有限元分析颈椎棘突骨折内固定有效性

发布时间：2018-05-03 00:36

本文选题：颈椎棘突骨折 + 内固定　；参考：《中国生物医学工程学报》2017年04期

【摘要】：通过对颈椎棘突骨折(累及椎板)内固定治疗有限元模型的建立和分析,明确此种治疗方式对颈椎棘突骨折的有效性。先建立正常全颈椎(C0-T1)的有限元模型并与文献报告进行对比验证,模型验证后,在正常模型基础上建立颈椎棘突骨折(累及椎板)模型,并模拟直型接骨板行内固定治疗,测量并比较颈椎棘突骨折模型及手术内固定模型和原始正常模型在前屈、后伸、左右侧弯、左右旋转6种条件下活动度改变。以及颈椎各结构的应力变化。结果表明,在正常模型上结合临床病例建立的颈椎棘突骨折(累及椎板)外观逼真,生物力学相似度良好。骨折模型部分节段,主要为C7-T1的活动度(前屈+后伸9.20°,左右侧弯5.83°,左右旋转13.12°)较正常模型(前屈+后伸7.11°,左右侧弯4.92°,左右旋转9.59°)增大,尤其是旋转活动度,模拟植入内固定后稳定性增加(前屈+后伸4.07°,左右侧弯2.21°,左右旋转2.91°),且内固定钢板应力分析提示,承受最大应力值在安全范围。颈椎棘突骨折(累及椎板)及内固定模型可以较好地模拟临床实际病例,通过有限元分析预示,此型骨折存在潜在不稳的可能性,探讨微型棘突钢板在骨折手术治疗中的应用,具有一定的临床参考价值。
[Abstract]:Through the establishment and analysis of the finite element model for the treatment of cervical spine process fracture (involving lamina), the effectiveness of this treatment method for cervical spine process fracture was determined. The finite element model of normal cervical spine C0-T1) was established and compared with the literature report. After the model was verified, the cervical spine spinous process fracture (involving lamina) model was established on the basis of the normal model, and the straight plate was simulated to be treated with internal fixation. The changes of motion of cervical spinal process fracture model, surgical internal fixation model and original normal model were measured and compared under 6 conditions: anterior flexion, extension, left and right lateral bending, left and right rotation. And the stress changes of the cervical vertebrae. The results showed that the spinous process fracture (involving lamina) established in the normal model and clinical cases had a realistic appearance and good biomechanical similarity. In part of fracture model, the range of C7-T1 (flexion extension 9.20 掳, left and right lateral bending 5.83 掳, left and right rotation 13.12 掳) was higher than that of normal model (flexion extension 7.11 掳, left and right lateral curvature 4.92 掳, left and right rotation 9.59 掳), especially rotation activity. The stability of imitated internal fixation was increased (flexion extension 4.07 掳, left and right lateral bending 2.21 掳, left and right rotation 2.91 掳), and the stress analysis of internal fixation plate showed that the maximum stress was in the safe range. The model of cervical spine process fracture (involving lamina) and internal fixation can be used to simulate the actual clinical cases. The possibility of potential instability in this type of fracture is predicted by finite element analysis, and the application of mini-spinous process plate in the surgical treatment of fracture is discussed. It has certain clinical reference value.
【作者单位】：中国人民解放军第98医院骨科;上海交通大学医学院附属瑞金医院伤骨科研究所;
【基金】：南京军区医学科技创新项目(MS009) 湖州市自然科学基金(2016YZB03)
【分类号】：R687.3

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