倒悬旋转手法时腰椎各结构的应力分布  

Intra-stress Distribution of Lumbar Unit During the Hang Upside Down and Rotatory Manipulation

作　　者：桂志雄 严金林 严斌 张美超[2] 李义凯[2] 

机构地区：[1]湖北省黄石市中医医院,435000 [2]南方医科大学,广东广州510630

出　　处：《时珍国医国药》2007年第4期785-787,共3页Lishizhen Medicine and Materia Medica Research

基　　金：国家自然科学基金项目(No.30171184)

摘　　要：目的了解进行倒悬旋转手法时腰椎各结构的应力分布和变化的特点。方法使用正常L4-5腰椎CT片,以Mimics软件系统逐层重建,建立L4-5三维有限元模型。根据手法原理,将倒悬旋转手法进行分解,把各项力学参数代入三维有限元模型进行计算分析。即时显示手法作用时腰椎各结构内在应力的变化。结果应力变化主要集中于终板及椎间盘,以后部更为明显;应力在终板和椎间盘上又集中左侧后部和右侧前部,外层的应力大于内层;髓核和后部结构的应力变化较小。结论倒悬旋转手法时,应力在腰椎中不是均匀分布;终板要比椎间盘更容易受到损伤;该手法对小关节是安全、有效的,但旋转角度不宜过大。Objective To study the trait of intra - stress distribution of lumbar unit during the hang upside down and rotatory manipulation, Methods Sectional constructed with Mimics software system by normal lumbar L4-5 CT images. Set up a 3D finite element system of lumbar L4-5. The hang upside down and rotatory manipulation was decomposed by principium of manipulation. The finite element system was analyzed with the parameter of mechanics. The change of intra - stress distribution in lumbar unit was displayed simultaneously during simulating manipulation. Results The stress mainly distributed in the endplate and lumbar disc, especially in the posterior part. The stress distributed in the left - posterior part and the right - anterior part of the endplate and lumbar disc. The stress in the lateral of the endplate and lumbar disc was more than the inside. The intra - stress of nucleus and posterior area were less. Conclusion The intra - stress distribution is not even during the hang upside down and rotatory ma- nipulation. The endplate was more vulnerable than the lumbar disc. The manipulation was safe and effective for facet joints, but the rotatory levels of lumbar should not be too much during manipulation.

关 键 词：腰椎 有限元 倒悬旋转手法 椎间盘 终板 应力 

分 类 号：R244.1[医药卫生—针灸推拿学]