本文關(guān)鍵詞： 脊柱后凸 截骨術(shù) 有限元分析 生物力學(xué) 組織工程 骨科植入物 脊柱植入物 強(qiáng)直性脊柱炎 應(yīng)力分析 全脊椎截骨 去松質(zhì)骨截骨 截骨接觸面 截骨節(jié)段 截骨方式 國家自然科學(xué)基金　出處：《中國組織工程研究》2017年31期 　論文類型：期刊論文

【摘要】：背景:嚴(yán)重的強(qiáng)直性脊柱后凸畸形常采用矯形截骨術(shù)對(duì)患者進(jìn)行治療,但脊柱截骨矯形手術(shù)風(fēng)險(xiǎn)高,具體治療方案較為個(gè)體化,畸形脊柱的生物形態(tài)與力學(xué)特性錯(cuò)綜復(fù)雜。但有限元分析法對(duì)不規(guī)則物體的生物力學(xué)分析有其獨(dú)特的優(yōu)勢(shì)性。目前國內(nèi)通過有限元建模分析強(qiáng)直性脊柱后凸截骨治療的生物應(yīng)力特點(diǎn)鮮有報(bào)道。目的:建立強(qiáng)直性脊柱后凸三維有限元模型,探討截骨方式選擇與全脊柱變形位移趨勢(shì)及截骨接觸面、鈦棒、椎弓根螺釘?shù)葢?yīng)力分布的關(guān)系。方法:采用三維醫(yī)學(xué)圖形軟件構(gòu)建強(qiáng)直性脊柱后凸全脊柱模型,導(dǎo)入ANASYS有限元分析軟件,分別模擬在T_(12)和L_1椎體節(jié)段行2種截骨方式(全脊椎截骨術(shù)與去松質(zhì)骨截骨術(shù))的4個(gè)截骨模型。對(duì)椎體及螺釘分別施加相應(yīng)的載荷,得到4種工況下的一系列變形和應(yīng)力云圖。結(jié)果與結(jié)論:(1)T_(12)椎體截骨加載后各方向軸的全脊柱位移趨勢(shì)大于L_1椎體截骨模型;(2)去松質(zhì)骨截骨模型的應(yīng)力集中部位于后方的內(nèi)固定裝置,全脊椎截骨的生物應(yīng)力主要集中在鈦籠及截骨接觸面;(3)個(gè)體化的強(qiáng)直性脊柱后凸畸形手術(shù)治療會(huì)影響截骨節(jié)段及截骨方式的選擇,截骨節(jié)段的選擇將主要影響全脊柱的變形穩(wěn)定性,內(nèi)固定節(jié)段的應(yīng)力分布可能與截骨方式及內(nèi)固定裝置方式相關(guān);(4)該結(jié)論可為強(qiáng)直性脊柱后凸的生物力學(xué)分析提供一定的理論參考依據(jù)。
[Abstract]:Background: orthopaedic osteotomy is often used to treat severe ankylosing kyphosis, but the risk of orthopaedic surgery is high, and the specific treatment is more individualized. The biomorphology and mechanical properties of the deformed spine are complicated, but the finite element analysis has its unique superiority in the biomechanical analysis of irregular objects. At present, the domestic osteotomy of ankylosing kyphosis is analyzed by finite element modeling. The characteristics of biological stress in treatment are rarely reported. Objective: to establish a three-dimensional finite element model of ankylosing kyphosis. To explore the relationship between the choice of osteotomy mode and the trend of deformation displacement of the whole spine, the stress distribution of the osteotomy contact surface, titanium rod, pedicle screw, etc. Methods: the model of total scoliosis of ankylosing kyphosis was constructed by using 3D medical graphics software. The ANASYS finite element analysis software was introduced to simulate the four osteotomy models of two kinds of osteotomy (total vertebra osteotomy and cancellous osteotomy) in the T _ S _ (12) and L _ s _ 1 vertebrae, respectively. The corresponding loads were applied on the vertebrae and screws, respectively. A series of deformation and stress cloud maps were obtained under four different conditions. Results and conclusion: the displacement trend of the whole spine in all directions after loading of vertebral body osteotomy is greater than that of L1 vertebra osteotomy model. Results and conclusion the stress concentration of cancellous osteotomy model is located at the stress concentration of L1 vertebra osteotomy model. The internal fixation device in the rear, The biological stress of total spine osteotomy is mainly focused on titanium cage and osteotomy contact surface (3) the surgical treatment of ankylosing kyphosis deformity will influence the choice of osteotomy segment and osteotomy mode. The selection of osteotomy segments will mainly affect the stability of the deformation of the whole spine. The stress distribution of internal fixation segment may be related to osteotomy and internal fixation device. This conclusion can provide a theoretical reference for biomechanical analysis of ankylosing scoliosis.
【作者單位】： 新疆醫(yī)科大學(xué)第六附屬醫(yī)院脊柱外科研究所;
【基金】：國家自然科學(xué)基金(81360280)~~
【分類號(hào)】：R687.3
，

本文編號(hào)：1512526