可调式脊柱外固定器固定胸腰段脊椎骨折的有限元分析  

A finite element analysis of adjustable external spinal fixator for fixation of the thoracolumbar fracture

作　　者：欧炳金 周云帆 程顺达 钱启恒 农宁 赵煜文 孟祥奇[1] OU Bing-jin;ZHOU Yun-fan;CHENG Shun-da;QIAN Qi-heng;NONG Ning;ZHAO Yu-wen;MENG Xiang-qi(Dept of Orthopaedics,Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Suzhou,Jiangsu 215001,China)

机构地区：[1]南京中医药大学附属苏州市中医医院骨伤科,江苏苏州215001

出　　处：《临床骨科杂志》2023年第6期885-889,共5页Journal of Clinical Orthopaedics

基　　金：江苏省学位委员会及教育厅科研与实践创新计划(编号:SJCX21_0758);江苏省苏州市卫健委姑苏卫生人才培养项目(编号:GSWS2019021)。

摘　　要：目的探讨有限元模型下可调式脊柱外固定器固定胸腰段脊椎骨折的生物力学效应。方法对1例L 1椎体骨折经手法复位的男性患者的胸腰段椎体CT数据进行三维重建,建立脊柱T 11~L 3椎体有限元模型,在T 11~L 3棘突上施加10~60 N的压力,模拟佩带可调式脊柱外固定器时,脊柱在轴向、前屈、后伸、左右侧屈、左右旋转运动状态下的生物力学特征。结果外固定器压力为10~60 N时,后伸运动状态时的整体位移逐渐缩小,压力为40 N时整体位移最小。棘突后方模拟佩带可调式脊柱外固定器后,最大应力均不发生在伤椎、伤椎上下椎间盘,后伸运动状态时伤椎、椎间盘及关节突关节应力随压力增大而逐渐减少。结论可调式脊柱外固定器可限制胸腰段椎体的活动,减少伤椎及椎间盘的最大应力,获得良好的外固定物生物力学效应。Objective To investigate the biomechanical effect of adjustable spinal external fixator in the fixation of thoracolumbar fractures under the finite element model.Methods The CT data of thoracolumbar vertebra in a male patient with L 1 vertebral fracture reduced by manipulation were reconstructed in three-dimension to establish a finite element model of T 11~L 3 vertebrae.A pressure of 10~60 N was loaded on the T 11~L 3 spinous process to simulate the biomechanical characteristics of the spine under the motion states of axial,anterior flexion,posterior extension,left-right lateral flexion and left-right rotation when simulating to wear the adjustable external spinal fixator.Results When the pressure of the external fixator was 10~60 N,the overall displacement was gradually decreased under the posterior extension state,and the overall displacement was the smallest when the pressure was 40 N.When simulating to wear the adjustable spinal external fixator behind the spinous process,the maximum stress did not occur in the injured vertebra and the superior and inferior intervertebral discs of the injured vertebrae;under the motion state of posterior extension,the stress of the injured vertebra,the intervertebral disc and the joint of articular process were gradually decreased with the increase of the pressure.Conclusions Adjustable spinal external fixator can limit the movement of thoracolumbar vertebrae,reduce the maximum stress of injured vertebrae and intervertebral disc,and good biomechanical effect of external fixator can be obtained.

关 键 词：胸腰段脊椎骨折 伤椎 可调式脊柱外固定器 生物力学 有限元分析 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学] R318.01[医药卫生—临床医学]