多段固定对腰椎和关节的生物力学影响:有限元分析
Geng Zhao1,2, Lianlei Wang2, Hongwei Wang3
1School of Instrumentation and Optoelectronic Engineering, Beihang University, Beijing, China.
Orthopaedic surgery
|August 9, 2024
概括
短期脊柱固定 (≤2段) 极少影响神经关节 (SIJ) 应力. 然而,长期固定 (≥4段) 显著增加SIJ应力,特别是L1-L5固定,可能导致SIJ退化.
科学领域:
- 生物力学 生物力学
- 脊柱外科手术 脊柱外科手术
- 有限元分析 有限元分析
背景情况:
- 脊柱固定手术可以改变关节 (SIJ) 的生物力学环境.
- 这种变化可能会导致术后SIJ疼痛和退化.
研究的目的:
- 调查固定脊柱段在SIJs上变化的数量和位置的生物力学影响.
- 提供手术规划指导,以优化固定水平和改善手术结果.
主要方法:
- 基于CT图像的完整和11个腰骨盆有限元素 (FE) 模型的开发.
- 在生理负荷下模拟脊柱运动 (曲,延伸,曲,扭曲).
- 计算SIJ,椎间盘,螺丝和杆的峰值应力,以评估生物力学影响.
主要成果:
- 增加SIJ应力与更高数量的固定段相关,特别是L5或S1作为最下端的仪器脊椎 (LIV).
- 曲和曲运动在SIJs上产生了更高的·米塞斯应力.
- 与完整模型相比,固定≥4个段,特别是L1-L5,导致SIJ应力显著增加.
结论:
- 短期固定 (≤2段) 对SIJ应力产生最小的不良影响.
- 长期固定 (≥4段) 显著增加SIJ应力,造成退化的风险.
- 通过未固定段来保持腰椎脊柱的移动性,可以减轻SIJ退行风险.
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