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1. 内蒙古医科大学基础医学院解剖学教研室,内蒙古,呼和浩特,010059
2. 内蒙古医科大学研究生学院,内蒙古,呼和浩特,010059
3. 内蒙古医科大学数字医学中心,内蒙古,呼和浩特,010059
纸质出版日期:2019,
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冯会梅, 王星, 马渊, 等. 成人颈椎关节突区域微结构与微有限元力学研究[J]. 局解手术学杂志, 2019,(7):511.
FENG Huimei, WANG Xing, MA Yuan, et al. Microstructural and micro-finite element study on the area of cervical spondylosis in adults[J]. null, 2019,(7):511.
目的 分析成人颈椎关节突不同区域、C2~C7椎序间、左右侧别微结构的变化规律及其与关节突微有限元力学反应之间的关系,预测及评价由关节突微观形态及力学载荷的改变导致颈椎失稳、骨质疏松、关节突骨折等引起关节突损伤等颈椎疾患的风险。 方法 取由内蒙古医科大学解剖学教研室提供的36个成人新鲜颈椎上、下关节突,行Micro-CT扫描,手动勾选上、下关节突2个感兴趣区域(VOI),并计算关节突微结构参数;用环钻从关节突取体积为8 mm×8 mm×8 mm的立方体进行微有限元力学分析,对比分析关节突微结构与力学参数之间的关系。 结果 主效应分析上、下关节突区域间BV/TV、BS/BV、Tb.Sp参数之间差异有统计学意义(P<0.05);关节突左、右侧别间,仅Tb.Th参数值差异有统计学意义(P<0.05);不同椎序间关节突BV/TV、Tb.N、BS/BV、Tb.Th、Tb.Sp、Tb.Pf参数值差异均有统计学意义(P<0.05);交互效应仅在不同椎序间与上、下关节突区域间交互效应Tb.N参数值差异有统计学意义(P<0.05)。微有限元力学表现为关节突骨小梁微有限元模型所受的六个方向的应力分量为σx、σy、σz、σxy、σxz、σyz,分别对应的应力值为S11、S22、S33、S12、S13、S23,其中S33即在σz轴向应力值最大,符合关节突加载载荷的方向(沿Z轴方向加载),S12即σxy二维平面所受应力最小,表明颈椎在运动时关节突所受切应力小于主应力。 结论 C3关节突BV/TV、Tb.N参数值最大,BV/TV、Tb.Th与关节突应力呈正相关,与骨折程度、受力集中程度、内部剪切力呈负相关,因此,C3关节突载荷能力较好,发生骨折等损伤风险相对较小。C2关节突BS/BV、Tb.Sp、Tb.Pf参数值最大,Tb.Pf、Tb.Sp与应力呈负相关,与骨折、骨质疏松、增生、退变等呈正相关,说明C2关节突发生骨折、骨质疏松、增生、退变等颈椎疾病风险较其他关节突大。关节突骨小梁有限元模型在整个变形过程中塑性应变累计结果为零,即在此载荷条件下未发生塑性变形,没有发生屈服,说明在成人正常生理载荷条件下关节突骨小梁有限元模型未发生骨折。
Objective The changes of microstructure in different areas of cervical articular process
C2 to C7 and left and right side of cervical spine in adults and their relationship with micro-finite element mechanical response of articular process was analyzed
to predict and evaluate the risk of cervical spondylosis such as cervical instability
osteoporosis and articular process fracture caused by the change of micromorphology and mechanical load of articular process. Methods Fresh upper and inferior processes of cervical vertebrae from 36 adults were scanned by Micro-CT.The (VOI) of the two regions of interest of the upper and inferior processes of the cervical vertebrae were selected manually and the microstructure parameters of the articular processes were calculated.The micro-finite element analysis of the cubes with the volume of 8 mm×8 mm×8 mm taken by ring drill was made
and the relationship between the microstructure and the mechanical parameters of the facet was analyzed and compared. Results The main effect analysis showed that there were statistically significant difference in the BV/TV
BS/BV
Tb.Sp parameters between the upper and lower articular processes(P<0.05)
and the Tb.Th parameters were statistically significant between the left and right sides of the articular process(P<0.05).There were significant differences in BV/TV
Tb.N
BS/BV
Tb.Th
Tb.Sp
Tb.Pf parameters of articular process among different vertebrae sequences(P<0.05).The Tb.N parameters of interaction between different intervertebral sequences and upper and lower articular processes were statistically significant(P<0.05).The stress components in the six directions of the facet bone microfinite element model were σx
σy
σz
σxy
σxz
σyz.The stress components in the six directions of the facet microfinite element model were as follows:S11
S22
S33
S12
S13
S23.The axial stress value of S33 was the largest in the axial stress of σz
which accord with the direction of the loading of the joint process (along the direction of the Z axis)
and the stress of the twodimensional plane of S12 was the smallest
which indicated that the shear stress of the articular process of the cervical spine was less than the principal stress during movement. Conclusion The BV/TV
Tb.N parameters of C3 articular process are the largest.BV/TV
Tb.Th is positively correlated with the stress of articular process
negatively correlated with the degree of fracture
the degree of stress concentration and internal shear force.Therefore
the loading ability of C3 articular process is better
the risk of fracture and other injuries is relatively lower.BS/BV
Tb.Sp
Tb.Pf parameter value of C2 joint process are the largest
Tb.Pf
Tb.Sp are negatively correlated with stress
and positively correlated with fracture
osteoporosis
hyperplasia
degeneration and so on.It is suggested that the risk of cervical spine diseases such as fracture
osteoporosis
hyperplasia and degeneration of C2 joint process is higher than that of other joints.The cumulative result of plastic strain in the whole finite element model of facet bone is zero during the whole deformation process
that is to say
there is no plastic deformation nor yield under this load condition.It is shown that there is no fracture in the finite element model of facet bone under normal physiological load in adults.
颈椎关节突微结构微有限元力学Micro-CT
cervical vertebraarticular processmicrostructuremicrofinite element mechanicsMicroCT
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