切除不同范围钩突后颈椎关节突的有限元对比分析  

Comparative finite element analysis of the cervical articular process after resection of different ranges of the uncinate processes

作　　者：郝韵腾 史君 刘宇航 李琨 马渊[4] 张少杰 王超群 陈杰[3] 张志峰 郑雷刚 王星[3,4] 李志军 Hao Yunteng;Shi Jun;Liu Yuhang;Li Kun;Ma Yuan;Zhang Shaojie;Wang Chaoqun;Chen Jie;Zhang Zhifeng;Zheng Leigang;Wang Xing;Li Zhijun(Graduate School of Inner Mongolia Medical University,Hohhot 010110,Inner Mongolia Autonomous Region,China;Department of Physiology,School of Basic Medicine,Inner Mongolia Medical University,Hohhot 010110,Inner Mongolia Autonomous Region,China;Department of Anatomy,School of Basic Medicine,Inner Mongolia Medical University,Hohhot 010110,Inner Mongolia Autonomous Region,China;Center for Digital Medicine,Inner Mongolia Medical University,Hohhot 010059,Inner Mongolia Autonomous Region,China;Department of Imaging,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010050,Inner Mongolia Autonomous Region,China;Department of Joint,Second Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000,Inner Mongolia Autonomous Region,China;Department of Orthopedics and Traumatology,Inner Mongolia Autonomous Region Hospital of Traditional Chinese Medicine,Hohhot 010020,Inner Mongolia Autonomous Region,China)

机构地区：[1]内蒙古医科大学研究生院,内蒙古自治区呼和浩特市010110 [2]内蒙古医科大学基础医学院生理学教研室,内蒙古自治区呼和浩特市010110 [3]内蒙古医科大学基础医学院解剖学教研室,内蒙古自治区呼和浩特市010110 [4]内蒙古医科大学数字医学中心,内蒙古自治区呼和浩特市010059 [5]内蒙古医科大学附属医院影像科,内蒙古自治区呼和浩特市010050 [6]内蒙古医科大学第二附属医院关节科,内蒙古自治区呼和浩特市010000 [7]内蒙古自治区中医医院中医骨伤科,内蒙古自治区呼和浩特市010020

出　　处：《中国组织工程研究》2023年第18期2789-2796,共8页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(81860383),项目负责人:李志军;国家自然科学基金资助项目(81860382),项目负责人:王星;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),项目负责人: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;内蒙古自治区自然科学基金资助项目(2019MS08139),项目负责人:陈杰;内蒙古自治区高等学校青年科技英才支持计划资助(NJYT22009),项目负责人:王星;内蒙古自治区科技计划项目(2019GG158),项目负责人:王星;内蒙古医科大学科研重点项目(YKD2021ZD011),项目负责人:王星;内蒙古医科大学青年基金项目(YKD2020QNCX055),项目负责人:李琨;内蒙古自治区卫生健康委医疗卫生科技计划项目(202201217),项目负责人:王星。

摘　　要：背景:钩突增生常导致颈椎病发生,无需内固定的钩椎关节切除术具有重要意义,但尚存诸多问题。目的:建立全颈椎(C_(0)-T_(1))三维有限元模型,切除钩突不同范围后,探究颈椎关节突的应力变化特点和规律,为临床颈椎病的手术治疗提供理论依据。方法:对40岁男性正常成人志愿者进行全颈椎螺旋CT轴位薄层扫描来获得原始数据,应用Mimics、GeomagicStudio、Hypermesh、Abaqus等软件技术建立C_(0)-T_(1)全颈椎三维有限元模型,在C_(5)椎体上构建单侧钩突切除50%、100%和双侧钩突切除100%的3种模型组,然后加载相同力矩赋予前屈、后伸、左右侧屈和左右旋转6种工况,以观测切除不同范围钩突后颈椎关节突关节在不同状态下的应力与位移变化。结果与结论:①通过构建全颈椎正常与切除钩突不同范围后的有限元模型,加载相同力矩后发现颈椎关节突的受力集中区由正常组的C_(6)处上移至切除不同范围钩突组的C_(5)处,得出关节突的受力随椎序增加呈现递增趋势;②应力集中区位于C_(5)和C_(6)处,整体呈尖峰状,不同程度的钩突切除会降低颈椎的稳定性,降低程度随切除范围增大而增大。BACKGROUND:Uncinate processes hyperplasia often leads to cervical spondylosis.Uncinate process resection without internal fixation is of great significance,but there are still many problems.OBJECTIVE:To establish a three-dimensional finite element model of the whole cervical vertebrae(C_(0)-T_(1)),and to explore the characteristics and laws of stress change after excising different ranges of the uncinate process,so as to provide a theoretical basis for the surgical treatment of clinical cervical spondylosis.METHODS:Raw data were obtained from spiral CT thin-section scans of 40-year-old male normal adult volunteers.Mimics,GeomagicStudio,Hypermesh,Abaqus and other software technologies were used to establish(C_(0)-T_(1))full cervical three-dimensional finite element model.Models of 50%unilateral uncinate processes excision,100%unilateral uncinate processes excision and 100%bilateral uncinate processes excision were constructed on the C_(5)vertebral body.After loading the same torque,six working conditions of flexion,extension,lateral flexion and rotation were assigned to observe changes of stress and displacement of the cervical facet joint in different states after the resection of the uncinate process.RESULTS AND CONCLUSION:(1)By constructing the finite element model of the normal cervical vertebrae and the uncinate process in different ranges,after loading the same torque,the stress concentration area of the cervical articular process was now moved up from C_(6)in the normal group to C_(5)in the different ranges of uncinate process excision groups.The stress of the nodal process increased with the increase of the vertebral sequence.(2)The stress concentration areas were located at C_(5)and C_(6),and the overall shape was sharp.The degree of resection of the uncinate process reduced the stability of the cervical spine,and the degree of reduction increased with the extent of resection.

关 键 词：有限元 钩突 全颈椎 生物力学 钩椎关节 关节突 解剖结构 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R681.5