有限元法在脊柱结构与腰椎融合生物力学评价中的应用.pdf

中文摘要 中文摘要 目的：通过建立 L4,5 节段退变性滑脱原位椎间融合椎弓根螺钉内固定和复位椎间融合椎弓根 螺钉内固定的三维有限元模型来比较腰椎滑脱原位融合和复位融合两者在各种载荷下的生物力学 变化及其对腰椎稳定的影响。 材料与方法：根据健康成年男性的下腰椎CT 数据，利用mimics，Catia 和Patran，Marc 等软 件建立起L4，5 的FSU 的三维有限元模型，利用此模型模拟退变性腰椎滑脱；在此基础上建立L4,5 节段原位椎间融合椎弓根螺钉内固定和复位椎间融合椎弓根螺钉内固定模型，分析两模型在各种载 荷下的应力分布特点，并比较异同。 结果：L4，5 节段退变性滑脱原位椎间融合椎弓根螺钉内固定和复位椎间融合椎弓根螺钉内固 定三维有限元模型在前屈后伸侧屈旋转负荷下，该节段各部结构，包括椎体，椎弓根螺钉内固定器 和椎间融合器上的应力变化没有显著差异。两模型都显示椎间融合器和椎弓根螺钉内固定器上分布 的应力最大。 结论：对于退变引起的轻度腰椎滑脱，行原位椎间融合内固定和复位椎间融合内固定后，复位 与否对该节段生物力学没有明显影响。可靠的椎间融合和椎弓根螺钉内固定是融合节段获得稳定的 关键。 关键词: 有限元分析; 腰椎滑脱; 原位椎间融合；复位椎间融合 1 ABSTRACT OBJECTIVE Through developing the three-dimensional nonlinear finite element L4,5 degenerative spondylolisthesis models with in situ interbody fusion and pedicular instrumentation and with reductive interbody fusion and pedicular instrumentation to compare the biomechanical change of the the two models under some loads and its influence on the lumbar instability. MATERIAL AND METHODS Select a heathy adult male volunteer proved having no spinal disease by radiative and clinical examination to scan his lumbar vertebrae by Siemens Somatom Sensation 16 with 0.5mm per layer, and get the data of CT imaging and input the data in DICOM format. Achieve the superficial 3-D imaging and its boundary after the CT image being processed by Materialise Mimics software . The 3-D imaging is processed by Catia CAD software to become a 3-D entity. Make the 3-D entity of L4/5 intervertebral disc according to the measured data. Mesh these 3-D entities by ANSYS 8.1 FEA software. Assign different materials in different mechanical parameters to get a nonlinear 3-D FEA lower lumbar spine model.