摘要
背景:斜扳手法对于腰椎关节滑膜嵌顿的疗效可靠,已被临床广泛应用,但是斜扳手法治疗腰椎关节滑膜嵌顿的相关研究还比较欠缺。目的:利用三维有限元法分析斜扳手法治疗腰椎关节滑膜嵌顿的生物力学作用机制,为斜扳手法治疗腰椎关节滑膜嵌顿提供理论依据。方法:采集腰椎关节滑膜嵌顿患者的腰椎CT数据,利用Mimics和Ansys软件建立脊柱L运动单元的三维有限元模型。模拟临床左侧卧位斜扳手法的操作过程,分析斜扳手法对腰椎L节段各组织结构生物力学、形态变化以及小关节接触面积的影响。结果与结论:(1)建立了腰椎L节段三维有限元模型,并验证了模型的有效性;(2)在施加斜扳手法前后,左侧小关节软骨应力从2.959 MPa增加到14.35 MPa,应变从0.078 34增加到0.345 1,关节软骨接触面积从20.806 2 mm^(2)增加到94.872 7 mm^(2);而右侧小关节软骨应力从3.127 MPa减小到0 MPa,应变从0.081 96减小到0,关节软骨接触面从16.705 3 mm^(2)减小到右侧0 mm^(2);(3)提示斜扳手法对于腰椎滑膜嵌顿患者具有良好的疗效,其可以改变关节突关节的应力、应变、上下关节突的接触面积,充分松解、打开关节突关节,达到复位关节突关节、解除滑膜嵌顿的治疗目的。
BACKGROUND:Oblique-pulling manipulation has a reliable curative effect on lumbar synovial incarceration,and it has been widely used in the clinic.However,the related research on the treatment of lumbar synovial incarce ration by oblique-pulling manipulation is still relatively lacking.OBJECTIVE:To analyze the biomechanical mechanism and effect of oblique-pulling manipulation in the treatment of lumbar synovial incarceration by threedimensional finite element method,and provide theoretical basis for the treatment of lumbar synovial incarceration by oblique-pulling manipulation.METHODS:The CT data of patients with lumbar synovial incarceration were collected,and the three-dimensional finite element model of Lmotor unit of spine was established by using Mimics and Ansys software.The operation process of the oblique-pulling manipulation in the left lateral position was simulated,and the influence of the oblique-pulling manipulation on the biomechanics,morphological changes and facet joint conta ct area of each tissue structure of L45 segment of lumbar spine was analyzed.RESULTS AND CONCLUSION:(1) A three-dimensional finite element model of lumbar Lsegment was established,and the validity of the model was verified.(2) Before and after the oblique-pulling manipulation was applied,the stress of left facet joint ca rtilage increased from 2.959 MPa to 14.35 MPa;the strain increased from 0.078 34 to 0.345 1,and the contact area of a rticular cartilage increased from 20.806 2 mm^(2) to 94.872 7 mm^(2).On the other hand,the stress of the right facet joint ca rtilage decreased from 3.127 MPa to 0 MPa;the strain decreased from 0.081 96 to O,and the artic ular cartilage conta ct surfa ce decreased from 16.705 3 mm^(2) to 0 mm^(2) on the right.(3) It is concluded that oblique-pulling manipulation has a good effect on patients with lumbar synovial incarceration.It can change the stress and strain of the articular process and the conta ct area of the upper and lower a rticular processes,fully release and open the a rticular proces
作者
卢钰
向俊宜
尹本敬
保超宇
毕衡
李骥征
陈帅
何光雄
李具宝
Lu Yu;Xiang Junyi;Yin Benjing;Bao Chaoyu;Bi Heng;Li Jizheng;Chen Shuai;He Guangxiong;Li Jubao(Yunnan Provincial Hospital of Traditional Chinese Medicine,Kunming 650500,Yunnan Province,China;Yunnan University of Chinese Medicine,Kunming 650500,Yunnan Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2023年第27期4271-4276,共6页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金(81860862,81460736),项目负责人:李具宝
云南省应用基础研究计划面上项目(2011FB146),项目负责人:李具宝
云南省中青年学术和技术带头人后备人才(云科人发[2019]7号),项目负责人:李具宝
云南省高层次中医药人才学科带头人及云南省卫生科技计划项目(2017NS161),项目负责人:李具宝
云南省科技厅—云南中医学院应用基础研究联合专项青年项目(11372110236),项目负责人:卢钰。
关键词
腰椎小关节
三维有限元
滑膜嵌顿
斜扳手法
生物力学
lumbar facet joint
three-dimensional finite element
synovial incarceration
oblique-pulling manipulation
biomechanics
