经椎间孔腰椎椎间融合术式模型的生物力学研究  

Biomechanical Research of Transforaminal Lumbar Interbody Fusion Model

作　　者：颜文涛[1] 赵改平[1] 方新果[1] 郭昊翔 马童[2] 凃意辉[2] 

机构地区：[1]上海理工大学医疗器械与食品学院,上海200093 [2]上海市杨浦区中心医院,上海200090

出　　处：《生物医学工程学杂志》2015年第1期67-72,共6页Journal of Biomedical Engineering

基　　金：国家自然科学基金资助项目(51106099);上海市教委科研创新项目资助(12YZ109)

摘　　要：本文基于经椎间孔腰椎椎间融合(TLIF)治疗腰椎滑脱的术式模型,采用有限元方法探讨腰椎融合术内植物固定系统中融合器和椎弓根钉在不同组合下表现出的生物力学特性。首先,基于CT图像结合有限元前处理软件,建立人体腰椎L4-L5节段轻度滑脱及内植物不同固定组合方式下的三维非线性有限元模型。比较各模型在前屈、后伸、左右侧弯和左右轴向旋转6种工况下,腰椎活动范围和融合器、椎弓根钉的应力分布等生物力学特征。结果表明各术式模型的活动范围均较无损模型减少84%以上,稳定性显著提高。各术式模型中,单枚融合器辅加单侧椎弓根钉固定下融合器和椎弓根钉的应力值相对较大,但差异无统计学意义。研究结果可为TLIF的体外标本实验研究和临床分析提供相应的生物力学参考和印证,并为单侧内固定斜行椎间融合TLIF手术的可行性提供生物力学依据。Based on the surgical model using transforaminal lumbar interbody fusion（TLIF）to treat lumbar spondylolisthesis,this paper presents the investigations of the biomechanical characteristics of cage and pedicle screw in lumbar spinal fusion implant fixed system under different combinations with finite element method.Firstly,combining the CT images with finite element pretreatment software,we established three dimensional nonlinear finite element model of human lumbar L4-L5 segmental slight slippage and implant under different fixed combinations.We then made a comparison analysis between the biomechanical characteristics of lumbar motion range,stress distribution of cage and pedicle screw under six status of each model which were flexion,extension,left lateral bending,right lateral bending,left axial rotation and right axial rotation.The results showed that the motion ranges of this model under different operations were reduced above 84% compared with those of the intact model,and the stability of the former was improved significantly.The stress values of cage and pedicle screw were relatively larger when they were fixed by single fusion device additional unilateral pedicle screw,but there was no statistically significant difference.The above research results would provide reference and confirmation for further biomechanics research of TLIF extracorporal specimens,and finally provide biomechanical basis for the feasibility of unilateral internal fixed diagonal intervertebral fusion TLIF surgery.

关 键 词：经椎间孔腰椎椎间融合 腰椎滑脱 内固定 生物力学特性 有限元分析 

分 类 号：R318.01[医药卫生—生物医学工程] R687.3[医药卫生—基础医学]