确定相对的全腰部运动范围,以缓解横隔段退化后变形腰部体融合:一个有限元分析
Ke Li1, Shuai Cao2, Jing Chen1
1Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, 157th West Fifth Road, Xi'an, Shaanxi Province, 710004, China.
BMC musculoskeletal disorders
|March 5, 2024
概括
腰部融合可以增加相邻部分的应力. 这项研究确定了融合后安全的腰部运动范围 (ROM) 极限,以防止相邻段变性 (ASD) 并减少压力.
科学领域:
- 脊柱生物力学 脊柱生物力学
- 有限元素分析的研究.
- 脊柱融合的结果
背景情况:
- 腰椎融合手术可以导致对邻近的脊柱段的压力增加.
- 在相邻的部分异常增加的运动范围 (ROM) 可能会提高内压力 (IDP) 和面关节力 (FJF).
- 这可能会加速相邻段变性 (ASD).
研究的目的:
- 为了确定腰部融合后的相对总腰部ROM.
- 引导术后患者活动延迟相邻段变性 (ASD).
- 建立安全的ROM参数,以避免在相邻段增加IDP和FJF.
主要方法:
- 使用了经过验证的L1-S1有限元模型.
- 创建了一个模拟L4/5跨腰椎体融合 (TLIF) 的外科模型.
- 在最大L1-S1ROM下,在完整和TLIF模型之间比较了相邻部分的生物力学参数 (ROM,IDP,FJF).
主要成果:
- 与完整模型相比,TLIF模型显示了相邻细分ROM (12.6-28.9%),IDP (0.1-6.8%) 和FJF (0-134.2%) 的增加.
- 邻近的细分 IDP 和 FJF 增加,随着 L1-S1 ROM 总量的增加.
- 在TLIF模型中确定了相对总的L1-S1 ROM:11.03° (屈曲),12.50° (延伸),12.14° (横向曲) 和9.82° (轴旋转).
结论:
- 在TLIF建立后的相对总L1-S1ROM,比手术前值下降了19.6-29.3%.
- 坚持这些ROM限制可以抵消相邻段IDP和FJF的增加.
- 这种方法可以有效地缓解手术后的相邻细分退化 (ASD).
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