CAJ | 학술논문

目的：建立微创经椎间孔腰椎融合的有限元模型，通过比较不同固定方式的生物力学特性，来探讨最适宜的固定融合方式。方法分别建立以下融合固定模型：单枚融合器＋双侧椎弓根钉（A型）；双枚融合器＋双侧椎弓根钉（B型）；单枚融合器＋单侧椎弓根钉（C型）；双枚融合器＋单侧椎弓根钉（D型）。对各模型进行前屈、后伸、左屈、右屈、左旋、右旋、轴压加载，比较各模型的角位移、椎弓根钉及融合器的所受应力情况。结果各融合固定模型在不同工况下椎弓根钉及融合器所受应力的Von Mises峰值各有差异，但均在最大受力范围之内。各工况下四种模型角位移均较有限元模型减少，A/B型、C/D型相比角位移减少程度相当，而单侧椎弓根钉固定时脊柱稳定性较双侧椎弓根钉固定差。结论建立了不同固定方式的腰椎融合模型，验证了在微创经椎间孔腰椎融合术中使用单侧椎弓根螺钉加单枚融合器置入可提供适当的稳定，可以作为微创经椎间孔腰椎间融合术的固定方法选择。
목적：건립미창경추간공요추융합적유한원모형，통과비교불동고정방식적생물역학특성，래탐토최괄의적고정융합방식。방법분별건립이하융합고정모형：단매융합기＋쌍측추궁근정（A형）；쌍매융합기＋쌍측추궁근정（B형）；단매융합기＋단측추궁근정（C형）；쌍매융합기＋단측추궁근정（D형）。대각모형진행전굴、후신、좌굴、우굴、좌선、우선、축압가재，비교각모형적각위이、추궁근정급융합기적소수응력정황。결과각융합고정모형재불동공황하추궁근정급융합기소수응력적Von Mises봉치각유차이，단균재최대수력범위지내。각공황하사충모형각위이균교유한원모형감소，A/B형、C/D형상비각위이감소정도상당，이단측추궁근정고정시척주은정성교쌍측추궁근정고정차。결론건립료불동고정방식적요추융합모형，험증료재미창경추간공요추융합술중사용단측추궁근라정가단매융합기치입가제공괄당적은정，가이작위미창경추간공요추간융합술적고정방법선택。
Objective To develop and validate three-dimensional finite element models of transforaminal lumbar interbody fu-sion,and explore the most appropriate method of fixation and fusion by comparing biomechanical characteristics of fixation method . Methods Developing four fusion models:bilateral pedicle screws fixation with a single cage insertion model ( A);bilateral pedicle screws fixation with two cages insertion model ( B);unilateral pedicle screws fixation with a single cage insertion model ( C);unilateral pedicle screws fixation with two cages insertion model ( D) ,the models were subjected to different forces including axial compressive ,an-terior bending ,posterior extension ,left bending and rotation .The von Mises stress of the fusion segments on the pedicle screw and cages were recorded .Results There were differences in Von Mises peak stress between four models ,but were within the range of maximum force.The angular variation in A ,B,C and D decreased significantly compared with normal .There was no significant differences in angu-lar variation between A and B ,C and D.Bilateral pedicle screws fixation had more superior biomechanics than unilateral pedicle screws fixation.Conclusion The lumbar interbody fusion models were established using varying fixation methods ,and the results verified that unilateral pedicle screws fixation with a single cage could meet the demand in transforaminal single segment interbody fusion .