摘要
目的利用有限元方法分析斜扳法对骶髂关节(sacroiliac joint,SIJ)和髂腰韧带应力及位移的影响,探索斜扳法治疗SIJ紊乱的生物力学作用机制,为临床治疗提供依据。方法建立正常腰椎-骨盆有限元模型,并依据人体真实解剖结构重建髂腰韧带和关节软骨。验证模型有效性后,分别模拟垂直压缩、拔伸和斜扳法3种加载方式,分析SIJ与髂腰韧带的应力及位移情况。结果在3种载荷下,斜扳法加载时SIJ关节面应力(35.174 MPa)、位移(0.553 mm)及关节活动度(0.62°)均为最大;同时髂腰韧带的峰值应力(4.717 MPa)和位移(1.604 mm)也最大。斜扳法加载时,髂腰韧带总体位移大于关节面,而关节面最大应力高于髂腰韧带。结论在3种载荷中,斜扳法对SIJ及髂腰韧带产生应力及位移的影响最显著。推测斜扳法可引起SIJ轻微分离与旋转,改变其应力分布,并对髂腰韧带产生更为明显的拉伸效应。
Objective To analyze the influence of oblique-pulling manipulation on the stress and displacement of the sacroiliac joint(SIJ)and iliolumbar ligament using finite element analysis,and to explore the mechanism by which oblique-pulling manipulation treats sacroiliac joint subluxation,thereby providing a clinical basis for its treatment.Methods A finite element model of the lumbar spine-pelvis was established.The iliolumbar ligament and articular cartilage were reconstructed according to the actual anatomical structures of the human body.After the model was validated,vertical compression,tensile manipulation,and oblique-pulling manipulation were simulated to analyze the stress and displacement of the SIJs and iliolumbar ligaments.Results Under the three types of loading conditions,the SIJs exhibited the highest stress(35.174 MPa),displacement(0.553 mm),and range of motion(0.62°)when oblique-pulling manipulation was applied.The iliolumbar ligaments also showed the highest peak stress(4.717 MPa)and displacement(1.604 mm)under oblique-pulling manipulation.During the application of oblique-pulling manipulation,the peak displacement of the iliolumbar ligament was greater than that of the articular cartilage,whereas the maximum stress of the articular cartilage was higher than that of the iliolumbar ligament.Conclusions Among the three types of loading conditions,oblique-pulling manipulation has the most significant effect on the SIJs and iliolumbar ligaments.It is hypothesized that oblique-pulling manipulation induces slight separation and rotation of the SIJs,alters stress distributions,and exerts more obvious tensile effects on the iliolumbar ligaments.
作者
周炫宇
汪昱婷
林君龙
陈海云
任启凡
施世豪
王海洲
祁冀
ZHOU Xuanyu;WANG Yuting;LIN Junlong;CHEN Haiyun;REN Qifan;SHI Shihao;WANG Haizhou;QI Ji(The Second Clinical School,Guangzhou University of Chinese Medicine,Guangzhou 510405,China;Department of Geriatric Orthopedics,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China;Orthopedic Biomechanics Laboratory,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China;State Key Laboratory of Dampness Syndrome of Chinese Medicine,Guangzhou 510120,China)
出处
《医用生物力学》
北大核心
2025年第6期1638-1645,共8页
Journal of Medical Biomechanics
基金
国家自然科学基金项目(82205150)
广东省医学科研基金项目(A2024198)
广东省中医院院内专项(YN2023WSSQ08)
广东省中医药科学院优秀青年人才青苗计划项目(SZ2024QN03)
中国科协青年托举人才工程项目(YESS20240474)
国家重点研发计划项目(2022YFC3501003)。
关键词
骶髂关节
髂腰韧带
斜扳法
有限元分析
sacroiliac joint
iliolumbar ligament
oblique-pulling manipulation
finite element analysis
