伤椎椎弓根螺钉内固定治疗胸腰段椎体压缩骨折的三维有限元分析  

Establishment of 3D Nonlinear Finite Element Model of Thoracolumbar Vertebral Compression Fractures and Biomechanical Analysis Using Two Different Internal Fixations

作　　者：马立敏[1] 周烨[2] 张余[1] 夏虹[1] 尹庆水[1] 周霞[2] 

机构地区：[1]广州军区广州总医院骨科医院 [2]广州军区广州总医院医学实验科,广东省广州市流花路111号510010

出　　处：《中国数字医学》2013年第10期54-57,共4页China Digital Medicine

基　　金：国家自然科学基金(编号:81271957);全军医学科研"十二五"重点项目(编号:bws11c065);全军医学科研"十二五"面上项目(编号:cws11c268);穗科信字[2011]233-32号~~

摘　　要：目的:构建脊柱胸腰椎单纯压缩性骨折的三维有限元模型,探讨伤椎椎弓根螺钉内固定治疗胸腰段椎体压缩骨折的应力情况,为临床选择有效的内固定方法提供理论依据。方法:选取一无慢性腰背痛及胸腰椎外伤史的青年志愿者,利用CT扫描的Dicom数据图像和Simpleware5.0软件建立T12-L2椎体三维模型,模拟L1椎体骨折,并分别模拟联合伤椎置钉固定(有横连和无横连)两种治疗方法,将两种模型分别导入Abaqus6.9有限元分析软件,加载750N压力,10N·m扭矩载荷。结果:在轴向压缩状态下,腰椎骨折内固定后的应力分布发生变化,钉棒系统成主要应力集中部位。钉棒系统有无横连差异无统计学意义(P>0.05)。在扭转状态下,横连系统的应力主要集中在连接杆上,而无横连的应力主要集中在钉棒系统下段螺钉上,钉棒系统有无横连差异有统计学意义(P<0.05)。在屈曲状态下,应力主要集中在钉棒系统下段螺钉上,钉棒系统有无横连差异有统计学意义(P<0.05)。结论:有横连的六螺钉椎弓根螺钉系统置入可以优化内固定的载荷,减少断钉率。Objective： To construct a three-dimensional fnite element model of thoracolumbar vertebral compression fractures and to investigate the biomechanical mechanism of the treatment about thoracolumbar vertebral compression fractures with pedicle screws in injured level and t to provide theoretical support for its clinical application. Methods： A youth volunteer（male, aged 23）without chronic low back pain and trauma of thoracolumbar was chosen. We use Dicom datas and Simpleware software to built a 3-D finite element model to mimic the fracture of T12-L2 and L1 vertebra then two therapy approaches of posterior short segment internal fixation（PF）, and transvertebral pedicle screws internal fixation were performed by 3-D finite element model. These two models were put intoAbaqus 6.9 finite element analysis software, axial load 750N were loaded and 10Nm moment vertical compression, flexion, extension,and bending loadings were performed, respectively to study the corresponding Von Mises stress on the vertebral body and implant were calculated and load-displacement curve were obtained in the two models. Results： The stress under the vertical loading was the had no difference between the two groups（P〉0.05）and under bending, flexion and torsion condition in the three condition model screw stress has significant difference（P〈0.05）. Conclusions： The six-screw group （ with grip ） can be optimized to reduce the failure of internal fixation with pedicle screws in injured level.

关 键 词：胸腰椎 骨折 生物力学 有限元分析 

分 类 号：R651.2[医药卫生—外科学]