颈前路融合手术对相邻节段影响的有限元分析

发布时间：2018-08-28 20:49

【摘要】：目的通过有限元分析比较正常人体下颈椎、颈前路椎间盘切除植骨融合术(ACDF)后及颈前路椎体次全切植骨融合术(ACCF)后活动度(ROM)和相邻节段椎间盘及关节突关节的应力变化。方法建立正常人体下颈椎三维有限元模型。通过与已发表的关于颈椎ROM的文献相对比,验证该模型的有效性。模型验证成功后,建立下颈椎ACDF、ACCF模型,并对比正常颈椎、ACDF及ACCF术后ROM和相邻节段椎间盘及关节突关节的应力变化。结果所建立的下颈椎三维有限元模型在各个方向上的ROM与已发表研究所测得的ROM数值基本吻合,验证了模型的有效性。ACDF和ACCF术后总体ROM和融合节段ROM显著低于正常下颈椎。ACDF及ACCF术后相邻节段各个方向的ROM显著高于正常下颈椎。ACDF、ACCF术后相邻节段椎间盘及关节突关节应力峰值在各个运动方向上高于正常下颈椎组。结论颈椎融合术后总体ROM减少、相邻节段ROM增加,并且相邻节段椎间盘及关节突关节应力峰值升高,显著改变了颈椎的正常生理特性。
[Abstract]:Objective to compare the changes of (ROM), the stress of adjacent intervertebral disc and articular facet joints in normal human lower cervical vertebrae, anterior cervical intervertebral discectomy, anterior cervical intervertebral disc resection and fusion with (ACDF) and (ACCF) after subtotal cervical vertebrae fusion by finite element analysis. Methods the three-dimensional finite element model of lower cervical vertebra was established. The validity of the model was verified by comparing it with the published literature on cervical ROM. After the model was verified successfully, the ACDF,ACCF model of lower cervical vertebra was established, and the stress changes of ROM and adjacent intervertebral disc and articular facet joints after normal cervical spine ACDF and ACCF were compared. Results the ROM of the three dimensional finite element model of the lower cervical vertebrae in all directions is in good agreement with the published ROM. The validity of the model. ACDF and ACCF total ROM and fusion segment ROM were significantly lower than those of normal lower cervical vertebra. ACDF and ROM of adjacent segments after ACCF operation were significantly higher than those of adjacent segments of intervertebral disc and articular process after normal lower cervical vertebra. ACDF and ACCF. The peak value of joint stress in each movement direction was higher than that in normal lower cervical vertebra group. Conclusion after cervical fusion, the total ROM decreased, the ROM of adjacent segments increased, and the peak stress of adjacent intervertebral disc and articular facet increased, which significantly changed the normal physiological characteristics of cervical vertebrae.
【作者单位】：西安交通大学第二附属医院脊柱外科;
【基金】：国家自然科学基金(81571209) 教育部博士点基金项目(20120201130009)~~
【分类号】：R687.3

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