不同条件下旋提手法对颈椎关节突关节软骨应力的影响  

Influence of Rotation-Traction Manipulation on Articular Cartilage Stress of Cervical Facet under Different Conditions

作　　者：卜寒梅 王旭 冯天笑 王平[2] 朱立国[1,3] 魏戌 BU Hanmei;WANG Xu;FENG Tianxiao;WANG Ping;ZHU Liguo;WEI Xu(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Tianjin 300381,China;Beijing Key Laboratory of Traditional Chinese Orthopedics and Traumatology,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China)

机构地区：[1]中国中医科学院望京医院,北京100102 [2]天津中医药大学第一附属医院 [3]中医正骨技术北京市重点实验室

出　　处：《中国中医骨伤科杂志》2024年第3期35-39,44,共6页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：北京市科技新星计划交叉合作课题(20220484228);北京市科技新星计划项目(Z191100001119025);国家级非物质文化遗产代表性项目(160202013000190004,102160222020130009015)。

摘　　要：目的:观察不同方向及不同大小提扳力的旋提手法对颈椎关节突关节软骨的应力影响。方法:基于验证过的颈椎C_(3)~C_(7)三维有限元模型,模拟颈椎左侧旋提手法,分别加载中立位、不同定位方向、相同提扳力+不同定位方向以及相同定位方向+不同大小提扳力,比较C_(3)~C_(7)各节段双侧关节突关节软骨峰值应力情况。结果:在中立位时,最大峰值应力集中于双侧C_(6)~C_(7)节段;在不同定位方向时,最大峰值应力集中于旋转同侧C_(4)~C_(5)节段;在不同定位方向联合相同提扳力以及相同定位方向联合不同大小提扳力时,最大峰值应力均集中于旋转对侧C_(6)~C_(7)节段。结论:不同方向及不同大小提扳力的旋提手法对颈椎关节突关节软骨应力集中节段均有不同影响。Objective:To observe the efficacy of rotation-traction manipulation with different directions and different forces on the stress of cervical facet articular cartilage.Methods:Based on the verified three-dimensional finite element model of cervical spine C_3-C_7,the left cervical spine rotation-traction manipulation was simulated,and the neutral position,different positioning directions,the same lifting force combined with different positioning directions,and the same positioning direction combined with different lifting forces were respectively loaded,and the peak stress of bilateral facet articular cartilage at each segment of C_3-C_(7) was compared.Results:At the neutral position,the maximum peak stress was concentrated in bilateral C_6-C_(7) segments.The maximum peak stress is concentrated in the C_4-C_(5) segment on the same side of rotation at different orientation directions.When the same lifting force is combined with different positioning directions and different lifting forces are combined with the same positioning directions,the maximum peak stress is concentrated in the C_6-C_(7) segment on the opposite side of the rotation.Conclusion:The different directions and sizes of the lifting forces with rotation-traction manipulation have different effects on the stress concentration segments of the articular cartilage of the cervical facet.

关 键 词：旋提手法 颈椎 关节突关节软骨 应力 三维有限元 

分 类 号：R681.5[医药卫生—骨科学]