国人人工颈椎间盘假体的设计及有限元分析

发布时间：2018-02-10 06:54

本文关键词： 颈椎病椎间盘置换假体解剖　出处：《上海交通大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:通过对颈椎侧位X线片多项解剖学参数的测量及统计分析,了解不同颈椎节段的参数变化趋势及差异,为人工颈椎间盘假体的设计提供理论数据,并根据这些数据设计出一种符合国人解剖学特征的新型的人工颈椎间盘假体。再通过有限元分析,探讨该人工颈椎间盘假体置换手术前后颈椎生物力学的改变。方法:1、在大学城随机选择20-35岁青壮年志愿者350名,中立位、过屈、过伸位拍摄颈椎正、侧位X线片,排除椎体缺如,明显形态学异常以及罹患外伤、肿瘤等有可能导致测量不准确者整理并筛选资料后,得志愿者334人,测量中立、过屈、过伸位片C2/3、C3/4、C4/5、C5/6、C6/7椎间隙前缘、后缘以及椎间隙中央的高度、椎间盘角度,统计和分析。2、根据所得的数据,设计人工颈椎间盘,更加符合国人解剖特点;本新型人工椎间盘采用的材料将尽可能的以超高分子聚乙烯及PEEK等MR相容性较高的材料为主,这样能保证其对术后随访的影像学资料造成最小的干扰;假体表面进行羟基磷灰石喷涂,保证了假体良好的生物相容性及骨传导性。3、通过CT断层扫描正常志愿者颈椎间盘,将获得的数据通过Simpleware软件进行三维实体重建,利用Geomagic软件进行布尔运算,生成颈椎间盘有限元模型,进行前处理、网格划分,使用有限元分析软件Abaqus计算出不同情况下的活动度和应力分布。通过CT扫描数据图像建立的颈椎C5-C6节段的有限元模型,在这个颈椎模型上模拟人工颈椎间盘置换术,对置换前后颈椎在常见运动情况下的颈椎生物力学变化进行计算和分析。结果:1、中立位、屈曲位、过伸位颈椎侧位片显示各颈椎间隙高度,不同性别、部位、间隙、姿态间存在显著差异,屈伸运动中,椎间盘前缘的运动幅度较中部和后缘大,屈曲时颈椎间盘前份和中央部均被显著压缩。2、人工颈椎间盘由上、下两个半关节构成,超高分子量聚乙烯髓核固定于下终板,上终板为高抛光凹面,与髓核形成关节配合;假体的上下中板各均布6枚倒齿,倒齿插入上下椎体实现即刻固定。3、人工椎间盘置换后,手术节段运动范围相近,活动度也相近,很好的保留了椎体的活动度。结论:1、生理状态下,屈伸运动中,椎间盘前部的运动占整个椎间盘运动幅度的绝大部分,椎间设计、制造和临床运用中,维持目标椎间隙的高度和活动度至关重要。2、研制的人工颈椎间盘假体符合国家检验标准。在颈椎运动学方面,人工颈椎间盘植入后,椎体节段伸展运动、左右侧屈运动和旋转运动稳定性增加。在颈椎力学方面,人工颈椎间盘的设计符合椎间盘临近结构的应力要求,和椎间盘本身的力学性能要求。人工颈椎间盘置换后承载能力,结构强度,稳定性均达到椎间盘的要求。
[Abstract]:Objective: to study the variation trend and difference of cervical vertebrae parameters by measuring and analyzing the anatomical parameters of lateral cervical radiographs, so as to provide theoretical data for the design of artificial cervical disc prosthesis. According to these data, a new type of artificial cervical disc prosthesis is designed, which accords with the anatomical characteristics of Chinese people. To investigate the biomechanical changes of cervical vertebrae before and after the artificial cervical disc prosthesis replacement. Methods 350 adult volunteers aged 20-35 years were randomly selected to take X-ray films of cervical vertebrae in positive and lateral position in neutral position, overflexion and extension position. After eliminating the absence of vertebrae, obvious morphologic abnormalities, trauma, tumors, etc. that may lead to inaccurate measurements and sorting out and screening data, 334 volunteers were selected to measure the anterior edge of the intervertebral space of C2 / 3 / 3 / 4 / 4 / 4 / 5 / 5 / 5 / 6 of C67 / C _ 2 / 3 / 4 / 4 of C _ 3 / 4 / 4 / 5 C _ 5 / 6 / C _ (67). The height of the posterior edge and the center of the intervertebral space, the intervertebral disc angle, statistics and analysis. 2. According to the data obtained, the artificial cervical intervertebral disc is designed, which is more in line with the anatomical characteristics of the Chinese. The materials used in the new artificial intervertebral disc will be as high as possible ultrahigh molecular weight polyethylene (UHMWPE) and PEEK and other materials with high Mr compatibility so as to ensure the minimal interference to the imaging data of postoperative follow-up. Hydroxyapatite was sprayed on the surface of the prosthesis to ensure the good biocompatibility and bone conductivity of the prosthesis. The normal cervical intervertebral disc was scanned by CT tomography. The obtained data were reconstructed by Simpleware software. The finite element model of cervical intervertebral disc is generated by Boolean operation with Geomagic software. Using the finite element analysis software Abaqus to calculate the motion and stress distribution of different cases. The finite element model of C5-C6 segment of cervical vertebra was established by CT scanning data image, and the artificial cervical disc replacement was simulated on this model. The biomechanical changes of cervical vertebrae before and after replacement were calculated and analyzed. Results the lateral radiographs of the cervical vertebrae showed the height of cervical intervertebral space, different sex, position, space, and space in the lateral position of cervical vertebrae in 1: 1, neutral position, flexion position, hyperextension position. During flexion and extension, the anterior edge of the intervertebral disc was larger than that of the middle and posterior edge, and the anterior part and the central part of the cervical intervertebral disc were significantly compressed at the time of flexion. The artificial cervical intervertebral disc was composed of the upper and lower half joints. UHMWPE nucleus pulposus is fixed on the lower end plate, and the upper end plate is a highly polished concave surface, which forms a joint with the nucleus pulposus. Each of the upper and lower plates of the prosthesis is distributed with 6 inverted teeth, and the inverted teeth are inserted into the upper and lower vertebrae for immediate fixation. The range of motion of the surgical segment is similar, and the range of motion is similar, which preserves the motion of the vertebral body very well. Conclusion under the physiological condition of 1: 1, the anterior movement of the intervertebral disc accounts for most of the whole range of the movement of the intervertebral disc, and the intervertebral design. In manufacturing and clinical application, it is very important to maintain the height and range of motion of the target intervertebral space. The artificial cervical disc prosthesis meets the national test standard. In terms of cervical mechanics, the design of artificial cervical intervertebral disc conforms to the stress requirements of the adjacent structure of the disc and the mechanical properties of the disc itself. The structural strength and stability meet the requirements of the intervertebral disc.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R681.5

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