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纸质出版:2014
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房亚峰,吴卫东,张晋元,钱蕾,李鹏,孙培栋,欧阳钧.椎弓根延长术中离断部位对腰椎稳定性影响的有限元分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(22):2321-2326.
Fang Yafeng,Wu Weidong,Zhang Jinyuan,Qian Lei,Li Peng,Sun Peidong,Ouyang Jun.Effects of pedicle-lengthening osteotomy site on lumbar stability: a finite element analysis[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(22):2321-2326.
房亚峰,吴卫东,张晋元,钱蕾,李鹏,孙培栋,欧阳钧.椎弓根延长术中离断部位对腰椎稳定性影响的有限元分析[J].陆军军医大学学报(原第三军医大学学报),2014,36(22):2321-2326. DOI:
Fang Yafeng,Wu Weidong,Zhang Jinyuan,Qian Lei,Li Peng,Sun Peidong,Ouyang Jun.Effects of pedicle-lengthening osteotomy site on lumbar stability: a finite element analysis[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(22):2321-2326. DOI:
目的 利用有限元法分析比较L4椎弓根前端离断与后端离断并延长后对腰椎稳定性的影响。 方法 利用1名28岁健康女性腰椎(L
2
~L
5
)CT影像数据,采用Mimics 14.0、Geomagic Studio 2013、ANSYS 14.0 软件建立腰椎(L
2
~L
5
)完整模型(完整组)、L
4
椎弓根前端离断并延长模型(anterior osteotomy of pedicle,AP组)、L4椎弓根后端离断并延长模型(posterior osteotomy of pedicle,PP组)。在L
2
上分别施加400 N轴向压力及10 N·m 纯力偶矩,模拟腰椎受轴向压力及前屈、后伸、左旋、右旋、左侧弯和右侧弯运动,记录AP组及PP组Von Mises 应力云图及最大应力值,计算椎间运动范围(range of motion,ROM)。 结果 建立了正常人腰椎(L
2
~L
5
)有限元模型。AP组与PP组均在离断部位出现应力集中。在各个工况下,AP组与PP组应力分布差异明显,PP组应力分布相对较平均。椎间ROM比较显示:与完整组相比,PP组L
4
~L
5
、L
3
~L
4
椎间ROM变化范围较AP组小,AP组和PP组的L
2
~L
3
椎间ROM与完整组的相比比较接近。 结论 椎弓根后端离断力学稳定性优于前端离断,且对邻近节段影响相对较小。
Objective To compare the biomechanical properties of the anterior osteotomy of pedicle (AP) and posterior osteotomy of pedicle (PP) by finite element analysis
and to explore the effects of the pedicle-lengthening osteotomy site on lumbar stability. Methods CT images were obtained from a 28-year-old female volunteer
and then the inta
ct L
2
-L
5
AP
and PP models were established and analyzed with Mimics 14.0
Geomagic Studio 2013
and ANSYS 14.0 software. The axial force of 400 N and moment couple of 10 N·m were loaded on the upper surface of L
2
to simulate the flexion
extension
lateral bending
and rotation behaviors of the lumbar spine. The Von Mises stress distribution regularity of internal fixators and the maximum equivalent stress were evaluated
and the range of motion (ROM) were also analyzed. Results The intact model of lumbar spine (L
2
-L
5
) was established
and it was validated with the previously reported cadaveric experimental data from Yamamoto and Liu successfully. The stress was concentrated at the connection portion between plate and screw in the AP group
while it was distributed evenly in the PP group. Between the AP group and the PP group
there was significant difference in stress values under flexion
lateral bending and rotation conditions. Compared with the intact group
the change scope of ROM of L
4
-L
5
segment and L
3
-L
4
segment in the PP group was smaller than that in the AP group
and there was no significant difference in the ROM of L
2
-L
3
segment between the two groups. Compared with the intact model
the whole ROM of the lumbar spine increased about 1° in the AP group and the PP group. Conclusion As a new alternative method
PP provides better stability and lower influence on adjacent segment than AP.
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