不同负重方式对腰椎生物力学的影响  

Biomechanical effects of different load-carrying ways on lumbar spine

作　　者：赵赓 王连雷 王宏卫 刘新宇[2] ZHAO Geng;WANG Lianlei;WANG Hongwei;LIU Xinyu(Key Laboratory of Ultra-Weak Magnetic Field Measurement Technology,Ministry of Education,School of Instrumentation and Optoelectronic Engineering,Beihang University,Beijing 100083,China;Department of Orthopedics,Qilu Hospital,Cheeloo College of Medicine,Shandong University,Jinan 250012,Shandong,China;College of Artificial Intelligence and Big Data for Medical Sciences,Shandong First Medical University,Jinan 250102,Shandong,China)

机构地区：[1]北京航空航天大学仪器科学与光电工程学院极弱磁场测量技术教育部重点实验室,北京100083 [2]山东大学齐鲁医院骨科,山东济南250012 [3]山东第一医科大学医学人工智能与大数据学院,山东济南250102

出　　处：《山东大学学报（医学版）》2023年第6期70-78,共9页Journal of Shandong University:Health Sciences

基　　金：国家自然科学基金(81874022)。

摘　　要：目的结合骨骼肌肉模型及腰椎有限元模型研究直立状态下不同背包方式对椎旁肌收缩和腰椎各节段椎间盘应力分布的影响。方法建立无负重和使用双肩包、单肩包和手提包的4种骨骼肌肉模型以及腰椎的有限元模型。使用骨骼肌肉模型分析站立位下使用3种负重方式时的肌肉收缩力和腰椎椎间压力,并将其施加在腰椎有限元模型中来分析腰椎椎体、间盘和韧带的应力分布。结果与无负重模型相比,双肩包、单肩包和手提包的平均椎旁肌收缩力增加了31.0%、43.4%和105.1%。双肩包模型的椎旁肌收缩力左右均衡,单肩包模型中负重侧的总体椎旁肌收缩力较大,而在手提包模型中非负重侧的椎旁肌收缩力较大。多裂肌在不同负重条件下的收缩力均有统计学差异(P<0.05)。与无负重模型相比,双肩包、单肩包和手提包模型中T12~S1平均椎间压力分别增加了37%、45%和64%。双肩包、单肩包及手提包模型的椎体平均峰值应力分别增加了71.6%、122.3%和146.6%。双肩包、单肩包及手提包模型的纤维环峰值应力分别增加了155.6%、183.4%、195.8%;髓核峰值应力分别增加了95.2%、146.9%、161.5%。结论左右平衡的负重方式对肌肉和腰椎间盘的产生负荷最小。当使用非平衡负重方式时,肌肉的收缩使得躯体保持平衡,但同时也使得腰椎应力增加。Objective Based on the musculoskeletal model and the lumbar finite element model,to investigate the effects of different knapsack models on paraspinal muscle contraction and lumbar intervertebral disc stress distribution in the upright state.Methods The unloaded,backpack,shoulder-bag and handbag musculoskeletal models and finite element model were established.Muscle force and joint compression force were calculated in the musculoskeletal model,and input into the lumbar finite element model to analyze the stress distribution on lumbar spine.Results Compared with that in the unloaded model,average muscle force in the backpack,shoulder-bag and handbag model increased by 31.0%,43.4%and 105.1%,respectively.The muscle force was balanced between right and left in the backpack model;however,it was higher in the loaded side in the shoulder-bag model,and was higher in the unloaded side in the handbag model.The force of multifidus muscle was statistically different in the four loading conditions(P<0.05).The average joint compression force on T12-S1 in the backpack,shoulder-bag and handbag models increased by 37%,45%and 64%,respectively.The peak stress on the lumbar vertebral bodies in the three models increased by 71.6%,122.3%and 146.6%,respectively;the peak stress on the annulus fibrosus increased by 155.6%,183.4%and 195.8%,respectively;the peak stress on the nucleus pulposus increased by 95.2%,146.9%and 161.5%,respectively.Conclusion The balanced way of load-carrying can reduce the activation of muscles and the burden of lumbar spine,which has a protective effect on the body.When a shoulder-bag or handbag is carried,the trunk keeps balance due to muscle contraction,which increases the stress on intervertebral discs.

关 键 词：腰椎 椎旁肌 骨骼肌肉模型 有限元 应力分布 

分 类 号：R681.5[医药卫生—骨科学]