發(fā)布時(shí)間：2018-05-03 00:36

  本文選題：頸椎棘突骨折 + 內(nèi)固定��； 參考：《中國生物醫(yī)學(xué)工程學(xué)報(bào)》2017年04期

【摘要】：通過對頸椎棘突骨折(累及椎板)內(nèi)固定治療有限元模型的建立和分析,明確此種治療方式對頸椎棘突骨折的有效性。先建立正常全頸椎(C0-T1)的有限元模型并與文獻(xiàn)報(bào)告進(jìn)行對比驗(yàn)證,模型驗(yàn)證后,在正常模型基礎(chǔ)上建立頸椎棘突骨折(累及椎板)模型,并模擬直型接骨板行內(nèi)固定治療,測量并比較頸椎棘突骨折模型及手術(shù)內(nèi)固定模型和原始正常模型在前屈、后伸、左右側(cè)彎、左右旋轉(zhuǎn)6種條件下活動度改變。以及頸椎各結(jié)構(gòu)的應(yīng)力變化。結(jié)果表明,在正常模型上結(jié)合臨床病例建立的頸椎棘突骨折(累及椎板)外觀逼真,生物力學(xué)相似度良好。骨折模型部分節(jié)段,主要為C7-T1的活動度(前屈+后伸9.20°,左右側(cè)彎5.83°,左右旋轉(zhuǎn)13.12°)較正常模型(前屈+后伸7.11°,左右側(cè)彎4.92°,左右旋轉(zhuǎn)9.59°)增大,尤其是旋轉(zhuǎn)活動度,模擬植入內(nèi)固定后穩(wěn)定性增加(前屈+后伸4.07°,左右側(cè)彎2.21°,左右旋轉(zhuǎn)2.91°),且內(nèi)固定鋼板應(yīng)力分析提示,承受最大應(yīng)力值在安全范圍。頸椎棘突骨折(累及椎板)及內(nèi)固定模型可以較好地模擬臨床實(shí)際病例,通過有限元分析預(yù)示,此型骨折存在潛在不穩(wěn)的可能性,探討微型棘突鋼板在骨折手術(shù)治療中的應(yīng)用,具有一定的臨床參考價(jià)值。
[Abstract]:Through the establishment and analysis of the finite element model for the treatment of cervical spine process fracture (involving lamina), the effectiveness of this treatment method for cervical spine process fracture was determined. The finite element model of normal cervical spine C0-T1) was established and compared with the literature report. After the model was verified, the cervical spine spinous process fracture (involving lamina) model was established on the basis of the normal model, and the straight plate was simulated to be treated with internal fixation. The changes of motion of cervical spinal process fracture model, surgical internal fixation model and original normal model were measured and compared under 6 conditions: anterior flexion, extension, left and right lateral bending, left and right rotation. And the stress changes of the cervical vertebrae. The results showed that the spinous process fracture (involving lamina) established in the normal model and clinical cases had a realistic appearance and good biomechanical similarity. In part of fracture model, the range of C7-T1 (flexion extension 9.20 擄, left and right lateral bending 5.83 擄, left and right rotation 13.12 擄) was higher than that of normal model (flexion extension 7.11 擄, left and right lateral curvature 4.92 擄, left and right rotation 9.59 擄), especially rotation activity. The stability of imitated internal fixation was increased (flexion extension 4.07 擄, left and right lateral bending 2.21 擄, left and right rotation 2.91 擄), and the stress analysis of internal fixation plate showed that the maximum stress was in the safe range. The model of cervical spine process fracture (involving lamina) and internal fixation can be used to simulate the actual clinical cases. The possibility of potential instability in this type of fracture is predicted by finite element analysis, and the application of mini-spinous process plate in the surgical treatment of fracture is discussed. It has certain clinical reference value.
【作者單位】： 中國人民解放軍第98醫(yī)院骨科;上海交通大學(xué)醫(yī)學(xué)院附屬瑞金醫(yī)院傷骨科研究所;
【基金】：南京軍區(qū)醫(yī)學(xué)科技創(chuàng)新項(xiàng)目(MS009) 湖州市自然科學(xué)基金(2016YZB03)
【分類號】：R687.3

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