动态稳定器植入术后颈椎生物力学的有限元分析  

Finite Element Analysis of Biomechanics of Cervical Spine after Dynamic Cervical Implant Surgery

作　　者：王晨曦[1] 赵改平[1] 柏磊磊 陈楠心 宋燕美 陈二云[2] 赵庆华[3] 

机构地区：[1]上海理工大学医疗器械与食品学院,上海200093 [2]上海理工大学能源与动力学院上海市动力工程多相流动与传热重点实验室,上海200093 [3]上海市第一人民医院,上海200080

出　　处：《生物医学工程学杂志》2016年第4期645-651,共7页Journal of Biomedical Engineering

基　　金：国家自然科学基金资助项目(11502146;51106099);上海市自然科学基金资助项目(15ZR1429600);上海市科委科研计划项目(13DZ2260900)

摘　　要：本文研究动态稳定器（DCI）植入术对下颈椎邻近节段的关节活动度（ROM）、椎间盘与椎体的生物力学特性及力传导模式的影响。首先采用DCI植入和椎间植骨融合两种术式建立颈椎C5、6节段退变治疗的有限元模型,分析两种术式下C3-7段颈椎在前屈、后伸、侧弯和旋转时的ROM及椎间盘和椎体的应力分布情况。结果表明DCI植入后手术节段ROM保留效果明显（减小幅度〈25%）,对邻近节段运动学特性影响较小。植骨融合后手术节段的ROM丧失86%-91%,邻近节段的ROM和椎间盘、椎体应力均显著增加,C5椎体应力增加达171.21%。因此DCI植入对颈椎ROM和应力影响较小,本文结果可为DCI植入与植骨融合的临床手术提供理论依据。This study aims to investigate the range of motion（ROM）and the stress variation in the intervertebral disc and the vertebral body on adjacent segments and the influence of force transmission mode after the dynamic cervical implant（DCI）surgery.Two types of surgery,DCI implantation and interbody fusion were used to establish the finite element model of the cervical C5,6segment degeneration treatment.The ROM and the adjacent discs and vertebral body stresses of two procedures under flexion,extension,lateral bending and axial rotation working conditions were analyzed.The results showed that ROM of the surgical segment in DCI model was well preserved and could restore to the normal ROM distributions（reduction of the amplitude was less than 25%）,and the kinetic characteristics of adjacent segments was less affected.In fusion surgery model,however,ROM of the surgical segment was reduced by 86%-91%,while ROM,disc stress and vertebral stress of adjacent segments were increased significantly,and stress of the C5 vertebral body was increased up to 171.21%.Therefore DCI surgery has relatively small influence on cervical ROM and stress.The study provides a theoretical basis for DCI and fusion surgery in clinic.

关 键 词：动态稳定器 植骨融合术 下颈椎 有限元分析 生物力学 

分 类 号：R687.3[医药卫生—骨科学] R318.01[医药卫生—外科学]