椎间融合器高度对颈椎生物力学影响

发布时间：2018-03-14 03:13

本文选题：椎间融合器　切入点：椎间高度　出处：《医用生物力学》2017年03期 　论文类型：期刊论文

【摘要】：目的研究颈椎前路减压融合术中椎间融合器高度对颈椎生物力学影响,为融合器选择提供参考。方法建立正常颈椎C2~7节段有限元模型并验证,在C5~6节段分别植入高度为5、6、7、8 mm的融合器,施加1.5 N·m力矩使颈椎产生前屈、后伸、侧弯和轴向旋转运动,并探究融合器高度变化对颈椎活动度(range of motion,ROM)、小关节应力、椎间压强等的影响。结果融合器高度每增加1 mm,手术节段的角度值平均增加0.68°。植入融合器后C5~6 ROM范围小于0.44°。融合器高度差异对C4~5的ROM影响大于C6~7,对非融合节段ROM的影响小于7.3%。融合器高度差异对非手术节段ROM、小关节应力、相邻节段椎间压强的影响较小。关节囊韧带、融合器和钉板系统应力均随融合器高度增加而明显增加,6、7、8 mm融合器模型的关节囊韧带、融合器和钉板系统应力均远高于5 mm融合器模型。结论对于需要植入融合器的患者,建议植入物高度比原椎间隙高0~1 mm。
[Abstract]:Objective to study the effect of interbody cage height on cervical biomechanics in anterior cervical decompression and fusion. The cervical vertebrae were subjected to anterior flexion, extension, lateral bending and axial rotation with 1.5 N 路m torque. The effect of the height of the fusion cage on the range of motion of cervical spine and the stress of facet joints was investigated. Results for each 1 mm increase in the height of the fusion cage, the angle value of the operative segment increased by 0.68 掳. The range of C5 / 6 ROM was less than 0.44 掳. The difference of the height of the fusion cage had greater influence on the ROM of C4P5 than that of the C67, and on the non-fused segment of ROM. The effect of the fusion cage height difference on the non-operative segment rock, facet joint stress, The stress of the articular capsule ligament, fusion cage and nail plate system increased significantly with the height of the fusion cage. The stress of fusion cage and nail plate system is much higher than that of 5 mm fusion cage model. Conclusion the height of implants should be 0 ~ 1 mm higher than that of the original intervertebral space for the patients who need to implant the fusion cage.
【作者单位】：北京航空航天大学生物与医学工程学院生物力学与力生物学教育部重点实验室;国家康复辅具研究中心;北京大学第三医院骨科;
【基金】：国家自然科学基金项目(11120101001,11572029,11421202,11322223,11272273) 教育部博士点基金项目(2013110213004) 111引智项目(B13003) 国家科技重点研发计划(2016YFB1101101)
【分类号】：R318.01;R687

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