MED治疗腰椎间盘突出症术后三维有限元分析研究  

Three-dimensional finite element analysis of MED treatment of lumbar intervertebral disc after surgery

作　　者：陶伟伟[1] 鲍军平[1] 洪鑫[1] 吴小涛[1] 

机构地区：[1]东南大学附属中大医院骨科,南京210009

出　　处：《中国矫形外科杂志》2014年第21期1989-1994,共6页Orthopedic Journal of China

摘　　要：[目的]采用三维有限元的方法,通过Mimics及ANSYS相关软件对MED治疗腰椎间盘突出症术后的脊柱稳定性及生物力学进行研究。[方法]选择正常健康成人志愿者,对其腰椎进行薄层CT平扫,得出相关数据,将其导入Mimics中进行建模,划分网格,建立体模型,材料赋值,得出正常下腰椎模型。通过布尔剪切等功能,模拟手术,建立正常模型、MED摘除手术模型,小开窗手术模型及关节突摘除手术模型。将四组模型导入Ansys软件中进行同样的应力载荷模拟,得出相应的移位云图、应力云图、压力敏感云图,统计云图的数据,对数据进行分析。[结果]随着后路椎板切除面积增大,椎体应力移位明显变大,影响脊柱的稳定性。椎体的应力集中部不因后路手术而改变,而椎间盘切除后压力分布对椎体应力负荷的移位及应力改变较小,达到良好的远期生物力学效果。[结论]MED治疗腰椎间盘突出症术后对脊柱生物力学影响最小,能获得良好的远期生物力学稳定。[ Objective] A 3D finite element model was utilized for understanding spinal stability and biomechanics and as- sessing MED treatment of lumbar intervertebral disc after surgery. [ Methods ] Healthy adult volunteers were selected and scanned by lumbar CT. These radiographic data were imputed intp Mimics for modeling, meshing, and 3D model build- ing. Through Boolean shear function, the models of sham operation, the MED extraction operation, small fenestration operation and facet removal operation were established （named as A, B, C, D group） . These 4 models were imported into Ansys software and then the displacement nephogram, the stress nephogram and pressure sensitive cloud were obtained and analyzed. [ Re. suits] With the increases of posterior laminectomy area, the vertebral stress shift obviously increased, which may affect the spine stability. The main area of vertebral stress was not changed by posterior operation, and discectomy had little effect on pres- sure distribution, vertebral shift and stress changes. [ Conclusion] MED treatment of lumbar intervertebral disc after surgery has minimal impacts on spinal biomechanics, resulting in a good long - term biomechanical stability.

关 键 词：MED 腰椎间盘突出症 术后 有限元分析 

分 类 号：R687.3[医药卫生—骨科学]