CAJ | 학술논문

背景：随着颈椎后路手术技术的日益完善，侧块螺钉内固定技术已被广泛应用于颈椎的重建稳定性手术之中。然而，当前对于侧块螺钉内固定系统重建颈椎稳定性的有限元研究却很少。目的：建立精细下颈椎(C 3-C 7)及三节段全椎板切除后应用侧块螺钉内固定重建的三维有限元模型，对重建后的下颈椎及内固定进行生物力学分析。方法：采集1例30岁正常女性志愿者行全颈椎CT，得到Dicom数据集。应用Mimics 10.01、Geomagic Studio12.0、Solidworks2012、HyperMesh10.1、Abaqus 6.12软件建立下颈椎(C 3-C7)完整模型、全椎板切除模型以及侧块螺钉内固定系统重建模型。分析重建模型在前屈、后伸、侧弯和旋转运动状态下的应力变化情况。结果与结论：所建下颈椎有限元模型结构精细，外形逼真，共包含503911个四面体单元，93390个节点，并通过有效性验证。在软件中完成模拟手术过程，最终得到侧块螺钉内固定重建模型。侧块螺钉内固定系统对全椎板切除模型具有良好的稳定性，重建后颈椎的活动度远低于完整模型，且后伸时侧块螺钉内固定系统的应力最为集中。
배경：수착경추후로수술기술적일익완선，측괴라정내고정기술이피엄범응용우경추적중건은정성수술지중。연이，당전대우측괴라정내고정계통중건경추은정성적유한원연구각흔소。목적：건립정세하경추(C 3-C 7)급삼절단전추판절제후응용측괴라정내고정중건적삼유유한원모형，대중건후적하경추급내고정진행생물역학분석。방법：채집1례30세정상녀성지원자행전경추CT，득도Dicom수거집。응용Mimics 10.01、Geomagic Studio12.0、Solidworks2012、HyperMesh10.1、Abaqus 6.12연건건립하경추(C 3-C7)완정모형、전추판절제모형이급측괴라정내고정계통중건모형。분석중건모형재전굴、후신、측만화선전운동상태하적응력변화정황。결과여결론：소건하경추유한원모형결구정세，외형핍진，공포함503911개사면체단원，93390개절점，병통과유효성험증。재연건중완성모의수술과정，최종득도측괴라정내고정중건모형。측괴라정내고정계통대전추판절제모형구유량호적은정성，중건후경추적활동도원저우완정모형，차후신시측괴라정내고정계통적응력최위집중。
BACKGROUND:With the improvement of cervical posterior surgical techniques, lateral mass screw fixation technology has been widely used in the reconstruction surgery of the cervical spine for stability. However, currently, the finite element study on the lateral mass screw fixation reconstruction of the cervical spine is rare. OBJECTIVE:To establish a fine normal lower cervical spine (C3-C7 ) three-dimensional finite element model and a reconstructed finite element model with three-segment laminectomy with lateral mass screw fixation. Then, to do an initial biomechanical analysis of the lateral mass screw fixation reconstructed lower cervical finite element model. METHODS:We col ected a normal female volunteer aged 30 years old to do CT scan for the whole cervical spine. The Dicom data were obtained. Then, the CT scanning images were dealt with software Mimics 10.01, Geomagic Studio 12.0, Solidworks2012, HyperMesh 10.1 and Abaqus 6.12 software to build the normal lower cervical spine (C 3-C7 ) finite element model, the laminectomy finite element model and the rebuilt finite element model. At last, we analyzed the stress changes of reconstructed models under the state of flexion, extension, lateral bending and rotational motion. RESULTS AND CONCLUSION:The lower cervical spine finite element model contained 503 911 elements and 93 390 nodes with a fine realistic appearance. It successful y passed the validation. The surgical procedure was completed in the software, and the lateral mass screw fixation reconstruction finite element model has been established. Lateral mass screw fixation system provides good stability for the postoperative finite element model. The activity of rebuilt finite element model is much lower than the normal finite element model. In the extension condition, the stress of lateral mass screw fixation system becomes strong.