Chinese Journal of Tissue Engineering Research ›› 2020, Vol. 24 ›› Issue (27): 4285-4290.doi: 10.3969/j.issn.2095-4344.2792
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Finite element analysis of double-segment and single-segment vertebral column decancellation and vertebral column resection osteotomy for ankylotic kyphosis
Duan Yanji1, Chen Xiao1, Zhou Yongqiang1, Huang Kai1, Shen Donglan1, Ma Yuan2
1Department of Orthopedics, First People’s Hospital of Neijiang, Neijiang 641000, Sichuan Province, China; 2Department of Spine Surgery, Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 813002, Xinjiang Uygur Autonomous Region, China
Received:
2019-12-20
Revised:
2019-12-25
Accepted:
2020-02-14
Online:
2020-09-28
Published:
2020-09-05
Contact:
Ma Yuan, Associate professor, Doctoral supervisor, Department of Spine Surgery, Sixth Affiliated Hospital of Xinjiang Medical University, Urumqi 813002, Xinjiang Uygur Autonomous Region, China
About author:
Duan Yanji, Master, Physician, Department of Orthopedics, First People’s Hospital of Neijiang, Neijiang 641000, Sichuan Province, China
Supported by:
the National Natural Science Foundation of China, No. 81360280
CLC Number:
Duan Yanji, Chen Xiao, Zhou Yongqiang, Huang Kai, Shen Donglan, Ma Yuan.
Finite element analysis of double-segment and single-segment vertebral column decancellation and vertebral column resection osteotomy for ankylotic kyphosis [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(27): 4285-4290.
1.4.1 初步重建三维模型 该患者进行全脊柱CT扫描,CT采用TOSHIBA/Aquilion ONE 320排CT行扫描,扫描间隔1 mm,像素分辨率为512×512,层厚0.5 mm,共获取CT二维图像2 434张,以DICOM格式保存。将所得图像导入三维医学重建软件Mimics中,得到初步三维立体模型(图1A)。由于初步建立的三维模型不利于有限元分析软件的计算,采用Geomagic studio 2013对该模型进行三维修补和填充,修饰和优化一些孔洞和缺陷、不规则的边界,以改善四面体单元的模型质量。最后利用UG NX8.5模拟脊柱矫形术式,包括添加椎弓根螺钉和固定棒等后路内固定系统,模拟载荷平面,采用曲线和草图性能,同时构建连接椎体之间的僵化韧带模型。 1.4.2 建立三维有限元模型 将修饰后的截骨脊柱模型导入Ansys 15.0有限元分析软件,对模型中的皮质骨、松质骨、椎间盘、韧带、椎弓根螺钉、固定棒、Synmesh融合器等的弹性模量、泊松比进行赋值,采用尽量接近实体的全脊柱僵化韧带模型参数[15],见表1。建立强直性脊柱后凸的三维有限元模型,为了保证模型的精准度,采用四面体接触,共955 608个单元,1 554 431个节点(图1B)。 "
截骨方式:截骨角度采用肺门-髋轴法,对矢状面平衡及截骨角度进行计算,参考SONG等[1]利用肺门和髋轴入射角之间的平衡关系,使截骨角度更加接近真实人体生物力学平衡点(图2,Ansys中的L2,3椎体单节段的去松质骨截骨截骨设计图)。截骨方式分别为全脊柱截骨与去松质骨截骨[19],截骨模型简称分为去松质骨截骨模型与全脊柱截骨模型,分为双节段与单节段截骨,截骨节段分别是,对L1和L2椎体行单节段截骨,对T12、L2和T12、L3椎体行双节段截骨,即L1单节段全脊柱截骨模型、L1单节段去松质骨截骨模型、L2单节段全脊柱截骨模型、L2单节段去松质骨截骨模型、T12L2双节段全脊柱截骨模型、T12L2双节段去松质骨截骨模型、T12L3双节段全脊柱截骨模型、T12L3双节段去松质骨截骨模型8组。 "
截骨模型与加载:强直性脊柱炎常常伴随关节及韧带的纤维骨化和滑膜增厚。在实验过程中为了更加接近实体模型,以T12和L2椎体双节段全脊柱截骨模型(图3)为例说明,设颈椎顶点为a,T12与L2椎体截骨面后方位置处为b、c点(如模型为单节段截骨则标记为一点,如图4),骶骨前端为d。将脊柱想象为有一定抗弯刚度的曲杆,在加载过程中使截骨椎体产生一定曲度,使模型中的螺钉随着截骨上端运动。运动中由于不再接受垂直力的约束,其受到垂直的反力会更小。但由于截骨模型简化为铰支座,不传递弯矩,只会传递轴力,将发生轴向变形,几乎无侧向(垂直脊柱方向)运动。根据受力平衡条件,随着钛棒穿过螺钉两端的夹角改变,螺钉受到的拔力将向上,见图3,4。 "
截骨模型与加载:强直性脊柱炎常常伴随关节及韧带的纤维骨化和滑膜增厚。在实验过程中为了更加接近实体模型,以T12和L2椎体双节段全脊柱截骨模型(图3)为例说明,设颈椎顶点为a,T12与L2椎体截骨面后方位置处为b、c点(如模型为单节段截骨则标记为一点,如图4),骶骨前端为d。将脊柱想象为有一定抗弯刚度的曲杆,在加载过程中使截骨椎体产生一定曲度,使模型中的螺钉随着截骨上端运动。运动中由于不再接受垂直力的约束,其受到垂直的反力会更小。但由于截骨模型简化为铰支座,不传递弯矩,只会传递轴力,将发生轴向变形,几乎无侧向(垂直脊柱方向)运动。根据受力平衡条件,随着钛棒穿过螺钉两端的夹角改变,螺钉受到的拔力将向上,见图3,4。"
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