三维有限元法分析脊柱推拿手法的生物力学特征  

Three-dimensional finite element method to analyze biomechanical characteristics of spinal manipulation

作　　者：刘柏杰 周红海[1] 何心愉 覃鸿图 陈龙豪 田君明[1] 陆庆旺 Liu Baijie;Zhou Honghai;He Xinyu;Qin Hongtu;Chen Longhao;Tian Junming;Lu Qingwang(School of Orthopedics and Traumatology,Guangxi University of Chinese Medicine,Nanning 530001,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]广西中医药大学骨伤学院,广西壮族自治区南宁市530001

出　　处：《中国组织工程研究》2023年第27期4385-4392,共8页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(81360552,81660800),项目负责人:周红海;广西一流学科建设项目重点课题(2018XK057),项目负责人:周红海;广西高校中青年教师科研基础能力提升项目(2022KY0272),项目负责人:陈龙豪;广西研究生教育创新计划项目(YCSZ2022010),项目负责人:刘柏杰。

摘　　要：背景:脊柱推拿手法作为脊柱相关疾病疗效显著的物理治疗手段,被国内外学者广泛应用并逐渐向规范化和系统化发展,其作用机制及安全性一直是医疗群体的关注热点。三维有限元法是一种对人体力学行为进行数值模拟的有效工具,通过技术分析以明确手法对脊柱结构的生物力学效应,其具有一定的研究价值及临床意义。目的:综述三维有限元法的发展历程及其在颈椎、胸腰椎、腰椎推拿手法生物力学研究中的分析流程和应用概况。方法:由第一作者以“finite element,biomechanics,spine,cervical vertebrae,thoracolumbar,lumbar vertebra,manipulation”为英文检索词,应用计算机在PubMed及Web of Science数据库检索从建库至2022年4月为止的相关文献共495篇;以“有限元分析、脊柱、颈椎、胸腰椎、腰椎、推拿、手法、生物力学”为中文检索词,应用计算机在中国知网、万方及维普数据库检索从建库至2022年4月的相关文献共593篇,根据纳入标准选择其中的80篇进行综述。结果与结论:(1)通过三维有限元法对推拿手法作用下的脊柱结构进行应力应变分析,可获得模型各部件的应力值和位移值,客观、直观和准确地反映椎体、椎间盘、韧带、肌肉、血管和神经等部件的力学效应状况,为阐释脊柱推拿手法的作用机制、提高手法操作的安全性和有效性提供有力的证据依靠,极大地推进了临床推拿手法技术的发展,拥有良好的发展潜力。(2)目前三维有限元法在脊柱推拿手法生物力学研究上已取得重要进展,脊柱模型的椎旁软组织部件模拟不断完善,颈椎和腰椎推拿手法的基础研究不断深入,推拿手法的生物力学分析由固体力学发展至流体力学。(3)但现阶段应用中仍存在着脊柱模型影像学来源和各部件材料设定数据的代表性不足,脊柱推拿手法的模拟和加载过于简单,很多胸椎推拿手法的基础研究未BACKGROUND: As a physical therapy method with remarkable curative effect for spinal diseases, spinal manipulation has been widely used by scholars at home and abroad and gradually developed into standardization and systematization. Its mechanism of action and safety have always been the focus of medical attention. Three-dimensional finite element method is an effective tool for numerical simulation of human mechanical behavior. It has certain research value and clinical significance to clarify the biomechanical effect of manipulation on spinal structure through technical analysis.OBJECTIVE: To review the development of three-dimensional finite element method and its application in biomechanics of cervical, thoracolumbar and lumbar manipulations.METHODS: The first author used “finite element, biomechanics, spine, cervical vertebrae, thoracolumbar, lumbar vertebra, manipulation” as English search terms, and used computer to search PubMed and Web of Science databases from establishment to April 2022. There were a total of 495 related articles. The “finite element analysis, spine, cervical spine, thoracic and lumbar spine, lumbar spine, massage, manipulation, biomechanics” were used as the Chinese search terms. A total of 593 related articles from the establishment of the database to April 2022 were checked in CNKI, Wanfang, and VIP databases using computers,and 80 of them were selected for review according to the inclusion criteria.RESULTS AND CONCLUSION:(1) Through the three-dimensional finite element method to analyze the stress and strain of the spine structure under the action of massage manipulation, the stress value and displacement value of each part of the model can be obtained, which can objectively, intuitively and accurately reflect the vertebral body, intervertebral disc, ligament, muscle, blood vessel, nerve, etc. The mechanical effect status of the components provides strong evidence for explaining the mechanism of spinal manipulation, improving the safety and effectiveness of manipulation, gre

关 键 词：三维仿真模型 有限元分析 脊柱 颈椎 胸腰椎 腰椎 推拿 手法 生物力学 综述 

分 类 号：R452[医药卫生—治疗学] R318[医药卫生—临床医学] R605