&nbsp;切除不同范围钩突后颈椎椎间盘的有限元分析

杨洋; 史君; 李琨; 郝韵腾; 马渊; 张少杰; 李斌; 侯二飞; 王超群; 陈杰; 王建; 白雪; 王星; 李志军

doi:10.16098/j.issn.0529-1356.2024.01.013

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解剖学报 ›› 2024, Vol. 55 ›› Issue (1) : 88-97. DOI: 10.16098/j.issn.0529-1356.2024.01.013

解剖学

切除不同范围钩突后颈椎椎间盘的有限元分析

杨洋¹ 史君² 李琨^3,4 马渊⁴ 张少杰^3,4 侯二飞³ 王超群⁵ 陈杰³王星^3,4* 李志军^3,4*

作者信息 +

Finite element analysis of cervical intervertebral discs after removing different ranges of uncinate processes

YANG Yang¹ SHI Jun² LI Kun^3,4 MA Yuan⁴ ZHANG Shao-jie^3,4 HOU Er-fei³ WANG Chao-qun⁵, CHEN Jie³ WANG Xing^3,4* LI Zhi-jun^3,4*

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文章历史 +

摘要

目的通过建立C₀~T₁全颈椎三维有限元模型，探讨切除不同范围钩突后颈椎椎间盘的应力变化特点，为临床手术治疗提供实验依据。

方法对1例全颈椎进行CT扫描后建立正常颈椎三维模型，同时设计切除左侧50%、100%的钩突和切除双侧100%的钩突模型，加载相同力矩后比较4种模型在前屈、后伸、左右侧屈及左右旋转等6种工况下的受力变化（应力、位移）。结果随着钩突不同范围的切除，椎间盘应力和位移值集中位于C_5/6处，随后渐呈递减趋势。椎间盘在切除左侧C₅钩突50%后其应力值仅在C₅处存在侧别间差异，但在左侧或双侧切除100% C₅钩突后其应力值出现了侧别间差异。结论切除不同范围钩突（50%、100%）后可影响颈椎稳定性，且切除范围越大越影响颈椎稳定性。临床在该区手术切除时应尽可能选择最优原则，以最少切除而达到治疗效果为最佳。

Abstract

Objective To study the stress change characteristics of the cervical disc after removing different ranges of the uncinate process by establishing a three-dimensional finite element model of the C₀-T₁ whole cervical spine to provide a theoretical basis for clinical and surgical treatment. Methods After a CT scan of one case of the whole cervical spine, we established a three-dimensional model of the normal cervical spine and designed the model to excise 50% and 100% of the uncinate process on the left side and 100% of the uncinate process on both sides at the same time. The four models’ stress changes (stress and displacement) were compared after loading the same torque under six working conditions, forward flexion, back extension, left and right lateral flexion, and left and right rotation. Results With the removal of different ranges of the uncinate process, the stress and displacement values of the disc were concentrated at C_5/6 and then gradually decreased. Interlateral differences in disc stress values were found only at C₅ after removing 50% of the left C₅ uncinate process, and interlateral differences were found at all disc stress values after removing 100% of the C₅ uncinate process on the left or both sides. Conclusion Removal of different ranges of the uncinate process (50% and 100%) can affect cervical spine stability, and the larger the range of resection is the more it affects cervical spine stability. The best clinical principle is to choose the best possible surgical resection in this area that can achieve the least resection and the best therapeutic effect.

导出引用

杨洋史君李琨马渊张少杰侯二飞王超群陈杰王星李志军. 切除不同范围钩突后颈椎椎间盘的有限元分析[J]. 解剖学报. 2024, 55(1): 88-97 https://doi.org/10.16098/j.issn.0529-1356.2024.01.013

YANG Yang SHI Jun LI Kun MA Yuan ZHANG Shao-jie HOU Er-fei WANG Chao-qun CHEN Jie WANG Xing LI Zhi-jun. Finite element analysis of cervical intervertebral discs after removing different ranges of uncinate processes[J]. Acta Anatomica Sinica. 2024, 55(1): 88-97 https://doi.org/10.16098/j.issn.0529-1356.2024.01.013

中图分类号： Ｒ318. 04

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