腰椎定点旋转手法对L4~5不同退变程度椎间盘的生物力学影响  

Biomechanical effects of lumbar spine fixed-point rotation manipulation on L4~5 intervertebral discs with different degrees of degeneration

作　　者：苏少亭 周红海[1] 侯召猛 SU Shaoting;ZHOU Honghai;HOU Zhaomeng(Guangxi University of Chinese Medicine,Nanning 530001,China)

机构地区：[1]广西中医药大学,南宁530001

出　　处：《中华中医药杂志》2023年第10期4964-4967,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金项目(No.81660800);2021年广西名中医工作室建设项目(No.桂中医药科教发[2021]6号);广西研究生教育创新计划项目(No.YCBXJ2022004)。

摘　　要：目的:应用有限元研究腰椎定点旋转手法对L4~5不同程度退变椎间盘的生物力学影响。方法:建立椎间盘正常、轻度、中度、重度退变L4~5有限元模型,假定模型为左旁中央型突出,取L4~5椎间盘左旁中央区及左关节下区为观察点,观察腰椎定点旋转手法作用力对该区域产生的应力和位移。结果:在正常,轻度、中度、重度退变模型上的最大Von Mises应力值分别为:0.80116、0.60353、0.46824、0.41709 MPa,最大位移值分别为:0.53179、0.41503、0.37051、0.20067 mm,整个椎间盘上最大Von Mises应力值多集中在纤维环的外侧区域。结论:同样的手法作用力下,随着椎间盘退变等级的增加,其Von Mises应力及位移逐渐变小;椎间盘退变会对腰椎定点旋转手法的疗效产生影响,加大手法治疗时操作的旋扳力应要慎重。Objective:To study the biomechanical effects of lumbar fixed-point rotation manipulation on L4~5 degenerated intervertebral discs with finite element method.Methods.The L4~5 finite element model of normal,mild,moderate and severe disc degeneration was established.The model was left lateral central herniation,and the left lateral central area and left inferior articular area of L4~5 disc were taken as the observation point to observe the stress and displacement generated by the force of lumbar fixed point rotation on this area.Results:The maximum Von Mises stress value in the normal,mild,moderate and severe models was respectively:0.80116,0.60353,0.46824,0.41709 MPa,and the maximum displacement value was 0.53179,0.41503,0.37051,0.20067 mm,respectively.The maximum Von Mises stress value in the whole disc was concentrated in the lateral area of the annulus of fiber.Conclusion:Under the same manipulation force,the Von Mises stress and displacement of the intervertebral disc degeneration gradually decreased with the increase of the grade of the degeneration of the intervertebral disc.The operating force of the wrench should be careful.

关 键 词：腰椎 旋转手法 椎间盘 有限元 生物力学 

分 类 号：R246.9[医药卫生—针灸推拿学]