颈椎保留椎体后壁椎体次全切除减压结合钛笼植骨AO钢板内固定的有限元分析

发布时间：2018-04-13 06:50

本文选题：颈椎 + 有限元分析　；参考：《中国组织工程研究》2017年11期

【摘要】：背景:颈椎椎体次全切除减压标准术式是临床常用颈椎前路减压方法之一。近年来在颈椎前路手术治疗原则的指导下有学者提出了颈椎前路保留椎体后壁次全切除减压术,其保留了椎体后壁,不仅增加了颈椎的稳定性,还增加了植骨面积,有利于远期融合;同时椎体后壁的保留,可有效防止骨块及植入物误伤脊髓。目的:通过羊颈椎CT数据建立有限元模型,评估行颈椎前路保留椎体后壁椎体次全切除减压加钛笼植骨AO钢板内固定的力学稳定性。方法:选取实验用成年羊颈椎标本进行CT平扫,运用有限元软件将CT数据构建有限元模型(未行手术组)。保留椎体后壁组行C_4保留后壁椎体次全切除及钛笼植骨、AO钢板内固定术;不保留椎体后壁组进行传统术式,即不保留后壁的椎体次全切除及钛笼植骨加AO钢板内固定术。通过有限元软件测试分析颈椎标本各状态下的应力、位移变化。结果与结论:(1)虽然保留后壁组颈椎模型较未行手术组以及不保留后壁组位移略小,术后即刻稳定性较好;但保留后壁组与不保留后壁组位移及应力相比差异并无显著性意义;(2)综上,与传统椎体次全切除减压术相比,保留椎体后壁椎体次全切除减压加钛笼植骨AO钢板内固定具有较好的术后即刻稳定性。
[Abstract]:Background: subtotal cervical vertebra decompression is one of the commonly used anterior cervical decompression methods.In recent years, under the guidance of the principle of anterior cervical surgery, some scholars have proposed subtotal decompression of the posterior wall of the cervical vertebrae, which not only increases the stability of the cervical spine, but also increases the area of bone graft.At the same time, the preservation of the posterior wall of the vertebral body can effectively prevent the spinal cord injury caused by bone grafts and implants.Objective: to establish a finite element model based on the CT data of sheep cervical vertebrae to evaluate the mechanical stability of anterior cervical vertebrae preserving posterior wall vertebra subtotal decompression and titanium cage bone graft AO plate internal fixation.Methods: we selected adult sheep cervical vertebrae specimen to perform CT plain scan and used finite element software to construct the finite element model (no operation group).The patients in the posterior wall group were treated with subtotal resection of posterior wall vertebral body and internal fixation with AO plate with titanium cage bone graft, while the group without posterior wall was treated with subtotal vertebral body resection and titanium cage bone grafting plus AO plate internal fixation.The stress and displacement of cervical vertebrae were tested and analyzed by finite element software.Results and conclusion (1) although the cervical vertebrae model in the posterior wall group was slightly smaller than that in the non-operative group and the non-retaining posterior wall group, the stability of the cervical spine was better immediately after operation.However, there was no significant difference in displacement and stress between the group with and without retaining the posterior wall.Preservation of posterior vertebral body subtotal decompression and titanium cage bone graft with AO plate internal fixation has good immediate stability after operation.
【作者单位】：哈尔滨医科大学附属第五医院骨科;
【基金】：黑龙江省自然科学基金资助项目(2014/07-17/07)~~
【分类号】：R687.3

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