中华中医药杂志, 2019,34(4):1395-1400.