CAJ | 학술논문

背景:近年来随着对脊柱生物力学研究的深入,人工椎间盘被认为是治疗腰椎退行性变较理想的方法,但目前对人工腰椎间盘的生物力学研究还非常有限.目的:建立腰椎运动节段人工椎间盘置换的三维有限元模型并进行生物力学分析,观察人工椎间盘置换对腰椎小关节应力的影响.方法:在已建立的正常腰椎运动节段三维有限元模型的基础上去除L4～5椎间盘、上下终板的有限元单元,加入SB-Chaite Ⅲ型人工椎间盘的有限元模型,保留L4～5椎间隙的纤维环及相关韧带,形成L4～5运动节段人工椎间盘置换的三维有限元模型.对三维有限元模型在垂直压缩、前屈、后伸、侧弯等不同载荷下进行生物力学分析,记录小关节的应力,并与正常运动节段三维有限元模型相应部位的应力进行对比.结果与结论:生物力学分析结果显示,人工椎间盘置换后:①垂直压缩时上下椎体、双侧小关节内应力与正常节段相比差异无显著性意义(P > 0.01).②前屈、后伸时上下椎体前、后方及双侧小关节内应力与正常节段相比差异无显著性意义(P > 0.01).③侧弯时上下椎体左右两侧及双侧小关节内应力与正常节段相比差异无显著性意义(P > 0.01).提示人工腰椎间盘置换后小关节应力可保持在正常运动节段的水平,人工腰椎间盘置换可以达到腰椎生物力学性能重建的目的.
배경:근년래수착대척주생물역학연구적심입,인공추간반피인위시치료요추퇴행성변교이상적방법,단목전대인공요추간반적생물역학연구환비상유한.목적:건립요추운동절단인공추간반치환적삼유유한원모형병진행생물역학분석,관찰인공추간반치환대요추소관절응력적영향.방법:재이건립적정상요추운동절단삼유유한원모형적기출상거제L4～5추간반、상하종판적유한원단원,가입SB-Chaite Ⅲ형인공추간반적유한원모형,보류L4～5추간극적섬유배급상관인대,형성L4～5운동절단인공추간반치환적삼유유한원모형.대삼유유한원모형재수직압축、전굴、후신、측만등불동재하하진행생물역학분석,기록소관절적응력,병여정상운동절단삼유유한원모형상응부위적응력진행대비.결과여결론:생물역학분석결과현시,인공추간반치환후:①수직압축시상하추체、쌍측소관절내응력여정상절단상비차이무현저성의의(P > 0.01).②전굴、후신시상하추체전、후방급쌍측소관절내응력여정상절단상비차이무현저성의의(P > 0.01).③측만시상하추체좌우량측급쌍측소관절내응력여정상절단상비차이무현저성의의(P > 0.01).제시인공요추간반치환후소관절응력가보지재정상운동절단적수평,인공요추간반치환가이체도요추생물역학성능중건적목적.
BACKGROUND: With deepening of spinal biomechanics, artificial lumbar disc replacement is considered to be the optimal choice for treating degenerative lumbar disease. However, studies concerning biomechanics of artificial lumbar disc are insufficient. OBJECTIVE: To establish the three-dimensional (3-D) finite element model of artificial lumbar disc replacement and to explore the effects of artificial lumbar disc replacement on zygapophyseal joints using biomechanical analysis. METHODS: Based on normal 3-D finite element model of lumbar motion segment, L4-5 intervertebral disc, superior and inferior endplates were removed, and then, the model of SB-Charite Ⅲ disc prosthesis was added, which remained annular fibrosus and ligaments at L4-5 intervertebral space. Thus, 3-D finite element model of L4-5 segments artificial lumbar disc replacement was constructed. Biomechanical analysis of this model was processed under axial load, forward flexion, lateral bending or posterior extension moments. The stress data were contrasted with the normal 3-D finite element model of artificial disc replacement. RESULTS AND CONCLUSION: After artificial lumbar disc replacement, the data of biomechanical analysis indicated: ①There was no significant differences between the zygapophyseal joint and normal segment of stress under axial load (P > 0.01). ②Compared with normal segment, the stress of anterior, posterior of upper and lower vertebral body and bilateral zygapophyseal joint had no obviously difference under forward flexion and posterior extension moments (P > 0.01). ③The stress differences between the both sides of upper and lower vertebral body and bilateral zygapophyseal joint were not significant under lateral bending moment (P > 0.01). Artificial lumbar disc replacement can keep the stress of motion segment at normal level, which can meet the needs of spinal functional reestablishment.