支架-骨粒-可吸收骨水泥式腰椎间融合术的有限元分析  

Finite Element Analysis of Lumbar Interbody Fusion with Stent-Bone Granule-Absorbable Bone Cement

作　　者：黄浩瀚 张凯[1] 程晓非 赵杰[1] 赵长清[1] HUANG Haohan;ZHANG Kai;CHENG Xiaofei;ZHAO Jie;ZHAO Changqing(Shanghai Key Laboratory of Orthopaedic Implants,Department of Orthopeadics,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院骨科,上海市骨科内植物重点实验室,上海200011

出　　处：《医用生物力学》2021年第2期184-188,共5页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(81272038);上海市科委项目(20S31900800)。

摘　　要：目的采用有限元分析方法研究镍钛记忆合金支架-自体骨粒-可吸收骨水泥式腰椎间融合术的生物力学性能。方法依次建立正常L3~5节段有限元模型(M0)、盒状融合器模拟植入的L4~5椎间融合术模型(M1)、镍钛记忆合金支架模拟植入的L4~5椎间融合术模型(M2)以及镍钛记忆合金支架模拟植入复合骨粒-可吸收骨水泥混凝物浇注植骨的L4~5椎间融合术模型(M3)。对模型进行力学加载,分析各模型生物力学稳定性和L4椎体下终板的峰值应力。结果M1、M2模型L4~5节段在前屈、后伸、侧屈、轴向旋转方向上的活动度较M0模型明显降低。在M3模型中,手术节段稳定性进一步提高,且L4下终板峰值应力远小于M1、M2模型。结论镍钛记忆合金支架与传统盒状融合器在单独用于腰椎间融合术时具有生物力学等效性,在复合应用骨粒-可吸收骨水泥混凝物浇注植骨后能进一步提升稳定性及降低终板应力。Objective To evaluate the biomechanical properties of lumbar interbody fusion with Ni Ti memory alloy stent-autogenous bone granule-absorbable bone cement.Methods The normal L3-5 segment finite element model(M0),L4-5 intervertebral fusion model with box fusion cage(M1),L4-5 intervertebral fusion model with Ni Ti memory alloy stent(M2)and L4-5 interbody fusion model with bone granule-absorbable bone cement for casting bone graft(M3)were constructed,respectively.The models were applied with mechanical loading to analyze the mechanical stability and the peak stress of L4 interior endplate.Results The range of motion(ROM)of L4-5 segment in M1 and M2 models was significantly lower than that of M0 model under flexion,extension,lateral flexion and axial rotation.In M3 model,the stability of the surgical segment was further improved and the peak stress of L4 interior endplate was much smaller than that of M1 and M2 models.Conclusions Ni Ti memory alloy stent and traditional box fusion cage have biomechanical equivalence when used alone in lumbar interbody fusion,and application of bone granule-absorbable bone cement for casting bone graft can further improve the stability and reduce the stress of endplate.

关 键 词：腰椎间融合术 镍钛形状记忆合金 椎间融合器 可吸收骨水泥 有限元分析 

分 类 号：R318.01[医药卫生—生物医学工程]