CAJ | 학술논문

背景：国内应用较广的棘突间动态系统Coflex存在较高的棘突骨折并发症发生率。目的：通过有限元分析，验证改良的Coflex设计中与脊柱棘突的接触中的刚性限制，为半刚性限制，从而减少在脊柱屈伸，侧屈及旋转活动中棘突的受力情况，降低棘突骨折的发生。方法：提取首都医科大学附属北京朝阳医院影像系统中腹部CT扫描患者的图像，建立腰椎三维有限元模型；通过精密仪器测量在CAD软件SolidWorks软件中建立Coflex及改良后的系统模型；在SolidWorks软件中进行棘突模型简化，在ANSYS软件中分析假体模型在拉力、剪切力和轴向旋转力作用下的静态受力情况。结果与结论：在拉力、横向剪切力和旋转力作用下，与Coflex系统相比，改良后的系统中棘突模型应力明显减小(P <0.01)。说明改良后的模型在棘突骨骼受力方面均优于原方案，能够减少在脊柱受力情况下的棘突应力，降低了棘突骨折的发生。
배경：국내응용교엄적극돌간동태계통Coflex존재교고적극돌골절병발증발생솔。목적：통과유한원분석，험증개량적Coflex설계중여척주극돌적접촉중적강성한제，위반강성한제，종이감소재척주굴신，측굴급선전활동중극돌적수력정황，강저극돌골절적발생。방법：제취수도의과대학부속북경조양의원영상계통중복부CT소묘환자적도상，건립요추삼유유한원모형；통과정밀의기측량재CAD연건SolidWorks연건중건립Coflex급개량후적계통모형；재SolidWorks연건중진행극돌모형간화，재ANSYS연건중분석가체모형재랍력、전절력화축향선전력작용하적정태수력정황。결과여결론：재랍력、횡향전절력화선전력작용하，여Coflex계통상비，개량후적계통중극돌모형응력명현감소(P <0.01)。설명개량후적모형재극돌골격수력방면균우우원방안，능구감소재척주수력정황하적극돌응력，강저료극돌골절적발생。
BACKGROUND:The Coflex is widely used in China, but it has a high complication rate of spinous process fracture. OBJECTIVE:With the help of finite element analysis, to verify if rigid restriction of spinous process contacts in modified Coflex design is semi-rigid restriction so as to reduce the stress of spinous process in spine flexion and extension, lateral bending and rotation and to decrease the risk of spinous process fracture. METHODS:The images were extracted from patients who had undergone abdomen CT scans in the Beijing Chaoyang Hospital affiliated to Capital Medical University. Three-dimensional finite element model of lumbar spine was established. The Coflex model and the corresponding modified Coflex model were established and then simplified in the SolidWorks software of CAD. Tensile force, shearing force and axial rotating force in resting state were analyzed in ANSYS software. RESULTS AND CONCLUSION:Under tensile force, transversal shearing force and axial rotating force, compared with Coflex system, the stress of spinous process model was reduced in the modified system (P < 0.01). These findings indicate that the forces of the modified model are superior to the force of Coflex. It can reduce stress in the spinous process under stresses and diminish the occurrence of spinous process fractures.