新型高度可调颈椎融合器的三维有限元分析  

Three-dimensional finite element analysis of a new height adjustable cervical fusion cage

作　　者：黄定安[1] 刘晨 Huang Dingan;Liu Chen(Department of Spine Surgery,The People’s Hospital of Huangshan City,Huangshan 245000,Anhui Province,China;Department of Spine Surgery,The First Affiliated Hospital of Wannan Medical College,Wuhu 241001,Anhui Province,China)

机构地区：[1]黄山市人民医院脊柱外科,安徽省黄山市245000 [2]皖南医学院第一附属医院脊柱外科,安徽省芜湖市241001

出　　处：《中国组织工程研究》2023年第18期2797-2803,共7页Chinese Journal of Tissue Engineering Research

基　　金：安徽省重点研究与开发计划国际科技合作专项(202004b11020027),项目负责人:刘晨。

摘　　要：背景:颈前路减压手术的核心是解除脊髓和神经的压迫,恢复椎间高度及颈椎的生理曲度。但是目前临床上所应用的融合器无法满足个体化需求,可能导致融合节段终板破坏,融合器下沉或移位。作者设计一种高度可调颈椎融合器,植入椎间隙可达到与椎间隙上下终板贴合。目的:通过三维有限元分析法评价新型颈椎高度可调椎间融合器的力学特点,为临床应用和进一步改进提供相应理论依据。方法:建立颈椎前路椎间盘切除减压融合内固定的三维有限元模型,分为正常组、融合器植入高度较低组、融合器植入高度适中组和融合器植入高度较高组进行重建,并在前屈、后伸、左右侧屈及左右旋转6个工况下,施加50 N预载荷以及1.0 N·m的运动附加弯矩,观察相应的椎体Von Mises应力峰值、融合器Von Mises应力峰值、椎间盘应力及椎体活动度情况。结果与结论:①融合器植入高度适中组对应的融合器Von Mises应力峰值和C_(3)-C_(7)椎体Von Mises应力峰值低于融合器植入高度较低组和融合器植入高度较高组;②植入不同高度融合器后C_(4/5)椎间盘应力差异较为明显;③融合器植入高度较高组C_(3)-C_(7)整体椎间相对活动度降幅最大,融合器植入高度适中组次之,融合器植入高度较低组整体椎间活动度降幅最小;④提示融合器植入高度适中可使颈椎达到即刻稳定,同时对融合器及颈椎椎体应力最小,从而有效避免颈椎融合器下沉。BACKGROUND:The core of anterior decompression is to relieve the compression of spinal cord and nerve and restore the intervertebral height and physiological curvature of cervical spine.However,the cage currently used in the clinic cannot satisfy the individualized needs,resulting in the destruction of the endplate of the fusion segment and the subsidence or displacement of the cage.In this study,a height adjustable cervical fusion cage was designed,which can be implanted into the intervertebral space to fit with the upper and lower end plates of the intervertebral space.OBJECTIVE:To evaluate the mechanical characteristics of the new height adjustable cervical fusion cage by three-dimensional finite element analysis,and to provide corresponding theoretical basis for clinical application and further improvement.METHODS:The three-dimensional finite element models of anterior cervical discectomy and fusion were established and the models were divided into normal group,lower cage implantation height group,moderate cage implantation height group and higher cage implantation height group.50 N preload and 1.0 N·M motion additional bending moment were applied under six working conditions of flexion and extension,left and right lateral flexion and left and right rotation.The corresponding peak Von Mises stress of vertebral body,peak Von Mises stress of cage,intervertebral disc stress and C_(3)-C_(7)vertebral motion range were observed.RESULTS AND CONCLUSION:(1)The peak Von Mises stress of fusion cage and the peak Von Mises stress of C_(3)-C_(7)vertebral body in the group with moderate cage implantation height were lower than those in the group with lower cage implantation height and the group with higher cage implantation height.(2)The stress difference of C_(4/5)intervertebral disc was obvious after implantation of different height cages.(3)The overall intervertebral relative activity of C_(3)-C_(7)decreased the most in the higher cage implantation height group,followed by the moderate cage implantation height group,and

关 键 词：三维有限元分析 颈椎融合器 高度可调 应力集中 生物力学 

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