腰椎间盘退变对软骨终板生物力学特性影响的有限元分析
Finite element analysis of lumbar disc degeneration on the biomechanical properties of the cartilage endplate effects
目的 研究腰椎终板不同位点的压应力分布规律，分析腰椎间盘退变对软骨终板压应力的影响。 方法 选取一青壮年男性新鲜尸体的腰椎运动节段标本，螺旋CT机对腰椎运动节段进行连续CT扫描，利用有限元分析方法，建立L4/5运动节段有限元分析模型，在此基础上建立椎间盘退变模型。模拟椎间盘正常状态和椎间盘退变状态，在L4、L5椎体终板上选择具有代表性的结点，分别代表椎体终板正中部、左右侧边缘、后中部和前中部，对上下软骨终板压应力分布进行有限元分析。 结果 椎间盘退变组较正常组的终板压应力均显著增大，上下终板在轴向加载、前屈、后伸、左旋和右旋加载时椎间盘退变组较正常状态时应力分布均显著增大，具有统计学意义（P<0.05）。 结论 腰椎椎间盘退变因素对终板的应力分布有明显影响， 随着椎间盘退变，椎间盘软骨终板应力显著增大。
Objective To study the compressive stress properties of the lumbar endplate distribution of different sites, and analyze the impact of the biomechanical properties of the cartilage endplate lumbar disc degeneration. Methods A lumbar motion segment was obtained from a fresh corpse of young age, which then underwent continuous spiral CT scans to provide data for establishment of L4/5 motion segment finite element analysis model using the finite element method and subsequently for establishment of disc degeneration model. The intervertebral disc degeneration state and normal state were simulated, and nodes were selected on L4, L5 vertebral endplates represent the central area, the left and right margins, and the anterior-central area. Stress distribution was then performed on these areas to using finite element analysis. Results Compared with the normal endplate, stress distribution were significantly increased on the disc degeneration group. Inferior endplate stress distribution in the end plates were significantly increased compared with the normal state when load was imposed in the axis, flexion, extension, left and right rotation (P<0.05). Conclusions The lumbar disc degeneration factors have a significant impact on the stress distribution endplate. Under the state of disc degeneration, endplate cartilage stress significantly increases.
Lumbar / Cartilage endplate / Lumbar disc degeneration / Biomechanics
[1] Jahng TA, Kim YE, Moon KY. Comparison of the biomechanical effect of pedicle-based dynamic stabilization: a study using finite element analysis [J]. Spine J，2013，13(1):85-94.
[2] Schroeder Y, Wilson W, Huyghe JM, et al. Osmoviscoelastic finite element model of the intervertebral disc[J]. Eur Spine J, 2006,15(Suppl 3): 361-371.
[3] Jaumard NV, Welch WC, Winkelstein BA. Spinal facet joint biomechanics and mechanotransduction in normal, injury and degenerative conditions[J]. J Biomech Eng, 2011,133(7): 710.
[4] Wu HS, Chen JH. Clarification of the mechanical behavior of spinal motion segments through a three-dimensional poroelastic mixed finite element model[J]．Med Eng Phys, 1996,18(3):215-224．
[5] Rolander SD．Motion of the lumbar spine with special reference to the stabilizing effect of posterior fusion. An experimental study on autopsy specimens[J]. Acta Orthop Scand, 1966, 90(Suppl):1-144.
[6] Shah JS, Coggins J, Rogers R, et al. Surface strain distribution in isolated single lumbar vertebrae[J].Ann Rheum Dis,1976, 35(1): 51-55.
[7] Nachemson A．Lumbar intradiscal pressure. Experimental studies on post-mortem material [J]．Acta Orthop Scand，1960, 43(Suppl):1-104．
[8] Caspar W. Anterio cervical fusion and interbody stabilization with the trapezial osteosynthetic plate technique [M]. AESCULAP Scientific Information Booklet, 1986.
[9] Mizrahi J, Silva MJ, Keaveny TM, et al. Finite-element stress analysis of the normal and osteoporotic lumbar vertebral body [J]. Spine (Phila Pa 1976) ,1993,18(14):2088-2096.
[10] Edwards WT, Zheng Y, Ferrara LA, et al. Structural features and thickness of the vertebral cortexin the thoracolumbar spine [J]. Spine (Phila Pa 1976), 2001, 26(2):218-225.
[11] Lim TH, Kwon H, Jeon CH, et al. Effect of endplate conditions and bone mineral density on the compressive strength of the graft-endplate interface in anterior cervical spine fusion[J]. Spine (Phila Pa 1976), 2001,26(8):951-956.
[12] Oxland TR, Grant JP, Dvorak MF, et al. Effects of endplate removal on thestructural properties of the lower lumbar vertebral bodies[J]. Spine (Phila Pa 1976), 2003, 28(8)：771-777.
[13]Pearcy MJ, Evans JH, O’Brien JP. The load bearing capacity of vertebral cancellous bone in interbody fusion of the lumbar spine [J]. Engineering in Medicine, 1983,12(4): 183-185.
[14] Grant JP, Oxland TR, Dvorak MF. Mapping the structural properties of the lumbosacral vertebral endplates[J]. Spine (Phila Pa 1976), 2001, 26(8):889-896.
[15]Choi KC, Ryu KS, Lee SH, et al. Biomechanical comparison of anterior lumbar interbody fusion: stand-alone interbody cage versus interbody cage with pedicle screw fixation -- a finite element analysis [J]. BMC Musculoskelet Disord, 2013, 26(14):220.
[16] Guehring T, Unglaub F, Lorenz H, et al. Intradiscal pressure measurements in normal discs, compressed discs and compressed discs treated with axial posterior disc distraction: an experimental study on the rabbit lumbar spine model [J]. Eur Spine J, 2006,15(5):597–604.
[17] Schmidt H, Midderhoff S, Adkins K, et al. The effect of different design concepts in lumbar total disc arthroplasty on the range of motion, facet joint forces and instantaneous center of rotation of a L4/5 segment [J]. Eur Spine J, 2009,18(11):1695-1705.
[18] Tang S, Rebholz BJ. Does anterior lumbar interbody fusion promote adjacent degeneration in degenerative disc disease? A finite element study [J]. J Orthop Sci, 2011,16(2):221-228.
[19]Shan Z, Fan S, Xie Q, et al. Spontaneous resorption of lumbar disc herniation is less likely when modic changes are present [J]. Spine (Phila Pa 1976), 2014, 39(4):736-744.
[20] Rätsep T, Minajeva A, Asser T. Relationship between neovascularization and degenerative changes in herniated lumbar intervertebral discs [J]. Eur Spine J, 2013, 22(11):2474-2480.
教育部青年教师基金（20114433120003）；广东省科技计划项目（2012B010200024）；广东省自然科学基金（S2013010014253）；广州市“珠江科技新星”人才培育计划（2012027）
京ICP备08002354号-3/
| 〈 |
|
〉 |
