摘要
背景:推拿是治疗颈椎病的一种有效方法,对椎间盘退化程度不同的颈椎进行推拿时,推拿力度因退化程度差异性会起到不同的效果,并且手法把控不当还可能对已经退化的颈椎造成损伤,目前相关研究还有所欠缺。目的:探究椎间盘退变程度不同的颈椎在正常承载与推拿下的力学变化机制,探究推拿旋转角度对不同退化程度椎间盘的影响,从而对不同退化程度颈椎提出操作手法指导。方法:建立三维人体颈椎(C2-C7)有限元模型,通过网格优化,得到几何相似度高、精确度高、网格数为200万级的颈椎模型。通过改变椎间盘参数得到退化程度不同的模型,利用有限元方法探究不同退化程度椎间盘在受到推拿作用下的力学机制。结果与结论:(1)退化后的椎间盘应力重新分布,髓核承载力减小,纤维环承载力显著增加,关节应力也增大;(2)在正常承载下,纤维环应力集中区域主要在人体后侧边缘,随着退化程度增加,应力集中区域从边缘向内延伸且面积增大;(3)推拿旋转时,纤维环应力集中区域主要在后侧和左右两侧,退化程度越高应力集中区域越大,应力值越大;(4)推拿旋转时,退化程度越高椎间盘的轴向位移小,变形能力越小;(5)C4-5椎间盘退化会对该节段椎体(C4,C5)最大应力和关节接触力产生影响,且应力值随退化程度增加而增大,但退化对其他节段无明显影响;(6)综合应力安全和变形能力,施加推拿手法时旋转角度应根据退化程度适当减小。
BACKGROUND: Massage is a cost-effective treatment for cervical spondylosis. When the cervical vertebrae with different degenerative degree of intervertebral disc are massaged, the massage strength will have different effects because of the different degenerative degree, and improper manipulation of massage may also cause damage to the degenerative cervical vertebrae. At present, the related research is still lacking. OBJECTIVE: To investigate the mechanism of mechanical changes of cervical vertebrae with different degrees of disc degeneration under normal load and massage, and to explore the influence of massage rotation angle on different degrees of disc degeneration, so as to provide operational guidance for cervical vertebrae with different degrees of disc degeneration. METHODS: The finite element model of three-dimensional human cervical vertebrae(C2-C7) with high geometric similarity and accuracy and 2 million grids was established. The model with different degrees of cervical vertebrae degradation was obtained by changing the parameters of intervertebral disc. The finite element method was used to explore the mechanical mechanism of different degenerative degrees of intervertebral disc under the action of massage. RESULTS AND CONCLUSION:(1) After degeneration, the stress of intervertebral disc was redistributed;the bearing capacity of nucleus pulposus decreased;the bearing capacity of annulus fibrosus increased significantly;and the joint stress also increased.(2) Under normal load condition, the stress concentration area of the fiber ring was mainly located at the posterior side of the cervical spine. With the increase of degradation degree, the stress concentration region extended inward from the edge and the area increased.(3) The stress concentration area of fiber ring was mainly at the back and left and right sides with massage angle. The higher the degree of degradation, the greater the stress concentration area and the greater the stress value was.(4) When the massage was in rotation phase, the higher the degree of degeneration, the smaller the axial displacement and the smaller the deformation ability of the disc was.(5) C4-5 intervertebral disc degeneration will affect the maximum stress and joint contact force of the vertebral body(C4, C5) of the segment, and the stress value increases with the degree of degradation, but the degradation has no obvious effect on other segments.(6) Combined with the stress safety and deformation ability, the rotation angle should be reduced according to the degree of degradation.
作者
王宇
雷建银
辛浩
罗凛
李志强
Wang Yu;Lei Jianyin;Xin Hao;Luo Lin;Li Zhiqiang(Institute of Applied Mechanics,College of Mechanical and Vehicle Engineering,Taiyuan University of Technology,Taiyuan 030024,Shanxi Province,China;Shanxi Key Laboratory of Material Strength and Structure Impact,Taiyuan 030024,Shanxi Province,China;National Demonstration Center for Experimental Mechanics Education(Taiyuan University of Technology),Taiyuan 030024,Shanxi Province,China;Guangdong Second Traditional Chinese Medical Hospital,Guangzhou 510095,Guangdong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第27期4278-4284,共7页
Chinese Journal of Tissue Engineering Research
基金
国家自然基金科学基金项目(81574093),项目名称:基于多体动力学方法构建颈部主要肌群在动伸推拿中的运动轨迹,项目负责人:罗凛。
关键词
颈椎
椎间盘退变
推拿
有限元
生物力学
拨伸旋转
应力
活动度
cervical vertebra
intervertebral disc degeneration
massage
finite element
biomechanics
extension rotation
stress
motion range
