北京生物醫(yī)學(xué)工程

不同固定方式治療急性脊柱創(chuàng)傷的脊柱生物力學(xué)指標(biāo)分析

Analysis of spinal biomechanical indexes in acute spinal trauma treated by different fixation methods

作者：李大猛魯鋒田云李德廣閻輝馬術(shù)友

單位：遵化市人民醫(yī)院(河北唐山 064200) <p>通信作者：李大猛。E-mail：[email protected]</p> <p> </p>

關(guān)鍵詞：脊柱；內(nèi)固定；有限元模型；生物力學(xué)；位移；應(yīng)力

分類號：R318.01

出版年·卷·期（頁碼）：2022·41·3（294-296）

摘要：

目的用脊柱力學(xué)指標(biāo)分析和比較前路內(nèi)固定術(shù)和后路切開椎弓根內(nèi)固定治療急性脊柱創(chuàng)傷的療效，以期得到更好的治療急性脊柱創(chuàng)傷的方法。方法基于正常胸腰椎有限元模型的基礎(chǔ)上構(gòu)建創(chuàng)傷模型，在創(chuàng)傷模型中對比不同固定模式載荷下模型整體的變形和 Von Mises 應(yīng)力。結(jié)果在中立位及前屈、左彎及右彎載荷下，前路內(nèi)固定術(shù)的位移均小于后路切開椎弓根內(nèi)固定術(shù)；在后伸載荷下，后路切開椎弓根內(nèi)固定術(shù)的位移均小于前路內(nèi)固定術(shù)。在中立位及前屈、后伸、左彎及右彎載荷下，前路固定術(shù)的椎體應(yīng)力均大于后路切開椎弓根內(nèi)固定術(shù)。結(jié)論前路內(nèi)固定在增加椎體剛度方面有較好的效果，活動更加接近于正常；后路切開椎弓根內(nèi)固定承受的應(yīng)力較大，出現(xiàn)內(nèi)固定斷裂的概率也較大。

Objective To analyze and compare the efficacy of anterior internal fixation and posterior incisional internal fixation in the treatment of acute spinal trauma using spinal mechanics, in order to obtain a better method for the treatment of acute spinal trauma. Methods The trauma model was established based on the normal thoracolumbar finite element model. The deformation and Von Mises stress of the model under different fixed loading modes were compared in the trauma model.Results The displacement of anterior internal fixation was smaller than that of posterior incisional internal fixation in neutral position and under anterior flexion, left bending and right bending loads; the displacement of posterior incisional internal fixation was smaller than that of anterior internal fixation under posterior extension loads. In neutral position and under anterior flexion, posterior extension, left bending and right bending loads, the stresses on the vertebral body were greater with anterior fixation than with posterior incisional pedicle internal fixation. Conclusions Anterior internal fixation is more effective in increasing the stiffness of the vertebral body, and the activity is closer to normal; posterior incisional internal fixation is subjected to higher stresses and has a higher probability of internal fixation fracture.

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