仿真分析不同步态下腰椎受力的生物力学变化  

Biomechanical changes of lower lumbar spine stress under different gaits by simulation analysis

作　　者：邓健全[1] 陈进军 梁洪生 陈小宇 Deng Jianquan;Chen Jinjun;Liang Hongsheng;Chen Xiaoyu(Department of Basic Medicine,Zhaoqing Medical College,Zhaoqing 526020,Guangdong Province,China;Department of Imaging,Zhaoqing Hospital of Traditional Chinese Medicine,Zhaoqing 526020,Guangdong Province,China)

机构地区：[1]肇庆医学高等专科学校基础医学部,广东省肇庆市526020 [2]肇庆市中医院影像科,广东省肇庆市526020

出　　处：《中国组织工程研究》2019年第28期4541-4545,共5页Chinese Journal of Tissue Engineering Research

基　　金：广东省医学科研基金项目(B2018207),项目参与人:陈进军,梁洪生,陈小宇~~

摘　　要：背景:临床保守治疗易导致腰椎间盘突出症复发,倒退行走是流行的一种用于治疗腰椎间盘突出症的康复锻炼方法。临床指导治疗后患者倒退行走并进行跟踪统计,肯定了倒退行走是一种有效的康复锻炼疗法。目的:以生物力学为出发点,用有限元的分析法探究倒退行走对腰椎康复治疗的意义。方法:基于CT 图像建立腰椎三维模型,然后模拟腰椎在不同运动状态下的力学环境,并对其进行有限元分析,从生物力学角度探究倒退行走在腰椎间盘突出症治疗中发挥的作用。结果与结论:①倒退行走时,L1-L2 段椎间盘的位移变化只有步态前进时的1/2,而且椎间盘应力也明显减小;②步态前进时L1-L2 段腰椎椎间盘的应力是倒退行走时的2.35 倍;③因此腰椎和椎间盘的应力和位移变化都相对于正常步态前进时变小,从而减轻了对髓核的压迫,有助于腰椎间盘突出症患者的恢复。BACKGROUND: Clinical conservative treatment can easily lead to the recurrence of lumbar disc herniation. Backward walking is a popular rehabilitation exercise method for the treatment of lumbar disc herniation. After clinical guidance treatment, patients walk backwards and follow up statistics, confirming that walking backwards is an effective rehabilitation exercise therapy. OBJECTIVE: Based on biomechanics, the significance of backward walking for lumbar rehabilitation was explored by finite element analysis. METHODS: The three-dimensional model of lumbar spine was established based on CT images, and then the mechanical conditions of lumbar spine were simulated. The finite element method was used to examine the role of backward walking in the treatment of lumbar disc herniation from the mechanical point of view. RESULTS AND CONCLUSION:(1) The displacement of L1-L2 intervertebral disc was only 1/2 of that of the gait, and the stress of the intervertebral disc was greatly reduced when walking backwards.(2) The stress of L1-L2 intervertebral disc during gait progression was 2.35 times as much as that during walking backwards.(3) Therefore, the changes of stress and displacement of lumbar spine and intervertebral disc are smaller than that of normal gait, which reduces the pressure on nucleus pulposus and helps the recovery of patients with lumbar disc herniation.

关 键 词：腰椎 腰椎间盘突出症 有限元分析 步态 倒退行走 生物力学 位移 应力 

分 类 号：R459.9[医药卫生—治疗学] R681.5[医药卫生—临床医学]