中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2015年
13期
978-982
,共5页
赵庆华%李吉鹏%张永兴%梁鹤%王雪鹏%晏鹏%吴小峰
趙慶華%李吉鵬%張永興%樑鶴%王雪鵬%晏鵬%吳小峰
조경화%리길붕%장영흥%량학%왕설붕%안붕%오소봉
脊椎肿瘤%成像,三维%有限元分析
脊椎腫瘤%成像,三維%有限元分析
척추종류%성상,삼유%유한원분석
Spinal neoplasms%Imaging,three-dimensional%Finite element analysis
目的 评价颈胸段骨肿瘤全脊椎切除术后单纯后路固定模型与后路内固定联合前路钢板固定模型两种固定方法的稳定性与应力传导情况.方法 采用CT图像和Mimics软件建立C5～T2椎体三维模型,模拟C7全脊椎切除术,并分别构建单纯后路固定与后路联合前路内固定模型,将模型导入ANSYS有限元分析系统,施加20N的分布载荷(模拟人体自重)及中性点施加1N·m力矩,模拟前屈、后伸、左,右侧弯、左,右旋转等运动模式下的椎体位移,应力传导及钛网应力分布等情况.结果 两种固定模式的相邻椎体位移均小于完整椎体模型,稳定性更佳,两种固定模式之间无明显差异;由于无钢板的应力遮蔽,单纯后路固定模型钛网应力传导效果优于后路联合前路内固定模型,更有利于植骨融合.结论 颈胸段肿瘤全脊椎切除术后两种内固定模式均能达到即可的稳定性,而单纯后路长节段固定具有更好的应力传导效果,因此,单纯后路固定在术后重建中更具优势.
目的 評價頸胸段骨腫瘤全脊椎切除術後單純後路固定模型與後路內固定聯閤前路鋼闆固定模型兩種固定方法的穩定性與應力傳導情況.方法 採用CT圖像和Mimics軟件建立C5～T2椎體三維模型,模擬C7全脊椎切除術,併分彆構建單純後路固定與後路聯閤前路內固定模型,將模型導入ANSYS有限元分析繫統,施加20N的分佈載荷(模擬人體自重)及中性點施加1N·m力矩,模擬前屈、後伸、左,右側彎、左,右鏇轉等運動模式下的椎體位移,應力傳導及鈦網應力分佈等情況.結果 兩種固定模式的相鄰椎體位移均小于完整椎體模型,穩定性更佳,兩種固定模式之間無明顯差異;由于無鋼闆的應力遮蔽,單純後路固定模型鈦網應力傳導效果優于後路聯閤前路內固定模型,更有利于植骨融閤.結論 頸胸段腫瘤全脊椎切除術後兩種內固定模式均能達到即可的穩定性,而單純後路長節段固定具有更好的應力傳導效果,因此,單純後路固定在術後重建中更具優勢.
목적 평개경흉단골종류전척추절제술후단순후로고정모형여후로내고정연합전로강판고정모형량충고정방법적은정성여응력전도정황.방법 채용CT도상화Mimics연건건립C5～T2추체삼유모형,모의C7전척추절제술,병분별구건단순후로고정여후로연합전로내고정모형,장모형도입ANSYS유한원분석계통,시가20N적분포재하(모의인체자중)급중성점시가1N·m력구,모의전굴、후신、좌,우측만、좌,우선전등운동모식하적추체위이,응력전도급태망응력분포등정황.결과 량충고정모식적상린추체위이균소우완정추체모형,은정성경가,량충고정모식지간무명현차이;유우무강판적응력차폐,단순후로고정모형태망응력전도효과우우후로연합전로내고정모형,경유리우식골융합.결론 경흉단종류전척추절제술후량충내고정모식균능체도즉가적은정성,이단순후로장절단고정구유경호적응력전도효과,인차,단순후로고정재술후중건중경구우세.
Objective To employ three-dimensional finite element modeling and biomechanical simulation for evaluating the stability and stress conduction of two postoperative internal fixed modelingmultilevel posterior instrumentation (MPI) and MPI with anterior instrumentation (MPAI) with neckthoracic vertebral tumor en bloc resection.Methods Mimics software and computed tomography (CT) images were used to establish the three-dimensional (3D) model of vertebrae C5-T2 and simulated the C7 en bloc vertebral resection for MPI and MPAI modeling.Then the statistics and images were transmitted into the ANSYS finite element system and 20N distribution load (simulating body weight) and applied 1N · m torque on neutral point for simulating vertebral displacement and stress conduction and distribution of motion mode,i.e.flexion,extension,bending and rotating.Results With a better stability,the displacement of two adjacent vertebral bodies of MPI and MPAI modeling was less than that of complete vertebral modeling.No significant differences existed between each other.But as for stress shielding effect reduction,MPI was slightly better than MPAI.Conclusion From biomechanical point of view,two internal instrumentations with neck-thoracic tumor en bloc resection may achieve an excellent stability with no significant differences.But with better stress conduction,MPI is more advantageous in postoperative reconstruction.
