摘要
精确建立复杂性腰椎管狭窄症LSS的退变腰椎有限元模型,进而分析减压手术结合椎弓根内固定、椎体间盘融合的效果。选取复杂性LSS患者采集CT数据,采用专用生物力学软件建立退变腰椎全节段模型,自适应划分网格并交互生成附属组织结构,同时构建正常腰椎模型和三种手术治疗模型,用相同边界条件进行对比分析。复杂性LSS模型活动度比正常模型减少20%左右;而单纯减压模型出现不稳,活动范围增加近40%;结合椎弓根内固定稳定性部分提高、活动范围只增加25%,而进一步结合椎体间盘融合后腰椎弯曲刚度超过正常模型。在应力方面,单纯减压的应力出现较大增加、达到1.7倍左右,结合椎弓根内固定和椎体间盘融合有比较明显的减压作用。显示单纯的减压手术虽然可以缓减神经疼痛,但可能进一步造成腰椎稳定性的破坏,结合椎弓根内固定不能提供全面的稳定性,进一步结合椎体间盘融合的治疗效果比较稳定。
This study is aimed to establish accurate FE model of complete lumbar spine with complex lumbar spinal stenosis （LSS） and conduct comparasion and analysis with normal model and decompression treated model. Patients with complex LSS were selected for the collection of the CT scan data. Using special modeling system, the lumbar was meshing adaptively and auxiliary tissues were created interactively. The complete FE model of Lumbar with complex LSS as well as normal models was generated. Same boundary conditions were applied. Results showed that the active movement range of complex LSS decreased about 20%, but the decompression model increased about 40% , the model with lag screw increased about 25% , and the model with intervertebral fusion was stiffer than normal model. The stress in the decompression model increased about 70% , and the lag screw and intervertebral fusion have obvious decompression effect. The treatment of simple decompression for lumbar spine with complex LSS can release the pain, however may result in unstable and accelerated degeneration. The model with lag screw cannot provide full stability, and the model with intervertebral fusion can provide best treatment.
出处
《中国生物医学工程学报》
CAS
CSCD
北大核心
2012年第4期566-571,共6页
Chinese Journal of Biomedical Engineering
基金
杭州市科技发展计划项目(20091233Q22)
关键词
腰椎管狭窄症
减压手术
椎间融合
有限元方法
lumbar spinal stenosis
decompression surgery
intervertebral fusion
finite element method
