三种前屈角度下坐位旋转手法对腰椎间盘作用的有限元分析

Analysis of effect on lumbar disc of rotation manipulation in three ante flexed levels by finite element

目的探讨不同前屈状态下坐位腰椎旋转手法对椎间盘的影响。方法使用腰椎CT片,以Mimics软件系统逐层重建,建立L4-5的三维有限元模型。根据手法原理,将坐位腰椎旋转手法进行分解,在6°、9°、12°三种腰椎前屈角度下,把各项力学参数代入有限元模型进行计算分析。结果①对于正常腰椎,椎间盘左侧后缘的应力随着腰椎前屈角度增大而增大,前屈角度的变化对位移的影响相对较小,椎间盘无明显向后突出。②对于退变腰椎,椎间盘右侧后缘的应力和位移均随着腰椎前屈角度增大而增大,12°状态下椎间盘右侧后缘明显向后突出。结论①该手法不会造成椎间盘损伤。②向健侧旋转优于向患侧旋转。③腰椎椎管狭窄患者不宜使用本手法。④手法时,前屈角度不宜太大。

Objective To study the effect of the rotation manipulation on degenerate lumbar disc in three anteflexed levels. Methods The lumbar CT scan imaging was sectionally reconstructed with Mimics software system,A 3D finite element system of L4-5 was set up. The lumbar rotation manipulation was decomposed by principium of manipulation. The parameter of mechanics was analyzed with the finite element system in three anteflexed levels：6°, 9° and 12°, Results The stress and displacement of the right side of lumbar disc were increased gradually during the manipulation. The stress and displacement of right and posterior side of lumbar disc were increased as anteflexed levels increased, The right and posterior side of lumbar disc protruded toward back evidently in 12°state. Conclusion The manipulation is safe for lumbar disc. It is more rational for rotation toward the healthy side. It is not suitable to anteflect too much during the manipulation. The manipulation is not applicable for lumbar spinal stenosis.