摘要
目的构建5岁儿童和成人上颈椎三维有限元模型,研究不同运动方向上两种模型的活动范围及应力分布。方法以1名5岁儿童及1名45岁成年人为研究对象,采用螺旋CT连续扫描颅骨至C_(5)椎体,利用Mimics 14.0、Geomagic Studio 10.0、Hypermesh 13.0、Abaqus 6.14软件构建出包括枕骨、C_(1~4)椎体、椎间盘及主要韧带。加载颅脑重量载荷及1.5 N·m扭转载荷模拟头部三维坐标轴的运动,观察上颈椎各方向活动范围及关节突和韧带的Mises应力。结果上颈椎(C_(0~1)、C_(1~2)、C_(2~3))的旋转、前屈、后伸活动范围儿童模型均显著大于成人模型(P<0.01),C_(0~1)侧屈活动范围儿童模型大于成人模型(P<0.01)。在各运动方向上,C_(0~1)、C_(1~2)关节突的平均Mises应力儿童模型均显著大于成人模型(P<0.05),C_(2~3)关节突成人模型均显著大于儿童模型(P<0.05);在前屈及后伸状态上,齿状突部位的平均Mises应力儿童模型均显著大于成人模型(P<0.01)。在各运动方向上,齿突尖韧带、翼状韧带、横韧带的平均Mises应力儿童模型均显著大于成人模型(P<0.01)。结论5岁儿童上颈椎C_(0~1)、C_(1~2)、C_(2~3)节段活动范围较大,使得上颈椎稳定性低于成年人,是儿童上颈椎不稳定的解剖学因素,运动中心上移是儿童期颈椎损伤高发的主要因素。
Objective The three-dimensional finite element models of the upper cervical spine in 5-year-old child and the adult are constructed to study the range of motion and stress distribution in the different motion directions.Methods A 5-year-old child and a 45-year-old adult were selected as the research objects,spiral CT was used to scan the skull to the C_(5) vertebra continuously,Mimics 14.0,Geomagic Studio 10.0,Hypermesh 13.0 and Abaqus 6.14 softwares were used to construct the occipital bone(C_(0)),C_(1~4) vertebrae,intervertebral disc and main ligament.The movement of the three-dimensional coordinate axes of the head was simulated by loading the craniocerebral weight load and 1.5 N·m torsion load,and the range of motion at various directions of the upper cervical spine and the Mises stress of the articular process and ligament were observed.Results For the upper cervical spine(C_(0~1),C_(1~2),C_(2~3)),the movement range of each segment in child model was significantly larger than that in adult model under rotation,anteroflexion and posterior-extension states(P<0.01),and for C_(0~1),the movement range of each segment in child model was larger than that in adult model under lateral flexion state(P<0.01).In various movement directions,the average Mises stress of C_(0~1) and C_(1~2) articular processes in child model were significantly larger than those in adult model(P<0.05),and for C_(2~3) articular process,the adult model was significantly larger than that in child model(P<0.05);under anteroflexion and posterior-extension states,the average Mises stress of the odontoid site in the child model were significantly larger than those in the adult model(P<0.01).In various directions,average Mises stress of the odontoid apical ligament,alar ligament and transverse ligament in the child model were significantly larger than those in adult model(P<0.01).Conclusions The ranges of motion of C_(0~1),C_(1~2),C_(2~3) segments of 5-year-old child are larger,which make the stability of the upper cervical spine lower than the adu
作者
刘振杰
解英静
侯玲玲
LIU Zhen-jie;XIE Ying-jing;HOU Ling-ling(Dept of General Medicine, Langfang Ruikang Hospital,Langfang,Hebei 065000, China)
出处
《临床骨科杂志》
2022年第1期132-136,共5页
Journal of Clinical Orthopaedics
基金
河北省卫健委医学科学研究项目(编号:20191741)。
关键词
上颈椎
有限元分析
5岁儿童
upper cervical spine
finite element analysis
5-year-old child
