颈椎后路单开门不同数量微型钛板固定对颈椎稳定影响的有限元分析
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南阳市中心医院

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Finite element analysis of the influence of different number of plate fixation on the stability of cervical spine after open-door cervical laminoplasty
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Nanyang Central Hospital

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    摘要:

    目的 应用有限元分析的方法研究颈椎后路单开门不同数量微型钛板固定对颈椎稳定的影响。方法 选择符合条件的颈椎后路单开门治疗的脊髓型颈椎病患者,利用Mimics、Geomaeic Studio建模软件,提取患者颈椎骨质图像,并进行补空、封装,建立颈椎的三维计算机模型。Creo 4.0软件中建立微型钛板模型。在Hypermesh中进行装配,构建出颈椎后路单开门微型钛板固定的有限元模型,在Abaaus6.1中设定材料力学参数、边界条件及载荷,模拟颈椎在屈曲、后伸工况下的反应。结果 ①本研究建立的脊髓型颈椎病的三维有限元模型,包括C2-T1椎体及椎间盘,共118 547个节点和569 332个单元,模型与正常人体具有高度的相似性。② 前屈、后伸载荷中,连续固定模型与正常模型各节段的活动度均显著小于间断固定模型,差异有统计学意义(P<0.01)。③屈曲载荷下,间断固定模型中固定椎板C3、C5、C7 显著高于正常模型及连续固定模型,而非固定椎板C4、 C6,显著低于正常模型及连续固定模型,差异有统计学意义(P<0.01)。后伸载荷下,各节段的Mises应力差异无统计学意义(P>0.05)。④屈曲载荷下,间断固定模型C3、C5、C7节段钛板的Mises应力显著高于连续固定模型,差异有统计学意义(P<0.01),后伸载荷中,连续固定模型间断固定模型中C3、C5、C7节段钛板的Mises应力低于间断固定模型,差异有统计学意义(P<0.01)。 结论 通过对颈椎后路单开门不同数量微型椎板固定的三维有限元分析,我们认为虽然连续固定方式增加了患者经济负担,但其对颈椎及椎板的稳定性优于间断固定模型。

    Abstract:

    Abstract Objective To study the influence of different number of plate fixation on the stability of cervical spine after open-door cervical laminoplasty with finite element analysis. Methods The male patient with cervical spondylotic myelopathy treated by open door cervical laminoplasty was sacned by CT, and in Mimics and Geomaeic studio ,the images were processed, and to establish 3D model of cervical spine. In Creo 4.0 , the plate model was established. After assembly in HyperMesh, the finite element model of open-door cervical laminoplasty fixed with plates was constructed. The mechanical parameters, boundary conditions and loads were set in abaaus 6.1 to simulate the response of cervical spine under flexion and extension. Results ① the three-dimensional finite element model of cervical spondylotic myelopathy established in this study, including c2-t1 and intervertebral disc, has 118547 nodes and 569332 units, which is highly similar to the normal human body.②In the flexion and extension load, the activity of each segment of the continuous fixation model and the normal model was significantly lower than that of the intermittent fixation model (P < 0.01).③ In the flexion load, C3, C5 and C7 of the fixed lamina in the intermittent fixation model were significantly higher than those in the normal model and the continuous fixation model, while C4 and C6 of the non fixed lamina were significantly lower than those in the normal model and the continuous fixation model (P < 0.01). There was no significant difference in Mises stress of each segment under extension load (P > 0.05).④ The Mises stress of C3, C5 and C7 plates in the intermittent fixation model was significantly higher than that in the continuous fixation model under flexion load (P < 0.01). The Mises stress of C3, C5 and C7 plates in the continuous fixation model was lower than that in the intermittent fixation model under extension load (P < 0.01). Conclusion Through the three-dimensional finite element analysis of different numbers of plates after open-door cervical laminoplasty, we believe that although the continuous fixation model increases the economic burden of patients, but its stability for cervical spine and lamina is better than the intermittent fixation model.

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  • 收稿日期:2019-12-09
  • 最后修改日期:2020-01-22
  • 录用日期:2020-03-09
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