三维有限元对新型钉尾横连在后路寰枢椎内固定中的力学稳定性评价#br#

doi:10.13418/j.issn.1001-165x.2023.6.16

摘要/Abstract

摘要： 目的利用三维有限元分析探讨不同连接模式的新型钉尾横连(horizontal screw-screw crosslink，hS-S CL)在寰-枢椎椎弓根钉棒内固定（C1-C2 pedicle screw-rod fixation，C1-C2 PSR）中生物力学特性，为临床选择最佳模式hS-S CL提供理论基础。方法分别建立寰枢椎有限元模型：正常组为A组，失稳组为B组，B组+C1-C2 PSR为C组，C组+新型钉尾横连（C1-C2 PSR+hS-S CL）包括：上横连（两寰椎螺钉钉尾）为D组、下横连（两枢椎螺钉钉尾）E组、斜形横连（左上右下为F组，左下右上为G组）、交叉横连H组。对各个有限元模型加载 1.5 N/m 的扭矩，计算出正常组、失稳组、六种内固定组在屈伸、侧屈、旋转的活动度及横连应力峰值，并提取内固定应力云图。结果 ①在6种工况下，正常组和内固定组的ROM较失稳组均明显降低；在屈伸状态下：全部内固定组的ROM基本一致，在侧屈和旋转状态下：D-H组ROM较无横连C组分别减少34%~44%和79%，36%~46%和76%~80%，39%~47%和78%~79%，40%~46%和78%~79%，49%~50%和91%~93%其中H组ROM在旋转状态减少最为明显。②内植物模型应力峰值：钉尾横连组最大应力总体上小于无横连组，所有内固定组在后伸时应力峰值最小。③内植物的应力云图显示：横连组应力分布区域基本一致，未出现明显的应力集中现象，应力分布区域为螺钉根部与骨质结合部，横连两端与螺钉尾槽结合部。结论交叉模式的新型钉尾横连在后路寰枢椎钉棒内固定具有最强的抗旋转稳定性，但横连两端的应力分布明显，该部位可能易发生横连的断裂。

关键词: 横连, , , 后路, , , 寰枢椎, , , 三维有限元

Abstract: Objective To explore the biomechanical characteristics of different modes of new horizontal screw-screw crosslink (hS-S CL) in C1-C2 pedicle screw-rod fixation (C1-C2 PSR) by three-dimensional finite element, which provided theoretical basis for clinical selection of the optimal hS-S CL. Methods The atlantoaxial finite element models were established respectively: the normal group was group A , the unstable group was group B, C1-C2PSR group was C, C1-C2PSR+ upper/lower hS-SCL , C1-C2PSR+ dS-SCL and C1-C2PSR+xS-SCL groups were D-H group respectively. The Range of motion (ROM) and Von Miss Stresses in flexion and extension, lateral flexion and rotation of the normal group, the unstable group and the six kinds of internal fixation groups were calculated by applying 1.5 Nm torque to each finite element model, and the stress cloud was extracted. Results ①Under the 6 working conditions, the ROM in the normal group and the internal fixation group was significantly lower than that in the unstable group. In flexion and extension state: the ROM of all internal fixation groups was basically the same. Under the conditions of lateral flexion and rotation, compared with that in the without crosslink group, the ROM in the D-H group was reduced by 34-44% and 79%, 36-46% and 76-80%, 39-47% and 78-79%, 40-46% and 78-79%, 49-50% and 91-93%, respectively, and the ROM in the H group decreased most obviously in the rotation state. ② The stress peak of internal plant model: the maximum stress of the crosslink group was generally smaller than that of the non-crosslink group, and the stress peak value of all the internal fixation groups was the lowest when the extension was carried out. ③ The stress cloud of internal plants showed that the stress distribution areas of the internal fixation in the crosslink fixation group were basically the same, and there was no obvious stress concentration phenomenon in the internal fixation, and the main stress distribution areas were the screw root and bone joint, and the crosslink ends were the screw tail groove or the joint rod joint. Conclusions The new hS-S CL in posterior C1-C2 pedicle screw-rod fixation has the strongest anti-rotation stability, but the stress distribution at both ends of the transverse connection is obvious, which may be prone to transverse fracture.

Key words: Crosslink, , , Posterior, , , Atlantoaxial, , , Three-dimensional finite element

中图分类号:

R318.01

欧阳北平, 马向阳, 罗春山, 邹小宝, 陆廷盛, 陈啟鸰. 三维有限元对新型钉尾横连在后路寰枢椎内固定中的力学稳定性评价#br#[J]. 中国临床解剖学杂志, 2023, 41(6): 721-727.

Ouyang Beiping, Ma Xiangyang, Luo Chunshan, Zou Xiaobao, Lu Tingsheng, Chen Qiling. Evaluation of mechanical stability of new horizontal screw-screw crosslink in posterior C1-C2 pedicle screw-rod fixation by three-dimensional finite element [J]. Chinese Journal of Clinical Anatomy, 2023, 41(6): 721-727.

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