颈椎棘突骨折生物力学稳定性的有限元分析  

Biomechanical stability of cervical spinous process fractures： a finite element analysis

作　　者：沈彦[1] 王朝阳[1] 吴荣[1] 

机构地区：[1]中国人民解放军第98医院骨科,浙江湖州313000

出　　处：《中华生物医学工程杂志》2016年第5期365-369,共5页Chinese Journal of Biomedical Engineering

基　　金：南京军区科技创新项目（MS009）;湖州市自然科学资金项目（2016ZYB03）

摘　　要：目的 利用有限元分析评价颈椎棘突骨折的生物力学稳定性.方法 选择1名35岁男性健康志愿者全颈椎体的CT扫描图像,采用Mimics17、Geomagic Studio 2012、Hypermesh12及ABAQUS 6.12软件初步建立正常颈椎C0～T1段三维六面体网格有限元模型并进行有效性验证,基于已验证的三维有限元模型,采用弱化网格单元强度的方法建立C7棘突骨折（累及椎板）模型,对正常及骨折模型分别施加屈伸、侧屈、旋转的生理载荷,比较在不同工况下的三维活动范围（ROM）及骨折断端节点位移,分析棘突骨折所致的生物力学稳定性.结果 在C6～C7节段,骨折模型的前屈、侧弯及扭转活动度比正常模型减小,而后伸活动度略微增大.在C7～T1节段,除后伸活动外,其余活动度均比正常模型要大,且活动度变化范围较为显著,而其余节段与正常模型几乎一样.结论 累及椎板的颈椎棘突骨折潜在生物力学不稳定性,治疗应区别单纯颈椎棘突骨折,尽早诊断及正确处理.Objective To evaluate the biomechanical stability of cervical spinous process fractures by finite element analysis.Methods The CT image of the cervical vertebrae of a 35-year-old male healthy volunteer was included.The six-sided three dimensional finite element model of the C0～T1 segment of the normal cervical vertebra was preliminarily established by Mimics 17,Geomagic Studio 2012,Hypermesh12 and ABAQUS 6.12,and was validated.Based on the validated three-dimensional finite element model,the model of the C7 spinous process fractures （involving lamina） was established by weakening the intensity of the mesh unit.The physiological load of flexion-extension,lateral flexion and rotation were performed on the normal and fractures models,respectively.The biomechanical stability of the spinous process fractures was analyzed by comparing the three-dimensional range of motion （ROM） and the displacement of the fractures nodes.Results In the C6-C7 segment,the ROM of the flexion,lateral flexion,and rotation of the fractures model diminished compared with that of the normal model,while the ROM of the extension slightly increased.In the C7-T1 segment,the ROM was significantly larger than that of the normal model except for the extension,and the change of ROM was significant.The remaining segments were almost identical to the normal model.Conclusion There is potential biomechanical instability in cervical spinous process fractures involving vertebral lamina.This condition should be differentiated from simple cervical spinous process fractures,diagnosed as early as possible,and given proper treatment .

关 键 词：颈椎 骨折 生物力学 有限元分析 

分 类 号：R683[医药卫生—骨科学] R318.01[医药卫生—外科学]