斜方肌对重度Lenke1型侧凸脊柱影响的有限元分析

Effects of Trapezius Muscle on Severe Lenke1 Scoliosis:A Finite Element Analysis

目的 建立考虑斜方肌的脊柱侧凸有限元模型,探究斜方肌对脊柱的力学特性影响。方法 建立脊柱侧凸患者胸腰椎及骶骨的有限元模型,并进行模型有效性验证。之后加入肩胛骨和斜方肌,模拟分析上躯干不同工况下斜方肌对Lenke1型侧凸脊柱各部分的影响。结果 脊柱-肌肉模型侧屈活动度比脊柱模型小0.23%,椎间盘轴向旋转平均降低0.078°;软组织应力在小关节上分布更均匀,软组织所受应力变化更平稳;6种工况中87.5%的腰椎小关节所受应力减小。结论 斜方肌可以增强脊柱抵抗变形的能力,同时使应力在脊柱上更符合循序渐进的分布,腰椎受力更小使得人体可以承受更多的外载荷。所建脊柱-肌肉模型更贴合实际,对于临床具有一定的参考价值。

Objective To establish the finite element model of scoliosis considering trapezius muscle,and explore the effect of trapezius muscle on mechanical properties of the spine.Methods The finite element models of thoracolumbar vertebrae and sacrum were established,and the validity of the models was verified.Scapula and trapezius muscle units were added,and the influence of trapezius muscle on various parts of the Lenke 1 scoliosis spine under different working conditions was simulated and analyzed.Results The range of motion(ROM) of the spine-muscle model under lateral flexion was 0.23% less than that of the spine model,and the axial rotation of the intervertebral disc under rotation was reduced by 0.078° on average.The stress in soft tissues was more evenly distributed on facet joints,and the stress changes in soft tissues were more stable.Under six working conditions,87.5% of the lumbar facet joints had reduced stress.Conclusions Trapezius muscle can improve the spine's ability to resist deformation,while it also aligns the stress on the spine with gradual distributions.The less stress on lumbar spine,the more external loads human body can bear.The spine-muscle model established in this study is more practical,with certain reference values in clinic practice.