改良颈椎后路单开门椎管扩大成形术三维有限元模型的建立与验证  

Three dimensional finite element model of a modified posterior cervical single open-door laminoplasty

作　　者：王奇[1] 杨雍[1] 费琦[1] 李东[1] 李锦军[1] 孟海[1] 苏楠[1] 范子寒 王炳强[1] 

机构地区：[1]首都医科大学附属北京友谊医院骨科,北京100050

出　　处：《中华医学杂志》2017年第21期1633-1637,共5页National Medical Journal of China

摘　　要：目的 建立一种改良颈椎后路单开门椎管扩大成形加短节段双侧侧块螺钉内固定手术前后的三维有限元模型，并验证其有效性。方法 选择接受颈椎后路改良手术的脊髓型颈椎病伴颈椎管狭窄患者，利用MIMICS软件对其手术前后的CT薄扫数据资料进行数据处理，建立颈2-7的实体模型，经逆向工程软件Geomagic Studio优化，导入有限元分析软件Abaqus进行网格划分，并添加主要韧带等结构，建立手术前后的颈2-7椎的有限元模型。在术前模型上施加1.5 kg·m^2·s^-2的作用力，模拟颈椎在前屈、侧屈和旋转工况下的反应，与其他颈椎有限元模型和体外生物力学的实验数据进行对比验证。结果 术前模型包括6个椎体（C2-7）、5个椎间盘（C2-3-C6-7）及后部结构与主要韧带，共102 258单元；术后模型还包括双侧短节段侧块螺钉内固定系统，共161 892单元，较好地模拟了颈椎后路内固定螺钉与椎体的真实关系。术前模型在前屈、侧屈和旋转工况条件下的活动度与既往的实验结果吻合。结论 新建立的改良颈椎后路单开门椎管扩大成形术的手术前后三维有限元模型具有良好的生物逼真度，可用于进一步生物力学分析。Objective To build a three-dimensional finite element models of a modified posterior cervical single open-door laminoplasty with short-segmental lateral mass screws fusion. Methods The C2-C7 segmental data were obtained from computed tomography （CT） scans of a male patient with cervical spondylotic myelopathy and spinal stenosis. Three-dimensional finite element models of a modified cervical single open-door laminoplasty （before and after surgery ） were constructed by the combination of software package MIMICS, Geomagie and ABAQUS. The models were composed of bony vertebrae, articulating facets, intervertebral disc and associated ligaments. The loads of moments 1.5Nm at different directions （flexion, extension,lateral bending and axial rotation）were applied at preoperative model to calculate intersegmental ranges of motion. The results were compared with the previous studies to verify the validation of the models. Results Three-dimensional finite element models of the modified cervical single open- door laminoplasty had 102258 elements （preoperative model） and 161 892 elements （postoperative model） respectively, including C2-7 six bony vertebraes, C2-3 - C6-7 five intervertebral disc, main ligaments and lateral mass screws. The intersegmental responses at the preoperative model under the loads of moments 1.5 Nm at different directions were similar to the previous published data. Conclusion Three-dimensional finite element models of the modified cervical single open- door laminoplasty were successfully established and had a good biological fidelity, which can be used for further study.

关 键 词：颈椎 椎管 成像 三维 有限元模型 

分 类 号：R687.3[医药卫生—骨科学]