角度人工椎间盘置换后对相邻下位椎间隙应力的影响  

Effects of artificial disc replacement with angles on stress of adjacent intervertebral disc

作　　者：柏传毅[1] 张维杰[1] 卫文博[1] 凌伟[2] 田振兴[2] 党晓谦[1] 王坤正[1] 

机构地区：[1]西安交通大学医学院第二附属医院骨一科,陕西西安710004 [2]西安交通大学航天航空学院,陕西西安710004

出　　处：《中国骨伤》2014年第9期756-761,共6页China Journal of Orthopaedics and Traumatology

基　　金：陕西省科技攻关资助项目[编号:2007k14-01(2)]~~

摘　　要：目的:探讨带角度人工颈椎间盘置换后椎间隙及相邻椎间隙应力变化。方法:根据已有的测量结果,设计角度人工椎间盘。对已建立的C4,5两节段带椎间盘的正常颈椎有限元模型、C4,5置换0°椎间盘假体和置换10°椎间盘假体后的颈椎模型进行轴向加压、前屈/后伸、侧弯、扭转加载,对比观察C4,5椎间隙应力变化;对已建立的C4-C63节段带椎间盘的正常颈椎有限元模型、C4,5置换0°椎间盘假体和置换10°椎间盘假体后的颈椎模型同样方式进行加载,对比置换节段及相邻节段的椎间隙应力变化。结果:C4,5两节模型加载中,轴向加载、前屈/后伸时80 MPa/0°假体与80 MPa/10°假体等效剪应力(Se)大小近似,较正常颈椎增大,侧弯时80 MPa/0°假体Se与正常颈椎接近,80 MPa/10°假体Se较正常颈椎增大。扭转时加载时扭转切应力(Szx/Szy)80 MPa/0°假体和80 MPa/10°假体接近正常颈椎。在C4-C63节段模型加载时,C4,5椎间隙置换80 MPa/10°假体后,轴向加载、前屈后伸、侧弯时,相邻下位节段(C5,6)的椎间隙Se均减小,扭转加载时Szx/Szy接近正常颈椎模型。结论:10°椎间盘假体植入椎间隙对颈椎相邻节段的椎间隙应力影响小,接近正常颈椎间盘力学性能。Objective：To evaluate stress changes of intervertebral space and adjacent intervertebral space after artificial disc replacement with angles. Methods：Artificial disc replacement with angles were designed according to existing data. Axial pressure,flexion/extension,lateral bending and torsion loading were applied on finite element models of normal cervical discs on C4,5 segments,C4,5 segments with 0°;artificial cervical discs and C4,5 segments with 10°;artificial cervical discs,then stress changes of C4,5 space was observed. The same loadings were applied on finite element models of normal cervical discs on C 4-C6 segments,C4,5 segments with 0°,C4,5 segments with 10°,then stress changes of replaced segments space and adjacent segment space were observed. Results：For C4,5 segments,80 MPa/0°artificial discs and 80 MPa/10°artificial discs had the similar equivalent shear stress（Se）,and were both larger than that of normal discs,when lateral bending were performed,80 MPa/0°artificial discs were closed to normal discs when axial pressure and flexion/extension were carried out ,while 80 MPa/10°artificial discs had a larger Se than that of normal ones,when torsion loading were applied,Szx/Szy stress of 80 MPa/0°;and 80 MPa/10°artificial discs were closed to normal ones. For C4-C6 segments,the axial pressure,flexion/extension and lateral bending of C5,6 were all lower than normal discs after C4,5 discs were replaced by 80 MPa/10°artificial discs,while Szx/Szy of torsion loading were closed to normal ones. Conclusion：Artificial discs with 10° have less influences on stress of adjacent intervertebral space and closer to mechanical property after being implanted into intervertebral space.

关 键 词：颈椎 椎间盘 生物力学 

分 类 号：R681.5[医药卫生—骨科学]