目的 基于EOS影像系统测量无症状骶椎腰化患者脊柱-骨盆矢状面解剖学参数，同时利用有限元分析方法评估弯腰情况下骶椎腰化患者下腰椎的受力情况。 方法 共纳入经EOS影像系统检查的44例受试者，其中骶椎腰化患者11例，依据性别及年龄且按照1∶3的比例纳入正常受试者33例。两组患者均测量并比较脊柱-骨盆矢状面参数：腰椎前凸角（LL）、骨盆投射角（PI）、骨盆倾斜角（PT）及骶骨倾斜角（SS），采用Pearson检验分析两组受试者PI与LL间相关性。同时利用有限元分析的方法，建立骶椎腰化下腰椎的有限元模型，分析前屈、后伸、左右弯腰动作时下腰椎模型的受力情况。 结果 两组患者PI、PT、SS及LL比较，差异均具有统计学意义（P＜0.05）。相关性研究发现，两组受试者PI与LL均成正相关，其中骶椎腰化组（r=.0.69，P<0.05）、正常组（r=0.52，P<0.05）。 模型进行前屈、后伸、左侧弯腰、右侧弯腰状态下，弯矩均为2 Nmm，应力集中现象均由下向上逐渐减小，最大应力集中点位于下关节突处。 结论 骶椎腰化患者的腰椎生理曲度及受力分布较正常者具有明显差异，尤其移行椎椎间盘与关节突关节应力集中现象明显，容易出现脊柱早期退变。
Abstract
Objective To measure the sagittal anatomical parameters of the spine and pelvis based on EOS imaging system, and to evaluate the stress of the lower lumbar spine by finite element analysis(FEA). Methods A total of 44 subjects examined by EOS imaging system were included, including 11 sacral lumbar vertebra patients and 33 normal subjects. The sagittal plane parameters of lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT) and sacral slope (SS) were measured and compared in both groups. Pearson test was used to analyze the correlation between PI and LL in the two groups. At the same time, the finite element model of the lower lumbar vertebra was established. The stress condition of the lumbar spine model during forward bending, backward extension and left and right bending was evaluated by FEA method. Results The differences of PI, PT, SS and LL between the two groups were statistically significant (P<0.05). The correlation study found that there was a positive correlation between the two groups of subjects’ PI and LL, including the lumbarization group (r=0.69, P<0.05) and the normal group (r=0.52, P<0.05). Under the conditions of forward bending, backward stretching, left bending and right bending, the bending moment of the model was 2 Nmm, and the stress concentration gradually decreased from bottom to top. The maximum stress concentration point was located at the lower articular process. Conclusion The physiological curvature and stress distribution of the lumbar spine in lumbarization population were different than normal, especially the stress concentration of the transitional intervertebral disc and articular process joint was obvious, and early degeneration of the spine was easy to occur.
关键词
骶椎腰化 /
脊柱-骨盆矢状面 /
有限元分析 /
解剖学 /
人
Key words
Lumbarization /
Spino-pelvic sagittal plane /
Finite element analysis /
Anatomy /
Human
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基金
江西省卫生计生委中医药科研课题;江西省卫生计生委科技计划项目;新余市科技计划项目
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