有限元分析不同牵伸时长相邻腰椎节段和椎间盘应力及位移的变化  

Effect of different stretching durations on adjacent lumbar segments: changes in intervertebral disc stress and displacement

作　　者：李民 董竑麟 汪桂珍 闫沛春 Li Min;Dong Honglin;Wang Guizhen;Yan Peichun(Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350003,Fujian Province,China;Fujian Provincial Key Laboratory of Rehabilitation Technology,Fuzhou 350003,Fujian Province,China;Rehabilitation Medical College of Fujian University of Traditional Chinese Medicine,Fuzhou 350003,Fujian Province,China)

机构地区：[1]福建中医药大学附属康复医院,福建省福州市350003 [2]福建省康复技术重点实验室,福建省福州市350003 [3]福建中医药大学康复医学院,福建省福州市350003

出　　处：《中国组织工程研究》2020年第21期3281-3286,共6页Chinese Journal of Tissue Engineering Research

基　　金：福建省科技厅高校产学研合作项目(2018Y4006)，项目负责人：李民;福建省康复产业研究院技术创新平台科研项目(2015Y2001-24)，项目负责人：李民;福建省卫生计生科研人才培养项目(2018-CX-48)，项目负责人：李民;福建省教育厅高校青年自然基金重点项目(JZ160444)，项目负责人：李民~~

摘　　要：背景:与传统牵伸手法对比,利用脊柱手法床气柱叠加结构进行牵伸可以很好地掌控牵引时间,通过有限元分析能详细计算出相邻腰椎节段的应力,为临床脊柱手法床的腰椎牵引提供更好的牵引处方理论依据。目的:利用脊柱手法床模拟倒盖金被手法进行牵伸,并通过有限元分析不同牵伸时长对相邻腰椎节段应力大小及分布的影响。方法:选择健康男性志愿者1例,年龄26岁、身高174 cm、体质量60 kg,受试者对试验方案理解并签署知情同意书,研究获得福建中医药大学附属康复医院伦理委员会的批准(批准号:2016XJS-001-01)。依据志愿者T12-S1的CT图像,建立正常人体腰椎的有效三维有限元模型,通过三维有限元分析利用脊柱手法床顶推L3棘突时,L3在手法的牵引下分别维持至10,20,30 s时,上下相邻的腰椎间盘、椎小关节的应力变化情况,并且分析该变化的内在规律及作用机制。结果与结论:①顶推高度为5 cm,作用时长介于1.25-17 s时,相邻腰椎节段的应力值是持续增大的,椎间盘:L2-L3为4.60-5.68 MPa,L3-L4为5.26-6.61 MPa;椎小关节:L2-L3为7.01-8.67 MPa,L3-L4为5.22-6.50 MPa;②在顶推作用时长超过24 s以后,相邻椎间盘、椎小关节应力基本保持不变;③因此脊柱手法床作用于腰椎时对相邻腰椎节段不会造成损伤;使用脊柱手法床的作用时长应在25-30 s之间。BACKGROUND:In contrast to traditional drafting techniques,the superposition structure of the bed air column of spinal manipulation contributes to controlling the duration of traction.Finite element analysis is used to calculate the stress of adjacent lumbar segments with different traction durations.It provides a better theoretical basis for lumbar traction prescription in clinical spinal manipulative bed.OBJECTIVE:To analyze the stress and distribution of adjacent lumbar segments with different traction durations using the finite element analysis when the spine manipulation bed is used for traction.METHODS:A healthy male volunteer,aged 26 years,with a height of 174 cm and a weight of 60 kg,was selected,who was fully informed of the study protocol and signed an informed consent.The study protocol was approved by the Ethics Committee of Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine with an approval No.2016XJS-001-01.According to the CT images of volunteers T12-S1,an effective three-dimensional finite element model of the lumbar spine was established.By means of three-dimensional finite element analysis,the stress changes of the lumbar vertebrae and facet joint adjacent to the L3 were calculated when the traction was maintained for 10,20 and 30 seconds respectively.The internal law and mechanism of the changes were analyzed and discussed.RESULTS AND CONCLUSION:(1)When the pushing height was 5 cm and the action time was 1.25-17 seconds,the stress value of adjacent lumbar segments increased continuously.For the intervertebral disc,the stress value was 4.60-5.68 MPa for L2-L3,and 5.26-6.61 MPa for L3-L4;for the facet joint,the stress value was 7.01-8.67 MPa for L2-L3 and 5.22-6.50 MPa for L3-L4.(2)The stress of adjacent vertebral segments and facet joints remained basically unchanged after pushing for more than 24 seconds.Therefore,when the spine manipulation bed acts on the lumbar spine,it will not damage the adjacent lumbar segments,and the duration of action should be betwe

关 键 词：牵伸 时长 腰椎 模型 生物力学 脊柱手法床 三维有限元 

分 类 号：R496[医药卫生—康复医学] R244[医药卫生—临床医学]