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
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:
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
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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