下颈椎两节段椎体次全切后前路椎弓根螺钉固定系统重建稳定性有限元模型的建立
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作者Author单位AddressE-Mail
李杰 LI Jie 宁波市医疗中心李惠利医院, 浙江 宁波 315000  
赵刘军 ZHAO Liu-jun 宁波市第六医院脊柱外科, 浙江 宁波 315000  
干开丰 GAN Kai-feng 宁波市医疗中心李惠利医院, 浙江 宁波 315000  
陈斌辉 CHEN Bin-hui 宁波市医疗中心李惠利医院, 浙江 宁波 315000  
陈意磊 CHEN Yi-lei 浙江大学医学院附属邵逸夫医院骨科, 浙江 杭州 310016
浙江省骨骼肌肉退变与再生修复转化研究重点实验室, 浙江 杭州 310016
Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital Affiliated to Medical College of Zhejiang University, Hangzhou 310016, Zhejiang, China  
桑裴铭 SANG Pei-ming 宁波市医疗中心李惠利医院, 浙江 宁波 315000  
贝迪恺 BEI Di-kai 宁波市医疗中心李惠利医院, 浙江 宁波 315000  
范腾迪 FAN Teng-di 宁波市医疗中心李惠利医院, 浙江 宁波 315000  
赵凤东 and ZHAO Feng-dong 浙江大学医学院附属邵逸夫医院骨科, 浙江 杭州 310016
浙江省骨骼肌肉退变与再生修复转化研究重点实验室, 浙江 杭州 310016
Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital Affiliated to Medical College of Zhejiang University, Hangzhou 310016, Zhejiang, China zhaofengdong@zju.edu.cn 
期刊信息:《中国骨伤》2022年,第35卷,第2期,第178-185页
DOI:10.12200/j.issn.1003-0034.2022.02.017
基金项目:浙江省医药卫生科技项目(编号:2018KY725);宁波市自然基金项目(编号:202003N4279)
中文摘要:

目的:建立下颈椎(C3-C7)两节段椎体次全切后的前路椎弓根螺钉内固定系统(anterior cervical transpedicular system,ACTPS)的固定模型,为下颈椎前路重建提供一种内固定手术的有限元建模方法。

方法:采集1名30岁成年健康男性志愿者颈段(C1-T1)的CT数据,应用Mimics 10.0、Rapidform XOR3、Hypermesh10.0、CATIA5V19、ANSYS 14.0软件建立下颈椎(C3-C7)三维非线性的完整模型作为完整组。记录完整组模型的单元数和节点数,对完整模型进行有效性验证后行C5、C6两节段椎体次全切,建立ACTPS模型作为ACTPS组,分别在完整组和ACTPS组的C3上施加75 N的轴向压力和1N·m的纯力偶矩,使完整组和ACTPS组模型在屈伸、侧弯、旋转方向运动,分析ACTPS组的椎间活动度和应力分布情况并与完整组比较。

结果:试验建立了正常人的下颈椎(C3-C7)三维非线性有限元模型,完整模型包括85 832个单元,23 612个节点。构建的ACTPS内固定模型应力分布比较均匀,与完整组比较,ACTPS组的整体活动度在屈伸、侧屈、旋转方向上分别减小,相应的邻近C3,4节段代偿性轻微增加。

结论:ACTPS固定系统的应力分布均匀,螺钉与钛板结合部位未出现应力集中区域,内固定断裂风险低,适合于两节段及以上颈椎前路减压后稳定性重建。
【关键词】颈椎  椎体  内固定装置  有限元分析
 
Establishment of finite element model of anterior cervical transpedicular system for reconstruction of cervical stability after subtotal resection of two segments of lower cervical spine
ABSTRACT  

Objective: To establish the fixation model of anterior cervical transpedicular system (ACTPS) after subtotal resection of two segments of lower cervical spine(C3-C7) in order to provide a finite element modeling method for anterior cervical reconstruction.

Methods: The CT data of the cervical segment (C1-T1) of a 30-year-old adult healthy male volunteer was collected. Used Mimics 10.0,Rapidform XOR3,HyperMesh 10.0,CATIA5V19 and ANSYS 14.0 to establish the three-dimensional nonlinear complete model of lower cervical spine(C3-C7) as the intact group. The number of units and nodes of the complete model were recorded. After the effectiveness of the complete model was verified,the C5 and C6 vertebral subtotal resection was performed,and the ACTPS model was established as the ACTPS group. The axial force of 75 N and moment couple of 1N·m was loaded on the upper surface of C3 in intact group and ACTPS group,the range of motion(ROM)and stress distribution in states of flexion extension,lateral flexion,rotation was compared between two groups.

Results: There were 85 832 elements and 23 612 nodes in the complete model of lower cervical spine(C3-C7) which was established in this experiment. The stress distribution of ACTPS internal fixation model was relatively uniform. Comparing with the intact group,the overall range of motion in ACTPS group was decreased in flexion extension,lateral flexion and rotation directions,and the corresponding compensation of adjacent C3,4 segment was increased slightly.

Conclusion: The stress distribution of ACTPS fixation system is uniform,there is no stress concentration area at the joint of screw and titanium plate,and the fracture risk of internal fixation is low. It is suitable for stability reconstruction after anterior decompression of two or more cervical segments.
KEY WORDS  Cervical vertebrae  Vertebral body  Internal fixation devices  Finite element analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:李杰,赵刘军,干开丰,陈斌辉,陈意磊,桑裴铭,贝迪恺,范腾迪,赵凤东.下颈椎两节段椎体次全切后前路椎弓根螺钉固定系统重建稳定性有限元模型的建立[J].中国骨伤,2022,35(2):178~185
英文格式:LI Jie,ZHAO Liu-jun,GAN Kai-feng,CHEN Bin-hui,CHEN Yi-lei,SANG Pei-ming,BEI Di-kai,FAN Teng-di,and ZHAO Feng-dong.Establishment of finite element model of anterior cervical transpedicular system for reconstruction of cervical stability after subtotal resection of two segments of lower cervical spine[J].zhongguo gu shang / China J Orthop Trauma ,2022,35(2):178~185
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