Biomechanical analysis of the lumbar spine and pelvis in adolescent
idiopathic scoliosis with lumbar major curve

doi:10.3969/j.issn.2095-4344.2468

Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (8): 1155-1161.doi: 10.3969/j.issn.2095-4344.2468

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Biomechanical analysis of the lumbar spine and pelvis in adolescent idiopathic scoliosis with lumbar major curve

Zhang Cong¹, Zhao Yan², Du Xiaoyu¹, Du Xinrui¹, Pang Tingjuan¹, Fu Yining¹, Zhang Hao¹, Zhang Buzhou¹, Li Xiaohe³, Wang Lidong⁴

¹Inner Mongolia Medical University; ²Department of Orthopedics, the Second Affiliated Hospital of Inner Mongolia Medical University;³Laboratory of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University; ⁴Inner Mongolia International Mongolia Hospital, Hohhot 010110, Inner Mongolia Autonomous Region, China

Received:2019-01-21 Revised:2019-01-29 Accepted:2019-03-18 Online:2020-03-18 Published:2020-01-21
Contact: Li Xiaohe, MD, Professor, Master’s supervisor, Laboratory of Anatomy, School of Basic Medical Sciences, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Wang Lidong, MD, Chief physician, Master’s supervisor, Inner Mongolia International Mongolia Hospital, Hohhot 010110, Inner Mongolia Autonomous Region, China
About author:Zhang Cong, Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Zhao Yan, MD, Chief physician, Master’s supervisor, Department of Orthopedics, the Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010110, Inner Mongolia Autonomous Region, China Zhang Cong and Zhao Yan contributed equally to this work.
Supported by:
the National Natural Science Foundation of China, No. 81460330; the Science and Technology Project for the Young Talents of Education Department of Inner Mongolia Autonomous Region, No. njyt-15-b05; the Science and Technology Program of Inner Mongolia Autonomous Region, No. 2016; the Science and Technology Innovation Guidance Project of Inner Mongolia Autonomous Region, No. 2017; the Natural Science Foundation of Inner Mongolia Autonomous Region, No. 2016ms08131; the Returned Overseas Foundation of Department of Human Resources and Social Security of Inner Mongolia Autonomous Region, No. 201620

Abstract

Abstract:

BACKGROUND: Adolescent idiopathic scoliosis causes changes in the structure and stress of the spine. The lumbar spine bears the greatest load in the spine, and the pelvis also plays the role of transmitting gravity. Therefore, the biomechanical analysis of the lumbar spine and pelvis in adolescent idiopathic scoliosis with lumbar major curve is particularly important.

OBJECTIVE: To establish the three-dimensional digital model of lumbar spine-pelvis in adolescent idiopathic scoliosis and undergo finite element analysis.

METHODS: The CT microscopic data of the lumbar spine-pelvis in a 13-year-old idiopathic scoliosis volunteer were used to reconstruct the three-dimensional digital model using mimics 15.0 software. The preliminary geometric model was established by Pro/E 5.0 software and imported into Hypermesh 13.0 for mesh generation. The model was finally subjected to finite element analysis by Abaqus 6.14 software. The displacement, stress changes of the model under six load conditions, and the stress changes of each vertebra and intervertebral disc were analyzed. The study was approved by the ethical committee of the hospital, and the patient family member signed the informed consents.

RESULTS AND CONCLUSION: (1) A three-dimensional finite element model of the lumbar spine-pelvis in adolescent idiopathic scoliosis was established. (2) Under the six kinds of loading conditions, the displacement of the upper part of the L₁ was the largest in the left and right flexion, and the displacement of the lower end of the tibia was the largest in the flexion. (3) The right margin of the intervertebral disc had highest stress under right flexion. Under anterior flexion position, the lumbar intervertebral disc was subjected to the highest stress on the anterior margin and the stress on the left margin was the least stressed. The posterior margin had the highest stress under posterior extension. The edge was subjected to the least stress; when the lateral flexion and the rotational position, the right edge was subjected to the most stress, and the leading edge was subjected to the least stress. (4) L₅ had the largest stress in all six movements, and the stress was concentrated on the upper and lower articular processes and pedicles, especially on the right side. (5) In summary, for adolescent idiopathic scoliosis, different loads may cause different stresses and displacement values of the vertebral body or intervertebral disc under different positions. These results are of great significance for the treatment and prevention of scoliosis.

Key words: adolescent, idiopathic scoliosis, main bend, lumbar vertebrae, pelvis, finite element analysis, biomechanics, the National Natural Science Foundation of China

CLC Number:

Zhang Cong, Zhao Yan, Du Xiaoyu, Du Xinrui, Pang Tingjuan, Fu Yining, Zhang Hao, Zhang Buzhou, Li Xiaohe, Wang Lidong.

Biomechanical analysis of the lumbar spine and pelvis in adolescent idiopathic scoliosis with lumbar major curve [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(8): 1155-1161.

Figures/Tables 8

2.2 三维有限元模型的验证由于脊柱侧凸的角度各不相同，没有公认的验证标准，故对正常脊柱腰骶验证的方法对于脊柱侧凸腰骶椎建模同样有效。此模型在前屈、后伸、侧屈、旋转作用下的平均刚度值与以往文献报道中模型的平均刚度值的比较结果基本吻合，因此所建的三维有限元模型是有效可靠的，可以应用于临床研究[16]。 2.3 韧带对脊柱承载能力的影响各椎骨间借韧带、软骨和滑膜关节相连，有限元模型中建立的前纵韧带、后纵韧带、黄韧带、关节囊韧带、横突间韧带、棘间韧带、棘上韧带、髂腰韧带、骶髂前韧带、骶髂后韧带，在脊柱承载前屈、后伸、左侧屈、右侧屈、左旋转、右旋转载荷时均能够承担一部分载荷[17]。其中前纵韧带、后纵韧带、黄韧带、棘上韧带对施加载荷后脊柱的运动起着尤为重要的作用。前纵韧带是椎体前面延伸的一束坚固的纤维束，有防止脊柱过度后伸的作用；后纵韧带位于椎管内椎体的后面，窄而坚韧，有限制脊柱过度前屈的作用；黄韧带位于椎管内，连结相邻两椎弓板间，有限制脊柱过度前屈的作用；棘上韧带是连结胸、腰、骶椎各棘突尖之间的纵行韧带，有限制脊柱前屈的作用。此次研究中未建立的肌肉也可承担载荷[18]，维持脊柱姿态。且竖脊肌一侧收缩使脊柱向同侧屈，两侧同时收缩使脊柱后伸和仰头；腹肌前外侧群包括腹外斜肌、腹内斜肌等使脊柱前屈、侧屈及旋转；后群为腰方肌使脊柱侧屈。 2.4 青少年特发性脊柱侧凸患者腰椎骨盆模型位移云图变化由位移云图可知，青少年特发性脊柱侧凸腰主弯模型在6种工况下(前屈后伸，左右侧屈及左右旋转)，L1椎体上部在左、右侧屈时位移变化最大，骶骨下端在前屈时位移最大，见图4。 "

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Biomechanical analysis of the lumbar spine and pelvis in adolescent idiopathic scoliosis with lumbar major curve

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