摘要
目的:通过有限元法在下颈椎损伤模型上比较4种内固定方式的生物力学特性。方法:选择1名28岁成年健康男性的颈椎CT数据,建立有限元正常颈椎模型和下颈椎三柱损伤模型,并在下颈椎三柱损伤模型上加入4种内固定方式建立起下颈椎前路颈前路椎体螺钉锁定钢板固定系统(anterior cervical locked-plate,ACLP)钉板模型、下颈椎后路椎弓根螺钉固定模型、下颈椎前路+后路椎弓根螺钉固定模型、新型复合型颈椎前路内固定模型,分别标为A、B、C、D组。在其颈椎上表面施加75 N的轴向压力和1.0 N·m纯力偶矩载荷,使模型产生前屈、后伸、旋转、侧屈运动。比较各模型在不同工况下的椎体间活动度、内固定物的应力分布情况。结果:相较于正常模型,在前屈、后伸、旋转、侧屈运动状态下,A组整体椎间活动度分别减少24.04°、23.12°、6.24°、9.06°;B组分别减少24.42°、24.34°、6.48°、9.20°;C组分别减少25.43°、25.29°、7.17°、9.57°;D组分别减少24.75°、25.50°、6.71°、9.12°。A组的应力峰值分别为53.9、79.9、61.4、80.3 MPa;B组分别为218.3、105.4、206.6、186.8 MPa;C组分别为40.8、97.2、47.1、39.4 MPa;D组分别为93.0、144.0、64.8、106.3 MPa。结论:新型复合型颈椎前路内固定方式的生物力学特性与前后路联合固定方式相近,优于下颈椎前路ACLP钉板方式和下颈椎后路椎弓根螺钉固定方式。
Objective To compare the biomechanical properties of four internal fixation methods in a lower cervical spine injury model using the finite element method.Methods Cervical CT data of a 28-year-old healthy adult male were utilized to establish a finite element model of the normal cervical spine and a lower cervical spine three-column injury model.Four internal fixation methods were then applied to the three-column injury model,resulting in four groups:Group A,anterior cervical locked-plate(ACLP)fixation system model(anterior approach);Group B,posterior cervical pedicle screw fixation model(posterior approach);Group C,combined anterior and posterior cervical pedicle screw fixation model;Group D,Novel composite anterior cervical internal fixation model.A 75 N axial compressive load and a 1.0 N·m pure moment were applied to the upper surface of the cervical spine model to simulate flexion,extension,rotation,and lateral bending movements.The intervertebral range of motion(ROM)and stress distribution of the internal fixators under different motion conditions were compared across all models.Results Compared with the normal model,the reductions in overall intervertebral ROM for each group under flexion,extension,rotation,and lateral bending were as follows:Group A,24.04°,23.12°,6.24°,and 9.06°;Group B,24.42°,24.34°,6.48°,and 9.20°;Group C,25.43°,25.29°,7.17°,and 9.57°;Group D,24.75°,25.5°,6.71°,and 9.12°.The peak stress values of the internal fixators in each group were:Group A,53.9 MPa,79.9 MPa,61.4 MPa,and 80.3 MPa;Group B,218.3 MPa,105.4 MPa,206.6 MPa,and 186.8 MPa;Group C,40.8 MPa,97.2 MPa,47.1 MPa,and 39.4 MPa;Group D,93.0 MPa,144.0 MPa,64.8 MPa,and 106.3 MPa.Conclusion The biomechanical properties of the novel composite anterior cervical internal fixation method are similar to those of the combined anterior-posterior fixation method,and superior to both the anterior cervical ACLP plate-screw fixation and posterior cervical pedicle screw fixation methods.
作者
侯志鹏
叶森琦
张吉辉
赵刘军
顾勇杰
于亮
HOU Zhi-peng;YE Sen-qi;ZHANG Ji-hui;ZHAO Liu-jun;GU Yong-jie;YU Liang(Department of Orthopaedics,Affiliated Yueqing Hospital of Wenzhou Medical University,Wenzhou 325600,Zhejiang,China;Department of Spine Surgery,Yuyao People's Hospital,Yuyao 315499,Zhejiang,China;Department of Spinal Surgery,Ningbo No.6 Hospital,Ningbo 315040,Zhejiang,China)
出处
《中国骨伤》
2025年第11期1156-1163,共8页
China Journal of Orthopaedics and Traumatology
基金
浙江省卫生健康科技计划(编号:2022KY341)
宁波市鄞州区农业与社会发展科技项目(编号:20191YZQ010061)。
关键词
颈椎
有限元分析
下颈椎
前路椎弓根螺钉
Cervical spine
Finite element analysis
Lower cervical
Anterior pedicle screws
