儿童经颈前路置入内固定系统的三维有限元分析  

Three-dimensional finite element analysis of anterior cervical fixation system in children

作　　者：李琨[1,2] 王星[1,2] 李志军[1,2] 高尚[1] 孙昊 熊峰 王鹏 Li Kun;Wang Xing;Li Zhijun;Gao Shang;Sun Hao;Xiong Feng;Wang Peng(Department of Human Anatomy,Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China;Digital Medical Center,Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China;Student Administration Office,Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学人体解剖学教研室,内蒙古自治区呼和浩特市010000 [2]内蒙古医科大学数字医学中心,内蒙古自治区呼和浩特市010000 [3]内蒙古医科大学学生管理处,内蒙古自治区呼和浩特市010000

出　　处：《中国组织工程研究》2022年第12期1866-1871,共6页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(81860382),项目负责人:王星;国家自然科学基金资助项目(81860383),项目负责人:李志军;内蒙古医科大学青年基金项目(YKD2020QNCX055),项目负责人:李琨;内蒙古医科大学英才培育项目(YCPY20200090),项目负责人:李琨;内蒙古医科大学英才培育项目(YCPY20200002),项目负责人:李琨;内蒙古医科大学实验室开放项目(2020ZN48),项目负责人:李琨;内蒙古医科大学大学生创新创业项目(202010132001),项目负责人:熊峰;内蒙古医科大学科技百万项目(YKD2017KJBW015),项目负责人:高尚;内蒙古自治区自然科学基金资助项目(2020LH08021),项目负责人:李志军;内蒙古自治区自然科学基金资助项目(2020MS03061),项目参与人:王星;内蒙古自治区自然科学基金资助项目(2019MS08017),项目负责人:张少杰。

摘　　要：背景:儿童枕-寰-枢关节在形态发育、生理特性等方面有自身的特征,临床损伤较常见。枕寰枢内固定装置是一种可以维持寰枢椎稳定性的方法,其生物力学特点与传统融合术之间的差异有待进一步研究。目的:运用三维有限元分析法对新型儿童枕颈前路内固定装置进行生物力学评价。方法:在建立的正常C0-C2关节三维有限元模型基础上删除横韧带及关节囊,模拟建立枕颈损伤模型,在该模型上置入新型儿童枕颈前路内固定装置构建其内固定有限元模型,运用有限元法对各模型的活动度及应力进行对比分析。结果与结论:儿童枕颈钛板-螺钉内固定有限元模型与正常儿童有限元模型相比,屈伸、侧屈、旋转运动都明显限制了枕寰枢活动度,说明此种枕颈内固定系统可取得较好的稳定性。枕寰枢骨性结构在前屈、后伸、侧屈及旋转时,应力主要集中在钛板与斜坡接触处、枢椎椎体处、螺钉与骨面接触处。最大应力均来源于螺钉与钛板接触处,说明枕颈内固定系统应力较分散,降低了螺钉-钛板断裂的风险。BACKGROUND:Occipito-atlanto-axial joint has its own characteristics in morphological development and physiological characteristics,and clinical injuries are common in children.The differences between the biomechanical characteristics of occipito-atlantoaxial internal fixation(a way to maintain the stability of the atlantoaxial spine)and conventional fusion need further study.OBJECTIVE:To evaluate the biomechanics of a new occipitocervical anterior internal fixation device in children by three-dimensional finite element analysis.METHODS:The transverse ligament and joint capsule were deleted on the basis of the established three-dimensional finite element model of the normal C0-C2 joint,and the occipitocervical injury model was simulated.A new type of anterior occipitocervical internal fixation device was placed on the model to construct the finite element model of internal fixation.The motion range and stress of each model were compared and analyzed by the finite element method.RESULTS AND CONCLUSION:Compared with the normal children’s finite element model of occipitocervical titanium plate-screw internal fixation,the occipitocervical and atlantoaxial motion was significantly limited in flexion and extension,lateral flexion and rotation,indicating that this occipitocervical internal fixation system could achieve better stability.During the flexion,extension,lateral flexion and rotation of the occipito-atlantoaxial structure,the stress mainly concentrated on the contact between the titanium plate and the slope,the axial vertebral body,and the contact between the screw and the bone surface.The maximum stress originated from the contact between the screw and the titanium plate,indicating that the stress of the occipitocervical internal fixation system was relatively dispersed,which reduced the risk of screw-titanium plate fracture.

关 键 词：枕寰枢 内固定 有限元 儿童 活动度 应力 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学]