摘要
目的研究生长棒技术治疗早发性脊柱侧凸过程中不同上固定节段选择对术后脊柱生物力学特性的影响。方法利用有限元技术分别建立同一患者行生长棒术前以及术后T1~L4、T2~L4、T3~L4固定共4个脊柱模型(C6~S1节段),在C6上表面分别施加7 N·m力矩载荷和1 rad角位移载荷,分析上固定椎体邻近结构的生物力学特性。结果生长棒术后脊柱整体活动度(range of motion,ROM)显著下降,固定T2~L4节段时,脊柱活动受限最大,邻近椎体代偿性活动显著增加,椎间盘应力增大最明显。结论生长棒上固定选择T2节段时,术后发生交界性胸椎后凸和脊柱退行性病变的风险最高,在临床手术中应加以避免。
Objective To study the effects of selecting different fixing segments on biomechanical characteristics of the spine during the treatment of early onset scoliosis(EOS)by growing rod technique.Methods By using finite element method,four spine models(C6-S1 segments)fixed by growing rod were established:preoperative model,T1-L4 fixed model,T2-L4 fixed model,T3-L4 fixed model.Then 7 N·m torque load and 1 rad angular displacement load were applied on superior surface of C6 segment to analyze biomechanical characteristics for adjacent structure of the fixed vertebral body.Results The whole spinal range of motion(ROM)decreased significantly after operation.When the T2-L4 segment was fixed,the spine activity was mostly restricted,the compensatory activity of adjacent vertebrae increased significantly,and the intervertebral disc stress increased significantly.Conclusions When T2 segment is selected as the upper instrumented segment,the risk of proximal junctional kyphosis and spinal degeneration is the highest,which should be avoided in clinical surgery.
作者
何沛檐
裴葆青
王唯
卢达
马诚浩
HE Peiyan;PEI Baoqing;WANG Wei;LU Da;MA Chenghao(Beijing Key Lab for Design and Evaluation Technology of Implantable and Interventional Medical Devices,Beijing Advanced Innovation Center for Biomedical Engineering,School of Biological Science and Medical Engineering,Beihang University,Beijing 100083,China)
出处
《医用生物力学》
CAS
CSCD
北大核心
2021年第6期849-854,共6页
Journal of Medical Biomechanics
基金
国家自然科学基金项目(11972065)
北京市自然科学基金-海淀原始创新联合基金资助项目(L202006)。
关键词
早发性脊柱侧凸
生长棒
椎间盘应力
early onset scoliosis(EOS)
growing rod
intervertebral disc stress
