解剖学报2024,Vol.55Issue(1) :88-97.DOI:10.16098/j.issn.0529-1356.2024.01.013

切除不同范围钩突后颈椎椎间盘的有限元分析

Finite element analysis of cervical intervertebral discs after removing different ranges of uncinate processes

杨洋 史君 李琨 马渊 张少杰 侯二飞 王超群 陈杰 王星 李志军
解剖学报2024,Vol.55Issue(1) :88-97.DOI:10.16098/j.issn.0529-1356.2024.01.013

切除不同范围钩突后颈椎椎间盘的有限元分析

Finite element analysis of cervical intervertebral discs after removing different ranges of uncinate processes

杨洋 1史君 2李琨 3马渊 4张少杰 3侯二飞 5王超群 6陈杰 5王星 3李志军3
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作者信息

  • 1. 内蒙古医科大学研究生院,呼和浩特 010110
  • 2. 内蒙古医科大学基础医学院生理学教研室,呼和浩特 010110
  • 3. 内蒙古医科大学基础医学院解剖学教研室,呼和浩特 010110;内蒙古医科大学基础医学院数字医学中心,呼和浩特 010059
  • 4. 内蒙古医科大学基础医学院数字医学中心,呼和浩特 010059
  • 5. 内蒙古医科大学基础医学院解剖学教研室,呼和浩特 010110
  • 6. 内蒙古医科大学附属医院影像科,呼和浩特 010050
  • 折叠

摘要

目的 通过建立C0~T1 全颈椎三维有限元模型,探讨切除不同范围钩突后颈椎椎间盘的应力变化特点,为临床手术治疗提供实验依据.方法 对 1 例全颈椎进行CT扫描后建立正常颈椎三维模型,同时设计切除左侧 50%、100%的钩突和切除双侧 100%的钩突模型,加载相同力矩后比较 4 种模型在前屈、后伸、左右侧屈及左右旋转等 6 种工况下的受力变化(应力、位移).结果 随着钩突不同范围的切除,椎间盘应力和位移值集中位于C5/6处,随后渐呈递减趋势.椎间盘在切除左侧C5 钩突 50%后其应力值仅在C5 处存在侧别间差异,但在左侧或双侧切除 100%C5 钩突后其应力值出现了侧别间差异.结论 切除不同范围钩突(50%、100%)后可影响颈椎稳定性,且切除范围越大越影响颈椎稳定性.临床在该区手术切除时应尽可能选择最优原则,以最少切除而达到治疗效果为最佳.

Abstract

Objective To study the stress change characteristics of the cervical disc after removing different ranges of the uncinate process by establishing a three-dimensional finite element model of the C0-T1 whole cervical spine to provide a theoretical basis for clinical and surgical treatment.Methods After a CT scan of one case of the whole cervical spine,we established a three-dimensional model of the normal cervical spine and designed the model to excise 50%and 100%of the uncinate process on the left side and 100%of the uncinate process on both sides at the same time.The four models'stress changes(stress and displacement)were compared after loading the same torque under six working conditions,forward flexion,back extension,left and right lateral flexion,and left and right rotation.Results With the removal of different ranges of the uncinate process,the stress and displacement values of the disc were concentrated at C5/6 and then gradually decreased.Interlateral differences in disc stress values were found only at C5 after removing 50%of the left C5 uncinate process,and interlateral differences were found at all disc stress values after removing 100%of the C5 uncinate process on the left or both sides.Conclusion Removal of different ranges of the uncinate process(50%and 100%)can affect cervical spine stability,and the larger the range of resection is the more it affects cervical spine stability.The best clinical principle is to choose the best possible surgical resection in this area that can achieve the least resection and the best therapeutic effect.

关键词

钩突/椎间盘/钩椎关节/颈椎/有限元/力学变化/解剖学/三维重建/

Key words

Uncinate process/Intervertebral disc/Uncovertebral joint/Cervical spine/Finite element/Mechanical change/Anatomy/Three-dimensional reconstruction/Human

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基金项目

国家自然科学基金(81860382)

国家自然科学基金(81860383)

内蒙古自治区自然科学基金(2020LH08021)

内蒙古自治区自然科学基金(2020MS03061)

内蒙古自治区自然科学基金(2019MS08017)

内蒙古自治区自然科学基金(2019MS08139)

内蒙古自治区高等学校青年科技英才支持计划(NJYT22009)

内蒙古自治区科技计划项目(2019GG158)

内蒙古医科大学科研重点项目(YKD2021ZD011)

内蒙古自治区卫生健康委医疗卫生科技计划项目(202201217)

内蒙古医科大学青年基金(YKD2020QNCX055)

出版年

2024
解剖学报
中国解剖学会

解剖学报

CSTPCD
影响因子:0.462
ISSN:0529-1356
参考文献量7
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