| 金新蒙,刘 杰,吕 枫,姜亚飞,王 雷.人工半骨盆假体置换联合腰椎椎弓根螺钉固定术后生物力学的有限元分析[J].现代生物医学进展英文版,2017,17(5):852-855. |
| 人工半骨盆假体置换联合腰椎椎弓根螺钉固定术后生物力学的有限元分析 |
| Biomechanical Finite Element Analysis of Hemipelvic Prosthesis Replacement Combined with Lumbar Pedicle Screw Fixation |
| Received:October 21, 2016 Revised:November 18, 2016 |
| DOI：10.13241/j.cnki.pmb.2017.05.012 |
| 中文关键词: 半骨盆 假体 椎弓根螺钉 有限元 生物力学 |
| 英文关键词: Hemipelvis Prosthesis Pedicle screw Finite element Biomechanics |
| 基金项目:上海市科委产学研医项目(12DZ1940205)；上海交通大学医工交叉项目(YG2013MS05) |
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| 中文摘要: |
| 摘要 目的：建立人工半骨盆假体置换与联合腰椎椎弓根螺钉固定后的三维有限元模型，评价腰骶段生物力学改变后半骨盆假体力学结构的特点。方法：采用CT薄层扫描采集原始数据，分别建立正常骨盆、半骨盆假体置换术后以及半骨盆假体置换联合腰椎椎弓根螺钉固定术后骨盆的三维有限元模型，分别在第4腰椎上终板平面施以500 N的垂直纵向载荷，分析不同骨盆模型的应力分布特点。结果：与正常骨盆有限元模型相比，半骨盆假体置换术后健侧骨盆应力分布以骶髂关节、髋臼窝及耻骨为主，置换侧半骨盆假体以耻骨连接棒、髋臼杯及髂骨座为主，最大应力出现在耻骨连接棒，应力峰值为65.62 MPa。联合腰椎椎弓根螺钉固定后健侧应力相对减小，置换侧髂骨固定座与骶骨固定处应力相对减小，应力分布以腰椎椎弓根钉棒、耻骨连接棒及髋臼杯为主，最大应力出现在椎弓根螺钉，应力峰值为107 MPa。结论：半骨盆假体置换联合腰椎椎弓根螺钉固定后钉棒分担了半骨盆置换后健侧骨盆及置换侧髂骨固定座与骶骨固定处附近的部分应力，缓解应力集中现象，降低术后骨盆破坏风险，一定程度上增加了半骨盆置换后骨盆的稳定性。 |
| 英文摘要: |
| ABSTRACT Objective: To establish the biomechanical characteristics of hemipelvic prosthesis replacement with posterior lumbar pedicle screw fixation by a three-dimensional finite element model. Methods: Finite element methods(FEM) of normal pelvis, hemipelvic replacement and hemipelvic replacement combined with lumbar pedicle screw fixation were established using thin-layer CT scanning(TLCS). With a vertical load of 500 N applied to the upper plate of the 4th lumbar vertebra,we analyzed the stress distribution characteristics of different models. Results: Compared with the finite element model of the pelvis, the stress distribution of the healthy side in the model of hemipelvic replacement is mainly located on sacroiliac joint, acetabular fossa and the pubic bone,and at the other side, it appears on the pubic bone connecting arm, acetabular cup and the fixed position between sacrum and iliac bone prosthesis. The maximum stress appears on the pubic connection arm and was 65.62 MPa. However, the stress of the healthy side and the fixed position between sacrum and iliac bone prosthesis relatively decrease after combining with lumbar pedicle screw fixation. The stress distribution mainly focused on the lumbar pedicle screw, titanium stick, pubic bone connecting arm and acetabular cup. The maximum stress appeared on the lumbar pedicle screw, and was 107 MPa. Conclusion: Combined with lumbar pedicle screw fixation,pedicle screw and titanium stick share partial stress on the sacroiliac joint, acetabular fossa and the pubic bone of the healthy side and the fixed position between sacrum and iliac bone prosthesis at the replaced side.It reduces the stress concentration and the risk of postoperative pelvic damage. To a certain extent, it increases the stability of the pelvis after hemipelvic replacement. |
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