摘要
目的利用三维有限元法评估腰椎经皮内镜下不同的关节突成形部位对椎间盘力学的影响。方法建立正常的L_(3~5)三维有限元模型,模拟腰椎经皮内镜技术分别在L_5上关节突"尖部"或"基底部"做直径7.5mm的圆柱状骨切除以模拟椎间孔成形,从而获得正常L_(3~5)模型、关节突尖部成形模型和关节突基底部成形模型3种模型。给予特定加载条件,比较3种模型在前屈、后伸、左右侧曲、左右旋转工况下L_(4/5)、L_(3/4)椎间盘应力变化情况。结果 L_5上关节突尖部成形后在左右旋转及后伸状态下L_(4/5)椎间盘的最大应力均较正常明显增大,以后伸状态最为明显;L_5上关节突基底部成形后在左右旋转状态下L_(4/5)椎间盘的最大应力较正常稍增大。L_5上关节突尖部、基底部成形后在6种不同运动状态下均对临近节段L_(3/4)椎间盘的应力变化影响均较小。结论腰椎经皮内镜技术下,L_5上关节突尖部成形较基底部成形对L_(4/5)椎间盘的生物力学影响较大。L_5上关节突成型对临近节段L_(3/4)椎间盘的应力变化的影响较小。
Objective To evaluate the influence of facet joint arthroplasty of different parts under lumber percutaneous on adjacent segment disc by using three-dimensional finite element method.Methods Established a normal 3D finite element mode of L3-5,simulate lumbar percutaneous endoscopy by doing cylindrical excision of bone whose diameter was 7.5 mm on the tip and basal part of L5 facet joint respectively so that obtained three models,the first one was normal lumbar vertebra mode,the second one was the tip of the facet joint was shaped,the third one was the basal part of the facet joint was shaped.Compared the stress of intervertebral disc of L3/4 and L4/5 when they were in the states of flexion,extension,left and right lateral flexion,left and right rotation on specific loading conditions.Results When the second model of which the L5 facet joint tip was shaped was in the states of extension,left rotation and right rotation,the stress of the intervertebral disc of L4/5 were more bigger than normal model,especially in the states of extension.When the third model of which the L5 facet joint basal part was shaped in the states of left and right rotation,the biggest stress of the intervertebral disc of L4/5 was increased slightly.However,the model of L5 facet joint tip or basal was shaped,the influence on the stress of the intervertebral disc of L3/4 was small,when the model was in the six states.Conclusion There would be more biomechanical influence on the intervertebral disc of L4/5 when the tip of L5 facet joint is shaped than the basal of the L5 facet joint is shaped under lumber percutaneous endoscopy.And the influence of L5 facet joint arthroplasty on the stress of intervertebral disc of L3/4 is small.
作者
余洋
樊效鸿
顾党伟
吴卫东
YU Yang;FAN Xiaohong;GU Dangwei;WU Weidong(Department of Orthopaedics,the Affiliated Hospital of Chengdu University of T.C.M,Chengdu,Sichuan 610075,China;Chengdu University of T.C.M,Chengdu,Sichuan 610075,China;Guangdong Key Laboratory of Biomechanics,Southern Medical University,Guangzhou,Guangdong 510515,China)
出处
《重庆医学》
CAS
2019年第1期120-123,共4页
Chongqing medicine
基金
四川省医学会重点课题(S17024)
关键词
腰椎经皮内镜
关节突成型
三维有限元
lumbar percutaneous endoscopy
arthroplasty
three-dimensional finite element
