不同的手术策略的生物机械比较跳跃水平的椎退行性磁盘疾病:一个有限元研究
Hanpeng Xu1, Ziwen Liu2, Yuming Yang2
1Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan.
Spine
|May 27, 2024
概括
跳跃水平前椎间盘切除和融合 (ACDF) 使用零轮装置显示,通过降低椎间盘和端板的压力,有望减少相邻段疾病. 然而,Zero-P装置可能会增加皮质骨压力,可能增加骨折风险.
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.
- 宫脊椎手术 宫脊椎手术
背景情况:
- 前宫椎切除和融合 (ACDF) 是退行性宫脊椎病的标准.
- 跳跃级疾病的手术方法和仪器选择仍然存在争议.
研究的目的:
- 为了比较零形状 (Zero-P) 与板 (CP) 设备在跳跃级多阶段 ACDF中的生物力学效应.
- 评估运动范围 (ROM),对端板和固定装置的应力,以及椎间盘间压力 (IDP).
主要方法:
- 构建了C2-C7椎的三个有限元素 (FE) 模型.
- 模拟非连续的2级零P (NCZP),非连续的2级板 (NCCP) 和连续的3级板 (CCP) 设备.
- 在模拟的日常活动中分析ROM,Von Mises压力和IDP.
主要成果:
- 与NCCP和CCP模型相比,NCZP模型显示相邻部分的ROM增量较低.
- 在NCZP模型中,IDP和端板应力增幅最小.
- 零-P设备的最大应力高于CP设备,类似于皮层骨压力.
结论:
- 使用零形状装置的非连续性ACDF可以降低相邻的椎间盘和末端板上的压力,从而有可能减少相邻分段疾病.
- 由于零-P装置造成的高皮层骨压力可能会增加骨折风险.
相关概念视频
01:27Degenerative Disc Disease I: Introduction
29
Degenerative disc disease is a chronic condition in which intervertebral discs gradually lose structure and function. It is not infectious or autoimmune; rather, it results from age-related biochemical and mechanical changes, influenced by genetic, metabolic, and environmental factors.Structure and Function of DiscsThe spine contains 23 intervertebral discs that absorb load, distribute forces, maintain spacing, and allow flexibility. Each disc consists of a nucleus pulposus, a gel-like core...
29
01:23Degenerative Disc Disease ll: Pathophysiology
30
The symptoms of degenerative disc disease arise from a combination of mechanical compression, vascular compromise, and biochemical inflammation, which together disrupt nerve function and produce pain.Mechanical CompressionDisc degeneration reduces height and elasticity, predisposing to herniation of the nucleus pulposus, a major cause of radicular pain. Herniations may be protrusion (bulging with intact annulus), extrusion (nucleus extends beyond disc but remains connected), or sequestration...
30