退变性腰椎侧凸六种工况运动下的生物力学的有限元分析  

Finite element analysis of biomechanics of degenerative lumbar scoliosis under six kinds of motion conditions

作　　者：周仕炼 胡星新 杨曦[1] 刘立岷[1] ZHOU Shilian;HU Xingxin;YANG Xi;LIU Limin(Department of Orthopaedics,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)

机构地区：[1]四川大学华西医院骨科,成都610041

出　　处：《华西医学》2018年第9期1099-1105,共7页West China Medical Journal

基　　金：四川省干部保健科研课题(川干研2017-103)

摘　　要：目的完整建立退变性腰椎侧凸(degenerative lumbar scoliosis,DLS)全腰椎节段的三维仿真模型,并对模型进行有限元分析,探讨其侧凸节段的生物力学改变。方法选取一例DLS患者的L1-5节段CT平扫数据,导入MIMICS 15、Solid Works、Hyper Mesh等软件中进行三维仿真模型的建立,并用有限元分析软件ANSYS15对模型进行分析,同时对各种结构赋予不同的材料属性及边界加载条件来模拟人体实际情况。结果所建成的三维模型总计856 154个单元、232 850个节点,包括精细重建的各个椎体、椎间盘组织、各种韧带以及关节突软骨等组织结构。在加载负荷和扭矩下,全腰椎节段活动范围减小,在4个椎间盘的应力分布情况中,呈现L2/3节段椎间盘(3.320 MPa)>L4/5节段椎间盘(0.783 MPa)>L3/4节段椎间盘(0.551 MPa)>L1/2节段椎间盘(0.462 MPa);在椎体的应力分布情况中,L5椎体(34.0 MPa)>L4椎体(33.6 MPa)>L3椎体(30.0 MPa)>L1椎体(23.3 MPa)>L2椎体(22.4 MPa)。结论 DLS患者腰椎六自由度活动范围下降,侧凸腰椎局部应力分布异常,顶椎体及顶椎间盘的反常应力改变可能是DLS发生或进展的生物力学基础。Objective To completely establish a three-dimensional（3 D） simulation model of degenerative lumbar scoliosis（DLS） with the whole lumbar segments, then to analyze the biomechanical changes of the scoliosis segments by finite element analysis. Methods A case of DLS patient was selected with L1-5 segments of CT scanning data,which was imported into MIMICS 15, Solid Works, Hyper-Mesh software to establish a 3 D simulation model, and ANSYS15 was used to analyze the model. At the same time, different material properties and boundary loading conditions were assigned to various structures to simulate the actual human body conditions. Results The 3 D model built a total of 856 154 units and 232 850 nodes, including the reconstruction of fine vertebral bodies, intervertebral disc tissue, structure of various ligaments and joint cartilages. Under the load and torque, the range of whole lumbar segments was decreased, in the stress distribution on the four discs： the L2/3 intervertebral disc stress value（3.320 MPa） 〉 L4/5 intervertebral disc stress value（0.783 MPa） 〉L3/4 intervertebral disc stress value（0.551 MPa） 〉 L1/2 intervertebral disc stress value（0.462 MPa）. The stress distribution of the vertebral body showed that, L5 vertebral stress（34.0 MPa） 〉 L4（33.6 MPa）〉 L3（30.0 MPa） 〉L1（23.3 MPa） 〉L2（22.4 MPa）. Conclusion The range of motion of the six degrees of freedom of the lumbar spine in DLS is decreased, the local stress distribution of the lumbar spine is abnormal, and the abnormal stress changes of the apical vertebral body and the top intervertebral disc may be the biomechanical basis for the occurrence or progression of DLS.

关 键 词：退变性腰椎侧凸 全腰椎节段 三维有限元分析 生物力学分析 

分 类 号：R681.5[医药卫生—骨科学]