椎板回植椎管重建有限元模型的建立与验证  

Establishment and Verification of Finite Element Model for Spinal Canal Reconstruction with Lamina Replantation

作　　者：刘国印 黄伟谦 徐院生 练仲华 蔡达威 陈建民 LIUGuoyin;HUANG Weiqian;XUYuansheng;LIAN Zhonghua;CAI Dawei;CHEN Jianmin(Department of Orthopaedics,Jinling Hospital of Nanjing Medical University,Nanjing Jiangsu 210000,China)

机构地区：[1]南京医科大学金陵临床医学院骨科,江苏南京210000 [2]厦门医疗器械研发检测中心有限公司结构分析实验室 [3]南安普顿大学环境科学与工程学院

出　　处：《联勤军事医学》2023年第10期831-836,共6页Military Medicine of Joint Logistics

基　　金：国家自然科学基金项目(82102547);江苏省自然科学基金面上项目(BK20181113)。

摘　　要：目的建立椎板回植椎管重建的有限元模型,并分析椎板回植椎管重建对L_(2~3)和L_(3~4)节段的生物力学效应。方法选择1名作者医院骨科就诊的健康成年男性志愿者,采集影像学资料,建立正常人体腰椎L2~4的有限元模型,并与对照组(Panjabi等[6]体外实验数据结果)进行比较,以验证该模型的有效性。根据处理方式分为正常赋值模型组、单纯椎板切除组和椎管重建组。在相同边界固定和生理载荷的条件下,进行前屈、后伸、左弯、右弯、左旋和右旋6种活动,计算各模型在6种加载工况处理下L_(2~3)和L_(3~4)节段关节活动度(range of motion,ROM)的变化情况,并进行比较分析。结果本实验所建立的正常赋值模型组L_(2~4)的有限元模型各个节段的ROM与对照组比较,差异均无统计学意义(P>0.05),验证了该模型的有效性,可用于实验研究。6种加载工况下,椎管重建组L_(2~3)和L_(3~4)的ROM低于单纯椎板切除组,差异均有统计学意义(P均<0.05);单纯椎板切除组L_(2~3)和L_(3~4)的ROM高于正常赋值模型组和对照组,组间比较差异均有统计学意义(P均<0.05)。椎管重建组与正常赋值模型组和对照组L_(3~4)的ROM比较,组间比较差异均无统计学意义(P>0.05)。前屈时,椎管重建组L_(2~3)的ROM高于正常赋值模型组和对照组,组间比较差异均有统计学意义(P均<0.05);后伸、左弯、右弯、左旋和右旋时,椎管重建组L_(2~3)的ROM与正常赋值模型组和对照组相比,差异均无统计学意义(P均>0.05)。结论本实验所建立的椎板回植椎管重建三维有限元模型可用于正常和手术模型的生物力学模拟和分析。单纯椎板切除严重影响脊柱生物力学的稳定性,而应用椎板回植椎管重建的方式可有效减少脊柱节段的ROM位移并维持其生物力学稳定性。Objective To establish a finite element model for spinal canal reconstruction with lamina replantation,and to analyze the biomechanical effects of spinal canal reconstruction with lamina replantation on L_(2-3)and L_(3-4)segments.Methods A healthy male adult volunteer was selected from department of orthopedics in author′s hospital,the imaging data was collected,a finite element model of normal human lumbar L_(2-4)was established,and compared with the control group(in vitro experimental data of Panjabi et al.~([6]))to verify the validity of the model.According to the different therapeutic regimen,the models were divided into normal assignment model group,laminectomy group and spinal canal reconstruction group.In the same conditions of fixed boundary and physiological load,6 kinds of activities including flexion,extension,left and right bending,left and right rotation were conducted,the range of motion(ROM)of L_(2-3)and L_(3-4)segments of each model under 6 loading conditions were calculated and compared.Results There was no significant difference in ROM of each segment of the finite element model of L_(2-4)in the normal assignment model group compared with the control group(P>0.05),which verified the effectiveness of the proposed model and could be used for experimental studies.Under the 6 loading conditions,the ROM of lumbar L_(2-3)and lumbar L_(3-4)in spinal canal reconstruction group was lower than that of laminectomy group,and the difference was statistically significant(all P<0.05);and the ROM of lumbar L_(2-3)and lumbar L_(3-4)in laminectomy group was higher than that in normal assignment model group and the control group,and the difference was statistically significant(all P<0.05).There was no statistically significant difference in the ROM of lumbar L_(3-4)between spinal canal reconstruction group and normal assignment model group,control group(P>0.05).In forward flexion,the ROM of L_(2-3)in the spinal canal reconstruction group was higher than that in the normal assignment model group and the control g

关 键 词：有限元模型 生物力学 椎板切除 椎板回植 椎管重建 关节活动度 

分 类 号：R687.3[医药卫生—骨科学]