步态仿真下腰椎间盘退变合并骶髂关节紊乱的有限元分析

发布时间：2018-05-11 11:30

本文选题：腰椎间盘退变 + 骶髂关节紊乱　；参考：《医用生物力学》2017年01期

【摘要】：目的通过观察腰椎间盘退变合并骶髂关节紊乱的生物力学特征,探讨腰椎间盘退变与骶髂关节紊乱相关性的生物力学机制。方法选取正常志愿者1名,腰椎间盘突出症合并骶髂关节紊乱者2名(骶骨错位、髂骨错位各1名),采集CT数据建立相应的正常、骶骨错位、髂骨错位腰椎-骨盆模型,同时采集其步态数据驱动Any Body仿真肌骨模型,得到腰椎骨盆周围肌肉力及髋关节力作为加载条件,进行有限元分析。比较患者与正常志愿者L4、L5椎间盘及骶髂关节应力变化。结果正常模型L4、L5左右及两侧骶髂关节应力曲线呈双峰,且无明显差异;骶骨错位模型与髂骨错位模型L4、L5左右及两侧骶髂关节应力曲线双峰改变甚至消失,L4左右两侧应力峰值差分别为0.55、0.80 MPa,L5左右两侧应力峰值差分别为4.05、2.08 MPa,骶髂关节右侧应力峰值与左侧峰值差分别为0.96、3.32 MPa。结论腰椎间盘退变合并骶髂关节错位导致人体承重力线的偏移,骶髂关节紊乱可加重身体两侧应力失衡,在腰椎间盘突出症的治疗过程不能忽视骶髂关节紊乱的影响。
[Abstract]:Objective to investigate the biomechanical mechanism of the relationship between lumbar disc degeneration and sacroiliac joint disorder by observing the biomechanical characteristics of intervertebral disc degeneration combined with sacroiliac joint disorder. Methods 1 normal volunteer and 2 patients with lumbar disc herniation and sacroiliac joint disorder (sacrum dislocation and iliac dislocation) were selected. Ct data were collected to establish the model of normal, sacral dislocation and iliac dislocation of lumbar vertebrae and pelvis. At the same time, the gait data were collected to drive the Any Body simulation model, and the muscle force around the lumbar pelvis and the hip joint force were obtained as the loading conditions, and the finite element analysis was carried out. Stress changes of intervertebral disc and sacroiliac joint were compared between patients and normal volunteers. Results the stress curves of normal model L _ 4, L _ 5 and bilateral sacroiliac joints showed double peaks, and there was no significant difference. The double peak change of stress curve of sacroiliac joint and bilateral sacroiliac joint between sacral dislocation model and iliac dislocation model and bilateral stress peak difference of 0. 55-0. 80 MPa L5 and 4. 05 ~ 2. 08 MPa respectively, right side of sacroiliac joint are 0. 05 ~ 0. 80 MPA ~ 0. 8 MPa, respectively. The right side of sacroiliac joint is right side of sacroiliac joint. The difference between the stress peak value and the left peak value is 0.96t 3.32 MPa, respectively. Conclusion the dislocation of sacroiliac joint combined with degeneration of lumbar intervertebral disc can cause the deviation of the load line of human body. The disorder of sacroiliac joint can aggravate the stress imbalance of both sides of the body. The effect of the disorder of sacroiliac joint can not be ignored in the treatment of lumbar disc herniation.
【作者单位】：上海中医药大学附属岳阳中西医结合医院推拿科;上海硅步科学仪器有限公司;
【基金】：国家自然科学基金项目(81173358) 上海市科委自然基金项目(13ZR1442900) 上海市教委创新课题(14YZ060)
【分类号】：R681

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