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颈椎前路融合手术中钢板摆放角度对颈椎稳定性影响的有限元分析

摘要点击次数: 1848 全文下载次数: 480 投稿时间：2020-04-11

作者	Author	单位	Address	E-Mail
武建超	WU Jian-chao	兰州大学第二医院骨科, 甘肃兰州 730030	Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
师政伟	SHI Zheng-wei	兰州大学第二医院骨科, 甘肃兰州 730030	Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
潘亦欣	PAN Yi-xin	兰州大学第二医院骨科, 甘肃兰州 730030	Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
李绍平	LI Shao-ping	兰州大学第二医院骨科, 甘肃兰州 730030	Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
周建伟	ZHOU Jian-wei	兰州大学第二医院骨科, 甘肃兰州 730030	Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China
汪玉良	WANG Yu-liang	兰州大学第二医院骨科, 甘肃兰州 730030	Department of Orthopaedics, the Second Affiliated Hospital of Lanzhou University, Lanzhou 730030, Gansu, China	wy160918@sina.com

期刊信息：《中国骨伤》2021年，第34卷，第4期，第372-377页

DOI：10.12200/j.issn.1003-0034.2021.04.016

基金项目:甘肃省科技计划-科技支撑计划（编号：17JR5RA249）

中文摘要:

目的： 利用有限元分析的方法，比较颈前路融合手术中钢板偏离颈椎长轴与钢板标准摆放的生物力学性能。

方法： 选取一名健康女性志愿者并进行CT扫描（C₁-T₁），应用Mimics 19.0，Geomagic Studio 2015，Solidworks 2018，Ansys Workbench 17.2等软件建立下颈椎（C₃-C₇）模型进而验证模型的可靠性，随后置入不同角度、不同长度的颈前路钢板，从而建立颈前路椎间盘切除减压融合术（anterior cervical discectomy fusion，ACDF）模型，在C₃上施加73.6 N轴向压力及1 NM的纯力矩，使模型产生屈曲、后仰、侧弯及旋转活动，观察模型应力云图，记录器械最大应力值及椎间活动度并进行分析比较。

结果： 建立下颈椎（C₃-C₇）有限元模型，与已发表的关于颈椎活动度的文献相对比，验证了模型的有效性。钢板摆放偏移轴线对内固定器械的应力分布、最大应力值及椎间活动度影响较小；单节段钢板相比于双节段钢板对钢板偏移的力学影响更小。

结论： 在颈椎前路钢板与颈椎长轴存在角度时对颈椎的力学稳定性影响不大。在临床手术钢板倾斜小于20°时，无须重新调整钢板位置。

【关键词】有限元分析下颈椎脊柱融合术内固定器

Finite element analysis of the effect of plate placement angle on cervical spine stability in anterior cervical fusion surgery

ABSTRACT

Objective: Using the method of finite element analysis,to compare the biomechanical properties between the plate deviating from the long axis of the cervical spine and the standard placement of the plate in the anterior cervical fusion surgery.

Methods: A healthy female volunteer was selected and CT scan (C₁-T₁) was performed. Using Mimics 19.0,Geomagic Studio 2015,Solidworks 2018,Ansys Workbench 17.2 to establish a lower cervical spine (C₃-C₇) model and to verify the reliability of the model. Subsequently,anterior cervical plates of different angles and lengths were placed to establish an anterior cervical discectomy fusion(ACDF) model. Applying 73.6 N axial pressure and 1 NM pure moment on C₃ to make the model produce flexion,extension,lateral bending and rotation activities,observed the model stress cloud diagram and recorded the maximum stress value of the instrument and the intervertebral mobility.

Results: The lower cervical spine(C₃-C₇) finite element model was established and verified against the published literature on the range of motion (ROM) of cervical spine. Effect of steel plate offset axis on stress distribution,maximum stress value and intervertebral ROM of internal fixation apparatus was minimal,and the mechanical effect of steel plate offset was less in double section steel plate than in single section steel plate.

Conclusion: Little effect on the mechanical stability of the cervical spine was anticipated when the anterior cervical plate was not perfectly aligned with the long axis of the cervical spine. If the tilt of the plate in clinical surgery is less than 20°,there is no need to readjust the position of the plate.

KEY WORDS Finite element analysis Lower cervical spine Spinal fusion Internal fixators

引用本文，请按以下格式著录参考文献：

中文格式:	武建超,师政伟,潘亦欣,李绍平,周建伟,汪玉良.颈椎前路融合手术中钢板摆放角度对颈椎稳定性影响的有限元分析[J].中国骨伤,2021,34(4):372~377
英文格式:	WU Jian-chao,SHI Zheng-wei,PAN Yi-xin,LI Shao-ping,ZHOU Jian-wei,WANG Yu-liang.Finite element analysis of the effect of plate placement angle on cervical spine stability in anterior cervical fusion surgery[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(4):372~377

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