有限元法分析强直性脊柱后凸去松质骨截骨与全脊椎截骨矫形的生物力学特点

发布时间：2018-02-15 05:24

  本文关键词： 脊柱后凸 截骨术 有限元分析 生物力学 组织工程 骨科植入物 脊柱植入物 强直性脊柱炎 应力分析 全脊椎截骨 去松质骨截骨 截骨接触面 截骨节段 截骨方式 国家自然科学基金　出处：《中国组织工程研究》2017年31期 　论文类型：期刊论文

【摘要】：背景:严重的强直性脊柱后凸畸形常采用矫形截骨术对患者进行治疗,但脊柱截骨矫形手术风险高,具体治疗方案较为个体化,畸形脊柱的生物形态与力学特性错综复杂。但有限元分析法对不规则物体的生物力学分析有其独特的优势性。目前国内通过有限元建模分析强直性脊柱后凸截骨治疗的生物应力特点鲜有报道。目的:建立强直性脊柱后凸三维有限元模型,探讨截骨方式选择与全脊柱变形位移趋势及截骨接触面、钛棒、椎弓根螺钉等应力分布的关系。方法:采用三维医学图形软件构建强直性脊柱后凸全脊柱模型,导入ANASYS有限元分析软件,分别模拟在T_(12)和L_1椎体节段行2种截骨方式(全脊椎截骨术与去松质骨截骨术)的4个截骨模型。对椎体及螺钉分别施加相应的载荷,得到4种工况下的一系列变形和应力云图。结果与结论:(1)T_(12)椎体截骨加载后各方向轴的全脊柱位移趋势大于L_1椎体截骨模型;(2)去松质骨截骨模型的应力集中部位于后方的内固定装置,全脊椎截骨的生物应力主要集中在钛笼及截骨接触面;(3)个体化的强直性脊柱后凸畸形手术治疗会影响截骨节段及截骨方式的选择,截骨节段的选择将主要影响全脊柱的变形稳定性,内固定节段的应力分布可能与截骨方式及内固定装置方式相关;(4)该结论可为强直性脊柱后凸的生物力学分析提供一定的理论参考依据。
[Abstract]:Background: orthopaedic osteotomy is often used to treat severe ankylosing kyphosis, but the risk of orthopaedic surgery is high, and the specific treatment is more individualized. The biomorphology and mechanical properties of the deformed spine are complicated, but the finite element analysis has its unique superiority in the biomechanical analysis of irregular objects. At present, the domestic osteotomy of ankylosing kyphosis is analyzed by finite element modeling. The characteristics of biological stress in treatment are rarely reported. Objective: to establish a three-dimensional finite element model of ankylosing kyphosis. To explore the relationship between the choice of osteotomy mode and the trend of deformation displacement of the whole spine, the stress distribution of the osteotomy contact surface, titanium rod, pedicle screw, etc. Methods: the model of total scoliosis of ankylosing kyphosis was constructed by using 3D medical graphics software. The ANASYS finite element analysis software was introduced to simulate the four osteotomy models of two kinds of osteotomy (total vertebra osteotomy and cancellous osteotomy) in the T _ S _ (12) and L _ s _ 1 vertebrae, respectively. The corresponding loads were applied on the vertebrae and screws, respectively. A series of deformation and stress cloud maps were obtained under four different conditions. Results and conclusion: the displacement trend of the whole spine in all directions after loading of vertebral body osteotomy is greater than that of L1 vertebra osteotomy model. Results and conclusion the stress concentration of cancellous osteotomy model is located at the stress concentration of L1 vertebra osteotomy model. The internal fixation device in the rear, The biological stress of total spine osteotomy is mainly focused on titanium cage and osteotomy contact surface (3) the surgical treatment of ankylosing kyphosis deformity will influence the choice of osteotomy segment and osteotomy mode. The selection of osteotomy segments will mainly affect the stability of the deformation of the whole spine. The stress distribution of internal fixation segment may be related to osteotomy and internal fixation device. This conclusion can provide a theoretical reference for biomechanical analysis of ankylosing scoliosis.
【作者单位】： 新疆医科大学第六附属医院脊柱外科研究所;
【基金】：国家自然科学基金(81360280)~~
【分类号】：R687.3
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