脊柱胸腰段钉棒系统后外侧前后一体内固定的有限元分析  

Finite element analysis of anteroposterior integration fixation by posterolateral nail-stick system for thoracolumbar disorders

作　　者：汪建良[1] 许科峰[1] 

机构地区：[1]解放军第101医院,江苏省无锡市214000

出　　处：《中国组织工程研究》2014年第40期6531-6535,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前脊柱胸腰段内固定方法均有优缺点,希望探索一种新的内固定方案,使脊柱有效固定的同时,可更安全、方便的进行其他操作。目的:建立脊柱胸腰段(T12-L2)三维有限元模型,观察钉棒系统后外侧前后一体内固定对胸腰段稳定性的影响。方法:基于人正常T12-L2节段的CT扫描数据,利用Geomagic 11.0、Ug 7.0、Hypermesh 10.0、Abaqus6.9.1软件建立T12-L2节段三维有限元模型,并在此基础上分别建立钉棒系统后路固定、前路固定、后外侧前后一体内固定模型,在T12上表面施加500 N预载荷,再施加7.5 N·m的力矩,模拟胸腰段前屈、后伸、左右侧屈及左右旋转等生理活动,观察不同工况下内固定节段的平均刚度。结果与结论:3种内固定模型在不同工况下的平均刚度均较正常模型的平均刚度高。在前屈、左右侧屈、左右扭转等不同工况下,后外侧钉棒系统前后一体固定的平均刚度均高于单纯后路固定,平均刚度分别较后路固定高13%,28%,11%,17%和9%,后伸时平均刚度低于后路固定,比后路固定低6%。但与前路相比,后外侧钉棒系统前后一体内固定在前屈、左右侧弯3种工况下的平均刚度低于前路固定,平均刚度分别比固定低15%,10%和14%,而在后伸、左右扭转情况下平均刚度高于前路固定,分别比前路固定高5%,12%和2%。提示后外侧钉棒系统前后一体内固定能够明显提高固定节段的稳定性,在抗后伸及左右扭转方面的稳定性略好于前路固定,而在抗前屈、左右侧弯、左右扭转方面略好于后路固定,因此可作为一种可选的内固定方法。BACKGROUND：Currently thoracolumbar fixation techniques have its advantages and disadvantages, it is necessary to explore a new internal fixation to fix the spine effectively and conveniently. 〈br〉 OBJECTIVE：To establish thoracolumbar （T12-L2） three-dimensional finite element model and observe the effect of anteroposterior integration fixation by posterolateral nail-stick system on thoracolumbar stability. 〈br〉 METHODBased on the CT scan data of normal human T12-L2 segments, we used Geomagic 11.0, Ug 7.0, Hypermesh 10.0, Abaqus 6.9.1 software to establish a three-dimensional finite element model of T12-L2 segments. Subsequently we established nail-stick system posterior fixation, anterior fixation, posterolateral anteroposterior integration fixation model. T12 segment was given 500 N preload and 7.5 N·m torque, to simulate thoracolumbar flexion, extension, lateral bending and rotation. The average rigidity of fixed segments under different conditions were observed. 〈br〉 RESULTS AND CONCLUSION：Three fixation models showed a higher average rigidity than normal model under different conditions. The average rigidity in anteroposterior integration fixation by posterolateral nail-stick system was increased by 13%, 28%, 11%, 17%and 9%, compared with simple posterior fixation under the conditions such as anterior flexion, lateral bending and lateral rotation, respectively. Under the posterior extension,＆amp;nbsp;the average rigidity was reduced by 6%than the posterior fixation. Compared with the anterior fixation, the average rigidity in anteroposterior integration fixation by posterolateral nail-stick system was reduced by 15%, 10%, and 14%under the conditions of anterior flexion and lateral bending. While the average rigidity was higher than anterior flexion under the posterior extension and lateral rotation, increasing 5%, 12%and 2%. The anteroposterior integration fixation by posterolateral nail-stick system can improve the stability of fixed segments, and the stability is higher than anterior

关 键 词：植入物 数字化骨科 钉棒系统 胸腰段 有限元模型 前后一体内固定 生物力学 

分 类 号：R318[医药卫生—生物医学工程]