ROI-C椎间融合器植入对颈椎生物力学的影响  

Effects of ROI-C Cervical Implantation on Biomechanics of Cervical Vertebra

作　　者：宋燕美 赵改平[1] 李鹏祥 夏费一 董自强 毕厚海 陈楠心 马童[2] 涂意辉[2] SONG Yanmei;ZHAO Gaiping;LI Pengxiang;XIA Feiyi;DONG Ziqiang;BI Houhai;CHEN Nanxin;MA Tong;TU Yihui(School of Medical Instrument and Food Engineering, University of Shanghai for Science and Technology, Shanghai200093, China;Department of Orthopedic Surgery, Yangpu District Central Hospital, Shanghai 200090, China)

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

出　　处：《医用生物力学》2018年第2期114-120,共7页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(11502146);上海市自然科学基金项目(15ZR1429600)

摘　　要：目的研究ROI-C椎间融合器植入颈椎C5～6节段后对下颈椎C3～7整体关节活动度（range of motion,ROM）、椎间盘与椎体生物力学特性及力传导模式的影响。方法采用ROI-C植入和植骨融合钢板内固定两种术式建立颈椎C5～6节段退行性病变的有限元模型,分析两种术式下C3～7颈椎段在前屈、后伸、侧弯和轴向旋转时ROM以及椎间盘、椎体和内植入器械的应力分布情况。结果 ROI-C植入后对邻近节段ROM的影响相对较小,减小了椎间盘的负荷,但椎体应力显著增加,C5椎体应力增加了251%。植骨融合内固定后,手术节段ROM减小86%～91%,邻近节段ROM以及椎间盘和椎体应力均明显增加。结论 ROI-C植入对颈椎ROM和椎间盘应力的影响较小,对椎体应力的影响较大。研究结果可为ROI-C植入和植骨融合钢板内固定临床植入手术方案的设计和研究提供理论依据。Objective To investigate the influence of ROI-C cervical implantation in the C5-6 segment on the C3-7 range-of-motion（ ROM）,biomechanical properties of the intervertebral disc and the vertebral body,and the mode of force transmission. Methods Two types of surgeries,ROI-C implantation and autograft fusion with plate fixation,were considered to establish the finite element model of cervical C5-6 segment degeneration. The ROM of C3-7 during flexion,extension,lateral bending,and axial rotation,as well as stress distributions on the adjacent discs,vertebral body,and implanted devices under two procedures,were analyzed. Results ROI-C implantation had a relatively small influence on the ROM of the adjacent segment. The stress on the vertebral discs was reduced,but the stress on the vertebral body increased significantly,with the C5 vertebral body stress increasing by 251%. In the fusion surgery model,the ROM of the surgical segment was reduced by 86%-91%,while the ROM of the adjacent segments and the stress on the vertebral disc and vertebral body increased significantly.Conclusions ROI-C implantation surgery has a relatively small influence on the cervical ROM and the intervertebral disc,and it has a greater impact on the vertebral body. The research findings provide a theoretical basis for the design of operation plans and clinical studies on ROI-C implantation and autograft fusion with plate fixation.

关 键 词：ROI-C椎间融合器 植骨融合钢板内固定术 下颈椎 有限元分析 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]