| 弯腰挺立手法治疗腰骶关节紊乱的有限元分析 |
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Received:December 13, 2018
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| 作者 | Author | 单位 | Unit | E-Mail |
| 王林 |
WANG Lin |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 黄发森 |
HUANG Fa-sen |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 孙长贺 |
SUN Chang-he |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 殷京 |
YIN Jing |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China |
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| 张清 |
ZHANG Qing |
中国中医科学院望京医院, 北京 100102 |
Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China |
Zhangqinggys@yahoo.com.cn |
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| 期刊信息：《中国骨伤》2019年32卷，第6期，第519-523页 |
| DOI：10.3969/j.issn.1003-0034.2019.06.007 |
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目的：分析腰骶关节紊乱患者有限元模型及施加弯腰挺立手法后的位移、应力及作用机制。
方法：建立1例腰骶关节紊乱患者的三维有限模型，运用有限元分析方法对模型进行轴向、34°斜向上、垂直向上3种工况加载进行观察分析。
结果：腰骶关节紊乱模型应力分布，L5椎体集中在下终板中央、椎间盘集中在间盘中央，S1及相关结构应力集中分布在椎体前后缘。模拟手法后应力主要集中在L5椎体上终板前缘、后缘和下终板中央圆形区域，椎体后部相关结构集中在椎弓根腹侧、峡部和椎板背侧，椎间盘应力分散于椎体后缘；S1椎体相关结构集中在骶骨椎体后缘和骶骨嵴上。位移结果：腰骶关节紊乱模型中左侧横突、上下关节突和棘突左侧部分向左明显移位，椎间盘向前突出移位。模拟手法后：L5椎体下切迹向前上方移位，椎间孔面积增大，L5椎体下关节突向前移行，骶骨上关节突向前下方移位，关节突关节距离加大，骶骨位移最大集中在椎体后缘和骶正中嵴上。
结论：腰骶关节建模成功可进行有限元分析；弯腰挺立手法作用机制明确，用于治疗腰骶关节紊乱有效、安全可施。 |
| [关键词]:腰骶部 脊柱关节紊乱 手法 骨科 有限元分析 |
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| Finite element analysis of bending and standing manipulation in the treatment of lumbosacral joint disorder |
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Abstract:
Objective:To analyze the displacement,stress and mechanism of lumbosacral joint disorder patients after bending and standing manipulation in the finite element model.
Methods:A three-dimensional finite element model of a patient with lumbosacral joint disorder was established. The finite element analysis method was used to observe and analyze the three loading conditions of the model:axial,34 degree inclined upward and vertical upward.
Results:In the lumbosacral joint disorder model,the L5 vertebral body was concentrated in the middle of the lower endplate,the intervertebral disc was concentrated in the center of the intervertebral disc,and the stress of S1 and related structures were concentrated in the anterior and posterior edges of the vertebral body. After simulated manipulation,stress mainly concentrated in the anterior,posterior and central circular areas of L5 vertebral upper endplate. The posterior structures of vertebral body concentrated in the ventral part of pedicle,isthmus and dorsal part of lamina. The stress of intervertebral disc dispersed in the posterior edge of vertebral body. Displacement results:In the lumbosacral joint disorder model,the left transverse process,the upper and lower articular process and the left part of spinous process were significantly displaced to the left,and the intervertebral disc was protruded forward. After simulated manipulation,the lower notch of L5 vertebral body moved forward and upward; the area of intervertebral foramen increased;the inferior articular process of L5 vertebral body moved forward;the superior articular process of sacrum moved forward and downward;the distance of articular process joints increased;and the displacement of sacrum concentrated on the posterior edge of vertebral body and the median sacral crest.
Conclusion:Successful lumbosacral joint modeling can be carried out by finite element analysis,and the mechanism of bending and erecting manipulation is clear,which is effective and safe for the treatment of lumbosacral joint disorders. |
| KEYWORDS:Lumbosacral region Spondyloarthropathy Manipulation orthopedic Finite element analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王林,黄发森,孙长贺,殷京,张清.弯腰挺立手法治疗腰骶关节紊乱的有限元分析[J].中国骨伤,2019,32(6):519~523 |
| 英文格式: | WANG Lin,HUANG Fa-sen,SUN Chang-he,YIN Jing,ZHANG Qing.Finite element analysis of bending and standing manipulation in the treatment of lumbosacral joint disorder[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(6):519~523 |
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