杠杆定位手法对腰椎间盘影响的有限元分析  

FEM Analysis of Lever Positioning Technique Impact on Lumbar Disc

作　　者：吕立江[1] 冯喆[1] 廖胜辉[2] 包家立[3] 范炳华[1] 应航[1] 初真秋[1] 朱朝阳[3] 

机构地区：[1]浙江中医药大学第三临床医学院,浙江杭州310053 [2]中南大学信息科学与工程学院,湖南长沙410083 [3]浙江大学医学院浙江省生物电磁学重点实验室,浙江杭州310058

出　　处：《中华中医药学刊》2014年第5期971-973,I0001,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(81273866);国家临床重点专科建设项目(国医卫发2013-42号);浙江省自然科学基金项目(Y2111054);浙江省科技厅公益技术项目(2012C33067)

摘　　要：目的:研究适合于杠杆定位手法的腰椎三维有限元建模方法,并分析杠杆定位手法对腰椎间盘生物力学的影响。方法:选取自愿者采集CT数据,进行三维重建并构建后伸40度体位,然后采用专用生物力学软件建立L3-S1节段腰椎三维有限元,同时生成无腰椎肌肉和有腰椎肌肉两组对比模型,根据实际杠杆定位手法实验收集的力学参数设置边界条件,进行有限元分析。结果:腰部肌肉对于推拿手法具有明显的协同和拮抗作用,有腰椎肌肉模型计算的腰部椎体各部分应力分布更自然合理。另外,结果表明杠杆定位手法使使纤维环有明显的回纳效果,使髓核向前中部靠拢、前中部内压增大。结论:腰椎三维有限元建模分析适合于分析杠杆定位手法对腰椎间盘生物力学的影响,为探讨杠杆定位手法对腰椎间盘突出症作用机理提供依据。Objective：To establish the accurate FE model of complete lumbar spine with complex lumbar spinal steno- sis （LSS）, and then to do the comparison and analysis with normal model and decompression treated model. Methods： Some patients with complex LSS were chosen and the CT scan data was collected. By using specially modehng system, the lumbar vertebrae were made meshing adaptively and auxiliary tissues were created interactively. Following, the complete FE model of lumbar vertebrae with complex LSS was generated as well as normal other treated models. And then, same boundary conditions were applied. Results ：The result demonstrated that the active movement range of complex I.SS was de- creased about 20%, but the decompression model increased about 40% and the model with lag screw increased about 25%, and the model with intervertebral fusion was stiffer than that of normal model. The stress in the decompression mod- el was increased about ？0%, and the lag screw and intervertebral fusion had obvious decompression effect. Conclusion ：The treatment of simple decompression for lumbar spine with complex LSS can release the pain, but may results are unstable and accelerate the degeneration. The model with lag screw can not provide full stability, and the model with intervertebral fusion can provide the best treatment.

关 键 词：杠杆定位手法 腰椎间盘 生物力学 有限元方法 

分 类 号：R244.1[医药卫生—针灸推拿学]