下腰椎连续相邻多椎体结核前路病灶切除钛网植骨内固定的有限元分析  

Finite element study of titanium mesh and internal fixation for anterior lumbar intervertebral tuberculosis with multiple adjacent vertebral tuberculosis

作　　者：杨立峰 彭春雷[2] 梁永永 宁伟[2] 杨斌辉 卫永鲲 马永刚 何少波 YANG Li-feng;PENG Chun-lei;LIANG Yong-yong;NING Wei;YANG Bin-hui;WEI Yong-kun;MA Yong-gang;HE Shao-bo(Department of Orthopedics,3201 Hospital,Hanzhong,Shaanxi 723000,China;不详)

机构地区：[1]三二〇一医院骨科,陕西汉中723000 [2]陕西理工大学,陕西汉中723000

出　　处：《中国骨与关节损伤杂志》2023年第1期34-38,共5页Chinese Journal of Bone and Joint Injury

基　　金：陕西省重点研发计划项目(2019SF-168)。

摘　　要：目的采用有限单元法分析一期前路病灶切除钛网植骨单钉棒或双钉棒内固定治疗下腰椎连续相邻多椎体结核的稳定性。方法选取健康成年男性1名,排除腰椎疾病。采用64排螺旋CT对腰椎进行层厚1 mm扫描,将扫描数据以Dicom格式导入Mimics软件中,利用轮廓提取和阈值分割的方法提取出骨骼图像,生成点云文件。将点云文件导入逆向重建软件Geomagic,建立曲面模型。最后导入CATIA软件中对曲面模型填充,生成正常L_(2)~S_(1)椎体实体模型,在正常实体模型上模拟L_(3)~L_(5)连续相邻多椎体结核前路病灶边缘化切除模型。将建立的内固定模型装配于病灶切除椎体实体模型上,最终建立了正常实体模型、前路钛网植骨单钉棒或双钉棒内固定模型。将三种模型分别导入有限元分析软件ANSYS中,对腰椎结构及内固定材料进行赋值和网格划分。对S_(1)骶椎底平面完全约束,分别在三种模型的L_(2)椎体上表面施加500 N的垂直面载荷和7.5 N·m的弯矩载荷,进行6种工况(前屈、后伸、左侧弯、右侧弯、左旋转、右旋转)的应力和总位移分析。结果单钉棒或双钉棒内固定模型应力均集中在固定棒上。单钉棒固定模型总位移>正常模型总位移>双钉棒固定模型总位移。结论下腰椎连续相邻多椎体结核前路病灶清除自体髂骨钛网植骨后,单钉棒或双钉棒内固定其受力主要由钉棒承担。单钉棒或双钉棒内固定模型均能提供腰椎稳定性。Objective To analyze the stability of single or double screw-rod internal fixation with titanium mesh for one-stageanterior debridement in the treatment of lower lumbar spinal tuberculosis by finite element method.Methods A healthy adultmale was selected and the lumbar diseases were excluded.64 slice spiral CT was used to scan the lumbar spine with a thicknessof 1 mm.The scanned data were imported into Mimics software in DICOM format.The bone image was extracted and the pointcloud file was generated by using the methods of contour extraction and threshold segmentation.The generated point cloud filewas imported into the reverse reconstruction software Geomagic to establish the surface model.Finally,the surface model wasfilled in CATIA software to generate the lumbosacral(L_(2)-S_(1))solid model of normal people.On the normal solid model,L_(3)-L_(5)con-tinuous adjacent multi vertebral tuberculosis anterior focus marginalization resection model was simulated.A new fixation modelin CATIA software was created,the internal fixation was drawn according to the clinical parameters of titanium mesh and nailrod,and the solid model was established.The established internal fixation model was assembled on the lesion resection verte-bral body solid model.Finally,the normal model,anterior single nail rod and titanium mesh fixation model or double nail rodand titanium mesh fixed model were established.The three models were respectively imported into the finite element analysissoftware ANSYS,and the lumbar structure and internal fixation materials were implanted and meshed.Under the complete con-straint of S_(1)bottom plane,500 N vertical plane load and 7.5 n·m bending moment load were applied to the upper surface of lum-bar 2 vertebral body of three models respectively.The stress and total displacement of six working conditions(forward flexion,backward extension,left and right flexion and left and right rotation)were analyzed.Results The stress of the two fixationmodels were concentrated on the fixation rod.The total displacemen

关 键 词：腰椎结核 有限元分析 钉棒 生物力学 

分 类 号：R681.5[医药卫生—骨科学]