椎板回植椎管重建对腰椎生物力学影响的有限元分析
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1.东部战区总医院秦淮医疗区;2.厦门医疗器械研发检测中心有限公司;3.Faculty of Engineering and the Environment, University of Southampton, Southampton, United Kingdom;4.东部战区总医院

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国家自然科学基金青年科学基金项目(82102547),江苏省自然科学基金面上项目(BK20181113) 。


Finite element simulation and biomechanical analysis of lamina replantation and spinal canal reconstruction
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1.Department of Orthopaedics, Jin Ling Hospital, Nanjing 210002, China;2.Jin Ling Hospital, Nanjing 210002, China

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National Natural Science Foundation of China (NSFC), No. 82102547; The Natural Science Foundation of Jiangsu Province, No. BK20181113.

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    摘要:

    目的:有限元分析比较椎板回植不同内固定方式重建椎管对腰椎活动度范围的影响变化。 方法:建立腰椎L2-L4三维有限元模型,并验证其有效性。根据处理方式不同分为正常赋值模型组、单纯椎板切除组、H型钛板组、L型钛板组和两孔钛板组。相同边界固定和生理载荷的条件下,计算各模型在前屈、后伸、左弯、右弯、左旋和右旋处理下L2-3和L3-4节段活动度变化情况。 结果:建立的腰椎L2-L4有限元模型可用于实验研究。H型钛板组仅在前屈时,L2-3活动范围高于正常赋值模型组(P<0.05);L型钛板组和两孔钛板组L2-3活动范围在后伸、右弯时,与正常赋值模型组相比差异均不明显(P>0.05),L3-4在前屈时与正常赋值模型组相比差异不明显(P>0.05)。L型钛板组和两孔钛板组在左弯、右弯、左旋和右旋时L2-3的活动度范围明显高于H型钛板组(P<0.05),在左弯、左旋和右旋时L3-4的活动度范围明显高于H型钛板组(P<0.05);两孔钛板组在右弯时L3-4的活动度范围明显高于H型钛板组(P<0.05)。 结论:椎管重建可有效减少病变节段的活动度并维持其生物力学稳定性,且H型钛板固定重建椎管在弯曲和旋转时,其生物力学稳定性要优于L型和两孔钛板。

    Abstract:

    Objective: To investigate the effect of different internal fixations in lamina replantation and spinal canal reconstruction on lumbar range of motion (ROM) by using finite element method. Methods: The lumbar L2-4 segment finite element model was established and compared with in vitro experimental data to verify the validity of the model. According to the different treatment methods, the research were divided into normal assignment model group, laminectomy group, H-shaped Titanium plate group, L-shaped Titanium plate group, and two-hole Titanium plate group. The same boundary loading was applied to the various finite element models and the ROM of lumbar L2-3 and lumbar L3-4 were compared under six conditions including flexion, extension, left and right bending, left and right rotation. Results: The validity was verified and the lumbar L2-4 segment finite element model could be used in experimental studies. the ROM of lumbar L2-3 was greater than that of normal assignment model group only under flexion loading condition (P<0.05). No significant difference in the ROM of lumbar L2-3 was found between normal assignment model group and L-shaped Titanium plate group or two-hole Titanium plate group under the loading conditions of extension and right bending (P>0.05), while there was no statistically significant difference in the ROM of lumbar L3-4 under flexion loading condition (P>0.05).The ROM of lumbar L2-3 in L-shaped Titanium plate group or two-hole Titanium plate group were greater than that of H-shaped Titanium plate group under the loading conditions of left and right bending, left and right rotation (P<0.05), while The ROM of lumbar L3-4 was greater than that of H-shaped Titanium plate group under the loading condition of left bending, left and right rotation (P<0.05). The ROM of lumbar L3-4 in two-hole Titanium plate group were greater than that of H-shaped Titanium plate group only under the right rotation loading condition(P<0.05). Conclusion: The application of lamina replantation and spinal canal reconstruction can effectively reduce the ROM of spinal segment and maintain its biomechanical stability. Lamina replantation and spinal canal reconstruction with H-shaped Titanium was significantly better than that of L-shaped Titanium plate and two-hole Titanium plate under bending and rotation.

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  • 收稿日期:2021-07-14
  • 最后修改日期:2022-01-06
  • 录用日期:2022-01-27
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