旋转手法对腰椎骨盆和股骨上端结构有限元模型的分析  

Finite element analysis of lumbar pelvic and proximal femur model with simulate lumbar rotatory manipulation

作　　者：胡华[1] 熊昌源[2] 韩国武 

机构地区：[1]湖北中医药大学 [2]湖北省中医院骨科,湖北武汉430000 [3]湖北省兴山县人民医院放射科

出　　处：《中国骨伤》2012年第7期582-586,共5页China Journal of Orthopaedics and Traumatology

摘　　要：目的:研究腰椎旋转手法时腰椎骨盆和股骨上端各结构位移和应力的特点。方法:使用腰椎CT片,以Mimics10.01软件建立腰椎骨盆和股骨上端几何模型,经Geomagic9对模型进行修改后导入Hypermesh10划分4面体网格并添加椎间盘与韧带。根据手法作用原理,将腰椎旋转手法进行分解,把各项力学参数导入三维有限元模型。利用Abaqus求解模块对4工况下模型的位移和应力进行计算分析,得到腰椎旋转手法作用时腰椎骨盆和股骨上端各结构位移和应力的变化。结果:①相同工况下腰椎位移的大小顺序是:L1>L2>L3>L4>L5,前柱>中柱>后柱。②不同工况下腰椎的位移大小顺序是:工况3>工况1>工况4>工况2。③相同工况下椎间盘从L1,2-L5S1各椎间盘位移大小顺序是:L1,2>L2,3>L3,4>L4,5>L5S1,同一椎间盘内各象限位移大小顺序为:第2象限>第3象限>第1象限>第4象限。④不同工况下各椎间盘的位移大小顺序是:L1,2>L2,3>L3,4>L4,5>L5S1,同一椎间盘不同工况下位移大小顺序是:工况3>工况4>工况1>工况2。⑤骨盆和髋关节在手法作用过程中存在明显的位移和应力集中。结论:①旋转手法的作用原理与腰椎骨盆和股骨上端各相应解剖部位因旋转而引起的相对位移有关;②在手法的操作过程中,不能随意加大侧弯和前屈的角度;③在腰椎旋转手法的施术过程中,必须综合考虑腰椎骨盆和股骨上端各部位的具体情况以确定适应证和禁忌证。Objective： To study the changes of displacement and stress in the model of lumbar pelvic and proximal femur during lumbar rotatory manipulation. Methods：The date of lumbar pelvic and proximal femur CT scan by Mimics 10.01 soft- ware was established a lumbar pelvic and proximal femur geometric model,then the model was modified with Geomagie 9, at last the modified model was imported into hypermesh 10 and meshed with tetrahedron, at the same time, add disc and liga- ments. According to the principle of lumbar rotatory manipulation, the lumbar rotatory manipulation were decomposed. The mechanical parameters assigned into the three-dimensional finite element model. The changes of displacement and stress in the model of lunbar pelvic and proximal femur under the four conditions were calculated with Abaqus model of Hypermesh 10. Results： （1）Under the same condition,the displacement order of lumbar was Ll〉L2〉L3〉L4〉Ls,anterior column〉middle column〉 posterior column. （2）Under the different conditions, the displacement order of lumbar, case 3 〉case 1 〉case 4〉case 2. （3）Under the same conditions, the displacement order of lumbar inter-vertebral disc from L1,2to L5S1 was L1,E〉L2,3〉L3,4〉L4,5〉LsSI, as for the same inter-vertebral disc ,the order was： second quadrant〉third quadrant〉first quadrant〉fourth quadrant. （4）Under the differ- ent conditions,the displacement order of the inter-vertebral disc was LI.2〉L2,a〉L3,4〉L4,5〉L5S1,but to same inter-vertebral disc： case 3〉case 4〉case l〉case 2. （5）There were apparent displacement and stress concentration in pelvis and hip during the ma- nipulation. Conclusion： （2）The principles of lumbar rotation manipulation closely related to the relative displacement caused by rotation of various parts of lumbar pelvic and proximal femur model ; （2）During the process of lumbai＂ rotatory manipulation, the angle of lateral bending and flexion can not be randomly increased; （3）During the process of lumbar rota

关 键 词：腰椎 椎间盘 手法 整骨 有限元分析 

分 类 号：R493[医药卫生—康复医学]