髓核摘除术对腰椎生物力学特性影响的有限元研究

中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (1): 89-93.

髓核摘除术对腰椎生物力学特性影响的有限元研究

李海波,　方　杰, 　陈其昕,　李方财,　唐小君

浙江大学医学院附属第二医院骨科, 杭州 310009

收稿日期:2010-04-26 发布日期:2011-01-24
通讯作者: 陈其昕,教授，主任医师，博士生导师，Tel: (0571)87783543，E-mail: zrcqx@zju.edu.cn E-mail:270810472@qq.com
作者简介:李海波（1984-），男，山东淄博人，硕士研究生，主要从事椎间盘及退行性脊柱侧凸力学研究，Tel:(0571)87783543
基金资助:
卫生部科学研究基金重点项目（WKJ 2005-Z-046）

Finite element analysis into the effect of discectomy on lumbar biomechanical characteristics

LI Hai-bo, FANG Jie, CHEN Qi-xin, LI Fang-cai，TANG Xiao-jun

Department of Orthopaedic Surgery, the Second Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310009, China

Received:2010-04-26 Published:2011-01-24

摘要/Abstract

摘要：

目的　采用三维有限元模型分析方法，探讨腰椎间盘突出症髓核摘除术对腰椎生物力学特性的影响。方法采用新型CAD方法精确建立腰椎L4～5活动节段有限元模型，构建正常模型、退变模型、髓核摘除模型和疤痕长入模型分别模拟正常椎间盘、退变椎间盘、髓核摘除后即刻和术后中长期时的椎间盘；并比较其生物力学特征。结果　(1)髓核摘除模型的刚度较退变模型减小，但较正常模型提高；　(2)疤痕长入模型腰椎节段刚度大幅回升并超过退变模型；(3)髓核摘除后即刻小关节突接触力减小，而疤痕长入模型则表现为小关节突接触力增加。结论　腰椎间盘髓核摘除术后即刻对腰椎稳定性和后部结构应力影响较小，而髓核摘除中长期后则可有腰椎运动节段变硬和关节突的应力增加。

关键词: 髓核摘除术, 腰椎, 生物力学特性, 有限元

Abstract:

Objective　To investigate the effects on the lumbar biomechanical characteristics caused by the discectomy in the treatment of the lumbar intervertebral disc protrusion using three-dimensional finite element model analysis methods.　Methods　The new effective CAD methods were adopted to accurately create the L4/5 segment's finite element model and simulate the normal disc, the degenerated disc, the denucleated disc immediately after operation as well as the postoperative disc in a long run; their biomechanical characteristics were also compared.　Results　⑴The stiffness of the denucleated model, compared with the normal one, was reduced; ⑵the stiffness of lumbar segment drastically rose and even surpassed that of the degenerated one due to the fact that the scar tissue has been full into intra-disc cavity.⑶The facet contact force was decreased in discectomy model and the scar growth model was increased.　Conclusion　There is small impact on lumbar stability and posterior structure after discectomy immediately. The lumbar motion segment may stiffen and the stress of articular process may increase after discectomy in a long run.

Key words: Discectomy, Lumbar, Biomechanical Characteristics, Finite Element

中图分类号:

R681.5

李海波, 方　杰, 陈其昕, 李方财, 唐小君. 髓核摘除术对腰椎生物力学特性影响的有限元研究[J]. 中国临床解剖学杂志, 2011, 29(1): 89-93.

LI Hai-Bo, FANG Jie, CHEN Qi-Xin, LI Fang-Cai, TANG Xiao-Jun. Finite element analysis into the effect of discectomy on lumbar biomechanical characteristics[J]. Chinese Journal Of Clinical Anatomy, 2011, 29(1): 89-93.

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