肾型n-HA/PA66腰椎间融合器在经椎间孔腰椎椎体间融合术中的有限元分析

王晓峰; 欧云生; 蒋电明; 李开庭; 杨博; 刘渤; 安洪

doi:10.13418/j.issn.1001-165x.2014.01.016

中国临床解剖学杂志 ›› 2014, Vol. 32 ›› Issue (1) : 67-71. DOI: 10.13418/j.issn.1001-165x.2014.01.016

临床生物力学

肾型n-HA/PA66腰椎间融合器在经椎间孔腰椎椎体间融合术中的有限元分析

王晓峰，　欧云生，　蒋电明，　李开庭，　杨博，　刘渤，　安洪

作者信息 +

A kidney-liked n-HA/PA66 cage In transforaminal lumbar interbody fusion: a finite element analysis

WANG Xiao-feng, OU Yun-sheng, JIANG Dian-ming, LI Kai-ting, YANG Bo, LIU Bo, AN Hong

Author information +

文章历史 +

摘要

目的　设计一种新型的“肾形”n-HA/PA66腰椎间融合器(cage)，通过三维有限元分析，研究其在经椎间孔腰椎椎间融合术(TLIF)中的生物力学特性。方法建立正常人体L3-L5节段三维模型，模拟经椎间孔腰椎椎间融合术，采用有限元分析方法进行应力分析，比较肾型与子弹头型n-HA/PA66腰椎间融合器应力分布的差异。结果　在前屈、后伸、左右旋转工况下两种不同cage的TLIF手术模型对比，子弹头型cage最大应力分别为32.8、32.8、31.4、31.3、32.8、34.2 MPa，肾型cage最大应力分别为13.2、11.4、10.9、10.1、11.7、11.1 MPa；而且肾型cage应力集中区域小于子弹头型cage。结论　肾型n-HA/PA66腰椎间融合器固定的椎体应力分布小而均匀，理论上可有效降低cage沉降率。

Abstract

Objective　To design a new “Kidney” like n-HA/PA66 lumbar fusion cage and analyze the biomechanics of this cage in transforaminal lumbar interbody fusion (TLIF) using the method of finite element analysis.　Methods　Develop a normal intact three validated model of L3-L5 lumbar segments, compare the biomechanical difference between new kidney-liked cage and usual bullet-liked cage by simulating the TLIF using finite element analysis.　Results　Compare different TLIF model with the two kinds of cage, the max stress of old cage and new cage was 32.8、32.8、31.4、31.3、32.8、34.2MPa and 13.2、11.4、10.9、10.1、11.7、11.1MPa, separately. And the new cage’s area of stress concentration was smaller than the old cage’s. Conclusion　This brand new cage has good biomechanical stability and reduced stress of the cage-endplate interface. This may reduce the sedimentation rate of cage.

导出引用

王晓峰, 欧云生, 蒋电明, 李开庭, 杨博, 刘渤, 安洪. 肾型n-HA/PA66腰椎间融合器在经椎间孔腰椎椎体间融合术中的有限元分析[J]. 中国临床解剖学杂志. 2014, 32(1): 67-71 https://doi.org/10.13418/j.issn.1001-165x.2014.01.016

WANG Xiao-Feng, OU Yun-Sheng, JIANG Dian-Meng, LI Kai-Ting, YANG Bo, LIU Bo, AN Hong. A kidney-liked n-HA/PA66 cage In transforaminal lumbar interbody fusion: a finite element analysis[J]. Chinese Journal of Clinical Anatomy. 2014, 32(1): 67-71 https://doi.org/10.13418/j.issn.1001-165x.2014.01.016

中图分类号： R687.3

参考文献

[1] 吴兰，李玉宝，杨维虎，等. n-HA/PA66复合材料与人皮质骨的定性和定量对比研究
[J]. 功能材料, 2005,36(6):892-895.

[2] 刘显宏，欧云生，蒋电明，等. n-HA/PA66与PEEK cage在颈前路椎间盘切除减压术后椎间隙重建的比较研究
[J]. 中国临床解剖学杂志, 2012,30(6):687-692.

[3] 欧云生，蒋电明，权正学，等. 纳米羟基磷灰石／聚酰胺66复合生物活性人工椎体在胸腰椎骨折前路重建手术中的应用
[J]. 中国修复重建外科杂志, 2007,21(10):1084-1089.

[4] 欧云生，蒋电明，权正学，等. n-HA/PA66复合生物活性融合器在颈椎病前路减压融合术中的初步应用研究
[J]. 生物医学工程学杂志, 2010,27(2):324-327.

[5] Zhao Z, Jiang D, Ou Y, et al. A hollow cylindrical nano-hydroxyapatite/polymide composite strut for cervical reconstruction after cervical corpectomy
[J]. J Clin Neurosci, 2012,19(4):536-540.

[6] Schmidt H, Heuer F, Simon U, et al. Application of a new calibration method for a three-dimensional finite element model of a human lumbar annulus fibrosus
[J]. Clin Biomech (Bristol, Avon), 2006,21(4): 337-344.

[7] Goel VK, Monroe BT, Gilbertson LG, et al. Interlaminar shear stresses and laminae separation in a disc. Finite element analysis of the L3-L4 motion segment subjected to axial compressive loads
[J]. Spine, 1995,20(6): 689-698.

[8] Salehi SA, Tawk R, Ganju A, et al. Transforaminal lumbar interbody fusion: surgical technique and results in 24 patients
[J]. Neurosurgery, 2004, 54(2):368-374.

[9] Hackenberg L, Halm H, Bullmann V, et al. Transforaminal lumbar interbody fusion: a safe technique with satisfactory three to five year results
[J].Eur Spine J, 2005,14(6):551-558.

[10]Shim CS, Park SW, Lee SH, et al. Biomechanical evaluation of an interspinous stabilizing device, Locker
[J]. Spine, 2008, 33(22): E820-827.

[11]刘曼，孟耀，周立伟，等. 纳米羟基磷灰石/聚酰胺66复合膜的结构及成骨样细胞相容性研究
[J]. 现代口腔医学杂志, 2012, 26(1):3-7.

[12]欧云生，蒋电明，权正学，等. n-HA/PA66复合生物活性人工椎体支撑植骨治疗胸腰椎爆裂型骨折合并截瘫
[J]. 中国临床医学, 2007,14(3):413-415.

[13]Yang X, Song Y, Liu L, et al. Anterior Reconstruction With Nano-hydroxyapatite/polyamide- 66 Cage After Thoracic and Lumbar Corpectomy
[J]. Orthopedics, 2012, 35(1):e66-73.

[14]Fukuta S, Miyamoto K, Hosoe H, et al. Kidney-type intervertebral spacers should be located anteriorly in cantilever transforaminal lumbar interbody fusion: analyses of risk factors for spacer subsidence for a minimum of 2 years
[J]. J Spinal Disord Tech, 2011, 24(3):189-195.

[15]Le TV, Baaj AA, Dakwar E, et al. Subsidence of polyetheretherketone intervertebral cages in minimally invasive lateral retroperitoneal transpsoas lumbar interbody fusion
[J]. Spine, 2012, 37(14):1268-1273.

[16]Evans JH. Biomechanics of lumbar fusion
[J]. Clin Orthop,1985, (193):38-46.