三维有限元法重建全椎板切除后颈椎三维模型  

Reconstruction of cervical spine curvature post laminectomy using three-dimensional finite element method

作　　者：桂斌捷[1] 申才良[1] 卜海富[1] 

机构地区：[1]安徽医科大学第一附属医院骨科,安徽省合肥市230022

出　　处：《中国组织工程研究与临床康复》2008年第48期9410-9414,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:颈椎后凸畸形是常见的医源性颈椎曲度异常,是一种进行性发展的颈椎畸形,其影响儿童和成人正常的颈椎生理功能。目的:以三维有限元法观察颈椎全椎板切除对颈椎曲度的影响,以及颈椎椎间盘、韧带结构对维持颈椎生理曲度的作用。设计、时间及地点:三维有限元分析,实验于2003-01/2004-01在解放军第二军医大学长征医院完成。材料:实验中高分辨率、层面间隔为1mm的颈椎横断面解剖图来自美国虚拟人计划中男性颈椎横断面解剖图,从The Visible Human Project网站免费下载。方法:采用高分辨率的颈椎横断面解剖图作为颈椎三维结构重建的数据源,重建全椎板切除后颈椎三维模型包括颅底至第1胸椎中上部所有颈椎结构,模型不包括C2～C7椎板、棘突、黄韧带、棘间韧带和棘上韧带。根据文献报道定义替代颈椎各结构的有限元单元类型和材质参数,如弹性模量。使用全椎板切除后颈椎模型,应用ansys6.1有限元分析软件,分析椎板切除后颈椎椎间盘和韧带结构对颈椎生理曲度的影响。主要观察指标:颈椎椎间盘、韧带结构(前纵韧带、后纵韧带)弹性模量变化对颈椎曲度的影响。结果:①全椎板切除后颈椎在多次反复加载负荷下,颈椎生理性前凸曲度减小,多次加载负荷后,颈椎上段生理性前凸消失,出现轻度后凸曲度。②颈椎椎间盘和韧带结构(前纵韧带、后纵韧带)弹性模量减小将加剧全椎板切除后颈椎后凸曲度,随着颈椎椎间盘、韧带结构弹性模量的增大,颈椎后凸曲度逐渐消失,并恢复正常生理性前凸曲度。结论:三维有限元分析显示,全椎板切除明显改变颈椎前凸曲度,使颈椎正常生理性前凸转变为后凸;颈椎椎间盘、韧带弹性模量增加将抑制全椎板切除后颈椎后凸曲度形成。BACKGROUND： Cervical kyphosis post laminectomy is a common iatrogenic, and progressive abnormality of the curvature of cervical spine, and can influence the function of cervical spine of children and adults. OBJECTIVE： To explore the effect of multiple levels of lanfinectomies on the curvature of cervical spine, and analyze the role of the elastic modulus of cervical intervertebral disc and ligaments on maintaining curvature of postlaminectomy cervical spine. DESIGN, TIME AND SETTING： Three-dimensional finite element analysis was performed in Changzheng Hospital, Second Military Medical University of Chinese PLA between January 2003 and January 2004. MATERIALS： The highly resolution pictures of the cross-section of cervical spine （interval distance of layer 1 ram） were came from male cross-section of cervical spinal of American visible human project, which was freely downloaded from The Visible Human Project. METHODS： The highly resolution pictures of cervical spinal cross-section were used as data to reconstruct the three-dimensional multiple levels postlaminectomy cervical spine models including all structure of spine from cranial base to the first thoracic vertebrae except the vertebral lamina, spinous process, ligamentum flavum, interspinous and supraspinous ligament from the second to the seventh cervical spine. The finite element and elastic modulus of the structures of cervical spine were defined according to previous reports. With this model and Ansys6.1 finite element analysis software, the effect of laminectomy on the curvature of cervical spine and impact of the elastic modulus of intervertebral disc and ligament to the curvature of postlaminectoy cervical spine were analyzed. MAIN OUTCOME MEASURES： The influence of the elastic modulus of cervical intervertebral disc and ligament （anterior and posterior longitudinal ligaments） on the curvature of the postlaminectomy cervical spine. RESULTS： The physical lordosis of multiple levels postlaminectomy cervical spine was reduced after m

关 键 词：颈椎后凸畸形 有限元 模型 

分 类 号：R681[医药卫生—骨科学]