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不同安装模式横连在后路寰枢椎钉-棒固定中的三维有限元对比分析

Contrastive analysis of different modes of installation crosslink in posterior C1-C2 pedicle screw-rod fixationbythree-dimensionalfiniteelement
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摘要 目的利用三维有限元分析横连在寰-枢椎椎弓根钉棒内固定(C1-C2 PSR)中生物力学特性。方法分别建立寰枢椎有限元模型:完整组为A组, 失稳组为B组, B组+C1-C2 PSR为C组, C组+棒-棒横连(hR-R CL)为D组, C组+钉尾横连(hS-S CL)为E组, 其中E组又包括:上横连(两寰椎螺钉钉尾)为E1组、下横连(两枢椎螺钉钉尾)E2组、斜形钉尾横连(dS-S CL)(左上右下为E3组, 左下右上为E4组)、交叉钉尾横连(xS-S CL)为E5组。对各个有限元模型加载1.5 N/m的扭矩, 计算出完整组、失稳组、六种内固定组在屈伸、侧屈、旋转的活动度(ROM)及横连应力峰值, 并提取内固定应力云图。结果失稳组较完整组的ROM明显增大, 内固定组在6种工况下的ROM较失稳组减少90.1%~98.5%, 横连组与无横连组在屈伸状态下的ROM基本一致, 但在侧屈及旋转状态下, 横连组较无横连组ROM分别减少33.3%~47.4%和76.4%~92.6%, 交叉横连组在旋转状态ROM减少最为明显。内植物模型应力峰值:横连组最大应力总体上小于无横连组, 所有内固定组在后伸时应力峰值最小。内植物的应力云图显示:横连组内固定装置的应力分布区域基本一致, 内固定未出现明显的应力集中现象, 且主要的应力分布区域为螺钉根部与骨质结合部, 横连两端与螺钉尾槽或连接棒结合部。结论横连能提高内固定的抗旋转稳定性, 交叉横连模式最为明显, 横连在降低内植物的最大应力同时也可能因其两端应力分布明显出现断裂。 Objective To analuze biomechanical properties of crosslink in C1-C2 pedicle screw-rod fixation by three-dimensional finite element.Methods The atlantoaxial finite element models were established respectively.Following 5 groups were set up:the normal group(group A),the unstable group(group B),C1-C2 pedicle screw-rod fixation(C1-C2 PSR)(group C),C1-C2 PSR+horizontal rod-rod crosslink(hR-R CL)(group D),C1-C2PSR+upper/lower horizontal screw-screw crosslink(hS-SCL)(group E1 and group E2),C1-C2PSR+upper left right/upper right left diagonal screw-screw crosslink(dS-S CL)(group E3 and group E4)and C1-C2PSR+x screw-screw crosslink(xS-SCL)(group E5).The range of motion(ROM)and Von Miss Stresses in flexion and extension,lateral flexion and rotation of group A,group group B and the six kinds of internal fixation groups(group C,group D,and groups E1-E5)were calculated by applying 1.5 N/m torque to each finite element model,and the stress cloud was extracted.Results The ROM of the unstable group was 78.0%-370.0%higher than that of the normal group,and the ROM of the internal fixation group was 90.1%-98.5%lower than that of the unstable group under 6 conditions.The ROM of the crosslink group and the group without crosslink was basically the same in flexion and extension state,but in lateral flexion and rotation state,ROM of the crosslink group decreased by 33.3%47.4%and 76.4%-92.6%,respectively,as compared with that of the group without crosslink,and ROM of the C1-C2PSR+xS-SCL group decreased most obviously in rotation state.For the stress peak of internal plant model,the maximum stress of the crosslink group was generally smaller than that of the non-crosslink group,and the stress peak value of all the internal fixation groups was the lowest when the extension was carried out.The stress cloud of internal plants showed that the stress distribution areas of the internal fix-ation in the crosslink fixation group were basically the same,and there was no obvious stress concentration phenomenon in the internal fixation,and the main stress distribution areas were the screw root and bone joint,and the crosslink ends were the screw tail groove or the joint rod joint.Conclusion The crosslink can improve the anti-rotation stability of internal fixation,and the xS-SCL mode was the most obvious.The crosslink can reduce the maximum stress of the internal fixation,but it may also break because of the stress distribution at both ends.
作者 欧阳北平 马向阳 罗春山 邹小宝 陆廷盛 蒲兴魏 陈啟鸰 江攀 Ouyang Beiping;Ma Xiangyang;Luo Chunshan;Zou Xiaobao;Lu Tingsheng;Pu Xingwei;Chen Qiling;Jiang Pan(Department of Spine Surgery,Guizhou Orthopedics Hospital,Guiyang 550004,China;Department of Orthopedics,General Hospital of Southern Theatre Command of PLA,Guangzhou 510010,China)
出处 《中华实验外科杂志》 CAS 北大核心 2023年第7期1290-1293,共4页 Chinese Journal of Experimental Surgery
关键词 寰枢椎 三维有限元 A]tlanto-axial Three-dimensional finite element
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