CAJ | 학술논문

目的通过腰椎三维有限元建模方法,研究平面力推拿揉法对腰椎间盘生物力学的影响.方法选取1例女性健康受试者,采用Somatom Sensation16型螺旋CT扫描机采集数据,进行精确三维分割与模型重建,生成正常人体L3～S1节段独立的三维实体模型,结合解剖知识构建肌肉实体模型后,采用专用生物力学软件建立L3～ S1节段腰椎三维有限元,根据推拿揉法的作用规律,按循环旋转方向在L4和L5棘突的外部肌肉处施加平面作用力50 N,观察腰椎间盘纤维环和髓核的变化.结果在推拿揉法的左右摆动作用下,纤维环和髓核在水平方向上产生一定的循环旋转运动,运动的主要趋势是向椎间盘的中部及周边集中,髓核水分也向中部及周边聚集,椎间盘内密度发生变化,中部及周边密度增高.整个模型中骨皮质的应力分布较为均匀,说明推拿揉法的力传递过程在很大程度上依靠腰椎实体肌肉的协同和拮抗作用,L4-5椎间盘的纤维环和髓核应力分布显示椎间盘中部及周边的两侧应力较大.结论在平面力推拿揉法作用下,腰椎纤维环和髓核向椎间盘中部及周边集中,椎间盘中部及两侧的应力较大.
목적 통과요추삼유유한원건모방법,연구평면력추나유법대요추간반생물역학적영향.방법 선취1례녀성건강수시자,채용Somatom Sensation16형라선CT소묘궤채집수거,진행정학삼유분할여모형중건,생성정상인체L3～S1절단독립적삼유실체모형,결합해부지식구건기육실체모형후,채용전용생물역학연건건립L3～ S1절단요추삼유유한원,근거추나유법적작용규률,안순배선전방향재L4화L5극돌적외부기육처시가평면작용력50 N,관찰요추간반섬유배화수핵적변화.결과 재추나유법적좌우파동작용하,섬유배화수핵재수평방향상산생일정적순배선전운동,운동적주요추세시향추간반적중부급주변집중,수핵수분야향중부급주변취집,추간반내밀도발생변화,중부급주변밀도증고.정개모형중골피질적응력분포교위균균,설명추나유법적력전체과정재흔대정도상의고요추실체기육적협동화길항작용,L4-5추간반적섬유배화수핵응력분포현시추간반중부급주변적량측응력교대.결론 재평면력추나유법작용하,요추섬유배화수핵향추간반중부급주변집중,추간반중부급량측적응력교대.
Objective To analyze the impact of plane force kneading on the biomechanics of the lumbar intervertebral discs.Methods A 3D solid model was prepared of the L3 to S1 segments of the spine of a healthy woman volunteer.Data collected using a Somatom Sensation 16 CT scanner and biomechanics software were used to define a 3D finite element model.Based on the regular pattern of kneading in Chinese manipulation,a planar rotatory force of 50 N was applied to the external muscles of the L4 and L5 spinal processes and any changes in the nucleus pulposus and the fibrillar annulus of the lumbar intervertebral discs of the finite element model was observed.Results The planar rotary kneading focused on the center and periphery of the discs.The fluid in the central nucleus pulposus also gathered in the center and periphery,and the disc density increased in the center and periphery.The stress distribution of the cortical bones over the entire model was very uniform,indicating that force transmission during kneading relies on synergistic and antagonistic action of the lumbar muscles.The L4-L5 intervertebral disc nucleus stress distribution showed high stress at the center and both sides of the intervertebral discs.Conclusion Under the action of planar kneading,the nucleus pulposus and the annulus of the lumbar spine gather at the center and periphery of the intervertebral disks,and the center and both sides experience high stress.