不同截骨方式修复强直性脊柱炎后凸畸形的有限元分析

发布时间：2018-04-24 06:31

本文选题：强直性脊柱炎 + 脊柱后凸　；参考：《中国组织工程研究》2017年19期

【摘要】：背景:强直性脊柱炎后凸是一类矢状面或者冠状面失衡的脊柱畸形,目前国内外缺乏对其矫形生物力学的研究,而生物力学对矫形后重建脊柱稳定性十分重要。目的:应用计算机建模软件建立强直性脊柱炎后凸截骨三维有限元模型,并分析其生物力学特性,为临床实践提供一定的理论依据。方法:基于CT数据建立强直性脊柱炎后凸畸形三维有限元模型,测量计算L3节段预截骨角度,模拟去松质骨截骨术和全脊椎截骨术进行截骨,并分析矫形后的生物力学指标变化。结果与结论:(1)建立了完整强直性脊柱炎后凸截骨矫形三维有限元模型,并且模拟手术操作建立L3去松质骨截骨术和全脊椎截骨术2种不同术式截骨模型;(2)除S1节段外,L3去松质骨截骨术的各节段钉棒应力及截骨接触面应力均高于L3全脊椎切除术,两者差距明显;(3)综上,2种不同截骨手术方式均能重建矢状面平衡,但去松质骨截骨术的钉棒应力高于全脊椎截骨术,且差距较为明显;在相同节段,相同角度下去松质骨截骨术发生内固定失败并发症的风险高于全脊椎截骨术。
[Abstract]:Background: ankylosing spondylitis (ankylosing spondylitis) is a kind of spinal deformities with sagittal or coronal disequilibrium. At present, there is a lack of research on orthopedic biomechanics at home and abroad, and biomechanics is very important for the reconstruction of spinal stability after orthopedic. Objective: to establish a three-dimensional finite element model of kyphosis osteotomy in ankylosing spondylitis with computer modeling software, and to analyze its biomechanical characteristics, and to provide a theoretical basis for clinical practice. Methods: a 3D finite element model of kyphosis in ankylosing spondylitis was established based on CT data. The angle of L3 pre-osteotomy was measured and calculated, and osteotomy was performed by simulating cancellous osteotomy and total spinal osteotomy. The changes of biomechanical indexes after orthosis were analyzed. Results and conclusion A complete three-dimensional finite element model of kyphosis osteotomy for ankylosing spondylitis was established. Two different osteotomy models of L3 cancellous osteotomy and total vertebra osteotomy were established by simulating the operation procedures. The stress of nail rod and osteotomy interface of L3 osteotomy was higher than that of L3 total spondylotomy except S1 segment of cancellous bone osteotomy, and the stress of each segment of L3 osteotomy was higher than that of L3 total spondylotomy, and the stress of each segment of L3 osteotomy was higher than that of L3 total chirotomy. (3) both different osteotomy methods can reconstruct sagittal balance, but the stress of nail rod in cancellous osteotomy is higher than that in total vertebra osteotomy, and the difference is obvious in the same segment. The risk of failure of internal fixation in cancellous osteotomy at the same angle was higher than that in total spinal osteotomy.
【作者单位】：新疆医科大学第六附属医院脊柱外一科;
【基金】：国家自然科学基金资助项目(81360280)~~
【分类号】：R318.01;R687.3

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