颈椎人工椎间盘置换有限元分析

中国临床解剖学杂志 ›› 2013, Vol. 31 ›› Issue (3): 328-332.

颈椎人工椎间盘置换有限元分析

徐波¹，　金大地²，　张美超 ³

1.南方医科大学南方医院脊柱骨科，广州 510515；　2. 南方医科大学第三附属医院骨科，广州 510630；
3.南方医科大学广东省医学生物力学重点实验室，广州 510515

收稿日期:2013-02-23 出版日期:2013-05-25 发布日期:2013-06-06
通讯作者: 张美超，副教授，E-mail: zmc@fimmu.com E-mail:xbyyl@fimmu.com
作者简介:徐波（1966-），男，河北省人，博士，副主任医师、副教授，研究方向：长期从事脊柱外科临床工作，主要研究范围为脊柱外科生物力学和临床应用解剖学，Tel：(020)61641728
基金资助:
国家863课题（2012AA02A603）

Finite element analysis of cervical spine following artificial intervertebral disc replacement

XU Bo¹ , JIN Da-di ², ZHANG Mei-chao³

1.Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China; 2. Department of Orthopedics, The Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China; 3.Department of Anatomy, Southern Medical University, Guangzhou 510515, China

Received:2013-02-23 Online:2013-05-25 Published:2013-06-06

摘要/Abstract

摘要：

目的　建立C4~5节段PrestigeTM-LP颈椎人工椎间盘植入后的三维有限元模型，进行手术节段的运动分析。方法采用对成年男性的新鲜尸体的颈椎标本进行CT三维扫描方法建立C4~5节段和PrestigeTM-LP人工间盘有限元，模拟完成C4~5人工椎间盘置换手术。测量生理加载下手术节段前屈/后伸、侧弯及轴向旋转运动角度。结果有限元模型对颈椎的结构，包括椎体间韧带、颈椎关节突关节、钩椎关节等均进行了精确的重建，并较好地模拟手术操作进行PrestigeTM-LP人工间盘植入。运动加载后运动角度，前屈5.7°，后伸3.5°，侧弯5.0°，旋转11.3°，与文献报道结果较为接近。结论　有限元模型具有精确度高，手术模拟真实的特点，可作为颈椎人工椎间盘生物力学研究的一种较好途径。PrestigeTM-LP颈椎人工椎间盘置换可较好地保留手术节段的运动功能。

关键词: 颈椎, 颈椎人工椎间盘, 有限元, 生物力学

Abstract:

Objective　To establish a three-dimensional finite element model of cervical spine C4～5 segment following PrestigeTM-LP artificial intervertebral disc replacement and analyze segmental motions. Methods　The geometry of C4～5 vertebrae was reconstructed from computer tomography (CT) scan images of an adult male human fresh cervical spinal specimen. A FEM of C4~5 vertebrae and PrestigeTM-LP prosthesis was established and simulated clinical operation by using ANSYS10.0 system. Motions of flexion, extension, lateral bending and axial rotation were determined in physiological loading.　Results　Detailed geometries of vertebral bodies were modeled including ligaments, facet joints, and uncovertebral joints. Motions of flexion, extension, lateral bending, axial rotation are 5.7°, 3.5°, 5.0°,11.3°，respectively and conform with what have been reported in the literature.　Conclusions　The FEM possesses a high precision of geometries of vertebral bodies and biomechanical character. PrestigeTM-LP artificial disc prosthesis well preserves intervertebral segmental motion for cervical spine.

Key words: Cervical spine, Cervical artificial disc, Finite element model（FEM）, Biomechanics

中图分类号:

R318.01

徐波, 金大地, 张美超. 颈椎人工椎间盘置换有限元分析[J]. 中国临床解剖学杂志, 2013, 31(3): 328-332.

XU Bei, JIN Da-De, ZHANG Mei-Chao. Finite element analysis of cervical spine following artificial intervertebral disc replacement[J]. Chinese Journal Of Clinical Anatomy, 2013, 31(3): 328-332.

参考文献

[1] Liu F, Cheng J, Komistek RD, et al. In vivo evaluation of dynamic characteristics of normal, fused, and disc replacement cervical spine
[J]. Spine, 2007, 32(23):2578-2584.

[2] Ajay J, David AC, Eubulus JK, et al. Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials
[J]. Spine J, 2010, 10(12): 1043-1048.

[3] Galbusera F, Fantigrossi A, Raimondi MT, et al. Biomechanics of the C5-C6 spinal unit before and after placement of a disc prosthesis
[J]. Biomechan Model Mechanobiol, 2006, 5(4): 253-261.

[4] Ha SK. Finite element modeling of multi-level cervical spinal segments (C3-C6) and biomechanical analysis of an elastomer-type prosthetic disc
[J]. Med Eng Phys, 2006, 28(6):534 -541.

[5] Miura T, Panjabi MM, Cripton PA. A method to simulate in vivo cervical spine kinematics using in vitro compressive preload
[J]. Spine, 2002, 27(1): pp43-48.

[6] 徐波，赵卫东，张忠民,等.人工颈椎间盘置换与前路颈椎融合内固定术后节段运动评价
[J].中华外科杂志，2010,48（13）：1016-1017.

[7] Wigfield CC, Gill SS, Nelson RJ, et al. The new frenchay artificial cervical joint: results from a two-year pilot study
[J]. Spine, 2002, 27(22): 2446-2452.

[8] Robertson JT, Metcalf NH. Long-term outcome after implantation of the prestige I disc in an end-stage indication: 42 year results from a pilot study
[J]. Neurosurgical Focus, 2004, 17 (3): 69-71.

[9] Bartolomei JC, Theodore N, Sonntag VK. Adjacent level degeneration after anterior cervical fusion: a clinical review
[J]. Neurosurg Clin N Am, 2005, 16 (4):575-587.

[10] Petr S, Lubomir J, Vladimir B III, et al. Clinical results and development of heterotopic ossification in total cervical disc replacement during a 4-year follow-up
[J].Eur Spine J, 2010, 19(2): 307-315.

[11] Lin CY, Kang H, Rouleau JP, et al. Stress analysis of the interface between cervical vertebrae end plates and the Bryan, Prestige LP, and cervical Disc prostheses
[J]. Spine, 2009, 34(15): 1554-1560.

[12] DiAngelo DJ, Robertson JT, Metcalf NH, et al. Biomechanical testing of an artificial cervical joint and an anterior cervical plate
[J]. J Spinal Disord Tech, 2003, 16(4):314-323.

[13] Chang UK, Daniel H K, Lee MC, et al. Range of motion change after cervical arthroplasty with ProDisc-C and Prestige artificial discs compared with anterior cervical discectomy and fusion
[J]. J Neurosurg Spine, 2007, 7(1):40-46.

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