人工椎间盘植入术后颈椎邻近节段生物力学变化的有限元分析  

Finite element analysis on adjacent segments for its biomechanical changes after artificial cervical disc prosthesis

作　　者：李斌[1] 赵文志[1] 陈秉智[2] 苏晋[1] 何盛为[1] 方旭[1] 

机构地区：[1]大连医科大学附属第二医院骨科,大连116027 [2]大连交通大学交通运输工程学院,大连116028

出　　处：《医用生物力学》2010年第2期94-99,共6页Journal of Medical Biomechanics

基　　金：国家自然科学基金资助项目(30970708)

摘　　要：目的研究人工椎间盘植入术后邻近节段的运动范围及椎间盘应力改变。方法将接触问题引入生物建模,建立正常全颈椎有限元模型,模拟C5/6椎间植骨融合和C5/6人工间盘植入,分析两种状态下其相邻节段的运动范围及椎间盘的应力改变。结果(1)所建立模型包含了韧带、关节囊及其他软组织结构,而且真实细腻,准确度高;(2)椎间植骨融合术后邻近椎间隙运动范围增加,相应椎间盘应力明显增大,上位节段髓核与纤维环的应力约增加70%,而下位节段髓核与纤维环应力约增加40%;(3)人工间盘植入后颈椎运动范围除仅后伸受限(P(0.05)外,邻近节段椎间盘应力增加不超过10%。结论植入的颈椎人工间盘可在一定程度上降低相邻椎体节段的应力,且有利于改善颈椎的活动度。Objective To study the range of movement （ROM） in adjacent vertebral segments and the changes in intervertebral disc stress after implanting artificial cervical disc. Method A 3D finite element model for normal cervical spine was established using CT images scanned from a cadaver cervical spine. Simulation of bone graft and fusion of vertebral bodies as well as implantation of intervertebral disc prosthesis were performed between C5 and C6. Then the ROM of adjacent functional spinal units （FSU,C4/5、C6/7） and the stress in C4/5 and C6/7 intervertabral disc were analyzed. Results （1）The model including the structures of ligaments,joint capsule and other soft tissue is built with high reality and accuracy;（2）Vertebral fusion increased movement range in adjacent FSU,and the stress in corresponding discs is significantly raised as well. The stress in nucleus pulposus and annulus fibrosus is increased about 70% at upper segment and 40% at lower segment; （3） After implantation of artificial disc,only the extension of cervicle spine is limited（P〈0.05）; the stress in adjacent intervertebral disks is increased less than 10%. Conclusions The implanted artificial cervical disc can appropriately reduce the stress in adjacent vertebral segments,which is beneficial to improve the movement of the cervical spine.

关 键 词：颈椎 生物力学 有限元 植骨融合 人工间盘 

分 类 号：R318.01[医药卫生—生物医学工程]