CAJ | 학술논문

目的：建立3种腰椎植骨融合方法（新型腰椎后路植骨融合、后外侧横突间植骨融合，后路椎间植骨融合）的有限元模型，并对比融合邻近节段的压应力变化。方法：螺旋CT扫描后并对图像行预处理，利用Mimics、 HyperMesh及Geomagic Studio 逆向工程软件建立3种植骨融合的有限元模型，并用ABAQUS 有限元处理软件进行有限元运算。结果：腰椎行植骨融合术后，各腰椎整体平均刚度（EF）均升高，椎间植骨模型EF升高最为明显。融合后临近节段间盘应力均有增加，其中上位临近节段后伸及旋转时，椎间植骨模型应力最大，与其余两种模型有统计学意义（P ＜0．05）；前屈时，横突间植骨应力最大，新型植骨应力最小，三者间差异分别有统计学意义（P ＜0．05）；侧屈时，三者间差异无统计学意义（P ＞0．05）。下位临近节段前屈及后伸时，椎间植骨模型应力最大，新型植骨应力最小，三者间差异均有统计学意义（P ＜0．05）；侧屈及旋转时，三者间应力差距较小，均无统计学意义（P ＞0．05）。结论：3种植骨融合术后腰椎的平均 EF 均增大，椎间植骨增大最明显，横突间植骨与新型植骨增大较小。融合术后临近间盘应力均增大，椎间植骨应力最大，新型植骨与横突间植骨较小。
목적：건립3충요추식골융합방법（신형요추후로식골융합、후외측횡돌간식골융합，후로추간식골융합）적유한원모형，병대비융합린근절단적압응력변화。방법：라선CT소묘후병대도상행예처리，이용Mimics、 HyperMesh급Geomagic Studio 역향공정연건건립3충식골융합적유한원모형，병용ABAQUS 유한원처리연건진행유한원운산。결과：요추행식골융합술후，각요추정체평균강도（EF）균승고，추간식골모형EF승고최위명현。융합후림근절단간반응력균유증가，기중상위림근절단후신급선전시，추간식골모형응력최대，여기여량충모형유통계학의의（P ＜0．05）；전굴시，횡돌간식골응력최대，신형식골응력최소，삼자간차이분별유통계학의의（P ＜0．05）；측굴시，삼자간차이무통계학의의（P ＞0．05）。하위림근절단전굴급후신시，추간식골모형응력최대，신형식골응력최소，삼자간차이균유통계학의의（P ＜0．05）；측굴급선전시，삼자간응력차거교소，균무통계학의의（P ＞0．05）。결론：3충식골융합술후요추적평균 EF 균증대，추간식골증대최명현，횡돌간식골여신형식골증대교소。융합술후림근간반응력균증대，추간식골응력최대，신형식골여횡돌간식골교소。
Objective To study the different biomechanics surgical effects of posterolateral fusion , the transverse fusion and the interbody fusion. Method Scan CT was followed with preprocess of images. The Mimics , HyperMesh and Geomagic Studio Reverse engineering softwares were used to establish the modles of lumbar fusion , then the finite element computation was conducted by using the Abaqus finite element software. Result The EF of each lumbar modle was established , the EF of the interbody fusionwas rised evidently. After the fusion , the stress of the adjacent lumbar were also rised, among them the stress of the upper adjacent segment in tnterbody fusion was the most in extension and rotation , with statistical significance ( P < 0 . 05 ) . In the antexion the stress of the transverse fusion was the most, and the new type of posterolateral fusion least, three of them all hadstatistical significance (P<0.05). In the lateral flexion, they had no statistical significance (P>0.05). About the under adjacent sengment, in the extension and antexion, the stress of the interbody fusion was the most, and the new type of posterolateral fusion was the least, the three of them all haved statistical significance (P<0.05, respectively). In the rotation and lateral flexion, with no statistical significance (P>0.05). Conclusion After the fusion, the EF of the lumbar and the stress of the lumbar disc are all established, the interbody fusion is most, while the others are lower.