3D打印寰枢椎侧块融合器的设计和解剖应用  

Design and anatomical application of the 3D printing atlantoaxial lateral mass cage

作　　者：孙泽宇 赵伟峰[1] 丁一[1] 李波[1] Sun Zeyu;Zhao Weifeng;Ding Yi;Li Bo(Department of Orthopedics,Guizhou Provincial People's Hospital,Guiyang 550002,Guizhou,China)

机构地区：[1]贵州省人民医院骨科,贵州贵阳550002

出　　处：《贵州医药》2025年第3期339-343,共5页Guizhou Medical Journal

基　　金：国家自然科学基金地区项目(82160419);贵州省人民医院青年基金项目(GZSYQN202104号);贵州省中医药管理局中医药、民族医药科学技术研究项目(QZYY-2024-114)资助。

摘　　要：目的设计一款基于解剖学测量及3D打印技术应用的新型寰枢椎侧块融合器,并初步探索其生物力学特性和应用。方法通过干燥骨性尸体标本和影像学测量获取寰枢椎侧块关节解剖数据,包括:寰椎侧块矢状径、横径,枢椎侧块矢状径、横径,侧块关节间高度,侧块关节面角度。应用Minics软件,Inspire2018软件建立寰枢椎侧块融合器模型并通过有限元分析其在垂直压缩,前屈后伸,侧方屈曲的生物力学特性。使用3D打印机器按照有限元分析模型打印出融合器,使用尸体标本模拟后路寰枢椎椎弓根螺钉内固定+双侧侧块融合器置入术并观察融合器位置。结果将根据解剖数据电脑设计的融合器做有限元生物力学分析显示垂直压力为700 N时,融合器最大变形1.84×10^(-2)mm,最大等效应力5.92×10^(2)MPa;当前侧加载力1000 N,后侧加载力500 N时,融合器最大变形1.3×10^(-3)mm,最大等效应力7.31×10^(2)MPa;当前侧加载力500 N,后侧加载力1000 N时,融合器最大变形3.79×10^(-2)mm,最大等效应力6.99×10^(2)MPa;侧方屈曲上表面加载力700 N,加载扭矩2 N.m时,最大变形2.70×10^(-2)mm,最大等效应力5.31×10^(2)MPa,均满足应力要求。模型上行后路寰枢椎椎弓根螺钉内固定+双侧侧块融合器置入术后见双侧融合器及椎弓根螺钉位置良好。结论3D打印寰枢椎侧块融合器在有限元分析和尸体上的初步探索提示能满足寰枢椎融合术的需求。Objective To design a new atlantoaxial lateral mass cage based on 3D printing technology and anatomical measurement to explore its biomechanical properties and application effects.Methods Review literature for anatomical data of atlantoaxial lateral mass,including the length,width,height between the joint.The model was established by software and the biomechanical characteristics of vertical compression,flexion,lateral bending was analyzed by finite element analysis.Titanium powder was used to build cages by a 3D printing machine and operation on cadaver model to observe the placement of the cage.Results The finite-element analysis showed when a vertical pressure was 700 N,the maximum deformation of the cage was 1.84×10^(-2) mm and the maximum equivalent stress was 5.92×10^(2) MPa.When forward side pressure was 1 000 N and the backward side pressure was 500 N,the maximum deformation of the cage was 1.3×10^(-3) mm and the maximum equivalent stress was 7.31×10^(2) MPa.When forward side pressure was 500 N and the backward side pressure was 1 000 N,the maximum deformation of the cage was 3.79×10^(-2) mm and the maximum equivalent stress was 6.99×10^(2) MPa.When the lateral pressure was 700 N and the torque was 2 N.m,the maximum deformation of the cage was 2.70×10^(-2) mm and the maximum equivalent stress was 5.31×10^(2) MPa.The position of the cages and the atlantoaxial pedicle screws were very well in the DR image.Conclusion Preliminary analysis of the 3D printed atlantoaxial lateral cage in finite element analysis and cadaver operation suggested that the needs of atlantoaxial fusion can be met.

关 键 词：寰枢椎侧块 融合器 3D打印 有限元分析 解剖学 

分 类 号：R681.5[医药卫生—骨科学]