CAJ | 학술논문

　　背景：脊柱在结构、形状、材料特性以及承受载荷方面都比较复杂，传统的生物力学方法不能完全解决这些特性问题。目的：探讨退变性脊柱侧弯椎间盘、关节突关节、椎体等的应力分布，为其发生、发展的生物力学机制提供依据。方法：基于退变性脊柱侧弯患者T12-S1上段连续的CT扫描图像，赋予模型特定的材料属性，建立完整、有效的退变性脊柱侧弯三维有限元模型。在前屈、后伸、左侧弯、右侧弯、左旋转、右旋转6种工况下对模型进行加载，计算和分析脊柱的活动度、椎间盘、椎体及关节突关节软骨的应力分布。结果与结论：退变性脊柱侧弯有限元模型比正常腰椎的活动度要小，椎间盘应力分布趋向于椎间盘的四周，后伸运动时各椎间盘应力最大，侧弯顶点椎体容易出现应力集中的情况，在旋转工况下关节突软骨的应力集中最明显，后伸工况下次之，尤其以侧弯顶点节段的关节突软骨影响最大。退变性脊柱侧弯侧弯顶点容易出现应力集中，后伸、旋转运动可加重退变性脊柱侧弯发展。
　　배경：척주재결구、형상、재료특성이급승수재하방면도비교복잡，전통적생물역학방법불능완전해결저사특성문제。목적：탐토퇴변성척주측만추간반、관절돌관절、추체등적응력분포，위기발생、발전적생물역학궤제제공의거。방법：기우퇴변성척주측만환자T12-S1상단련속적CT소묘도상，부여모형특정적재료속성，건립완정、유효적퇴변성척주측만삼유유한원모형。재전굴、후신、좌측만、우측만、좌선전、우선전6충공황하대모형진행가재，계산화분석척주적활동도、추간반、추체급관절돌관절연골적응력분포。결과여결론：퇴변성척주측만유한원모형비정상요추적활동도요소，추간반응력분포추향우추간반적사주，후신운동시각추간반응력최대，측만정점추체용역출현응력집중적정황，재선전공황하관절돌연골적응력집중최명현，후신공황하차지，우기이측만정점절단적관절돌연골영향최대。퇴변성척주측만측만정점용역출현응력집중，후신、선전운동가가중퇴변성척주측만발전。
BACKGROUND:Spine is relatively complex in structure, shape, material properties, and load bearing. The traditional biomechanical method cannot solve these problems. OBJECTIVE:To investigate the stress distribution of intervertebral disc, zygapophysial joints and vertebral body of degenerative scoliosis, and to provide accordance to the biomechanical mechanism of degenerative scoliosis occurrence and development. METHODS:Based on the successive CT images of spinal column from T12 to superior segment of S1 of degenerative scoliosis patients, the special material properties were attributed to the model to form the integrated and effective three-dimensional finite element model of degenerative scoliosis. The model was loaded on the anteflexion, extension, left lateral bending, right lateral bending, left rotation and right rotation conditons. Then the spinal activity and the stress distribution of intervertebral disc, vertebral body and articular cartilage of zygapophysial joints were calculated and analyzed. RESULTS AND CONCLUSION:The spinal activities of degenerative scoliosis finite element model were less than those of common lumbar spine. The stress distribution of intervertebral disc was inclined to the verge of it and the greatest stress was appeared on the extension motion. The apex of scoliosis was the place of stress concentration and the obvious stress concentration of articular cartilage of zygapophysial joints was appeared on the rotation motion, then fol owed by the extension motion, especial y that of articular cartilage of zygapophysial joints on the apex of scoliosis. Stress concentration is easily appeared on the apex of scoliosis, and the extension and rotation motion can aggravate the development of degenerative scoliosis.