强直性脊柱炎椎骨去松质骨化截骨术后钛棒有限元分析

苏宝科; 王永清; 康志杰; 王海燕; 金凤; 李筱贺; 曹振华; 霍佳萱; 左思涵; 王婧菡

doi:10.16098/j.issn.0529-1356.2024.03.012

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解剖学报 ›› 2024, Vol. 55 ›› Issue (3) : 339-344. DOI: 10.16098/j.issn.0529-1356.2024.03.012

解剖学

强直性脊柱炎椎骨去松质骨化截骨术后钛棒有限元分析

苏宝科1 王永清¹ 康志杰² 王海燕³ 金凤⁴ 李筱贺^3* 曹振华^5,6,7 霍佳萱⁸ 祝勇⁹ 李峰^6*

作者信息 +

Finite element analysis of titanium rods after vertebral column decancellation osteotomy for ankylosing spondylitis

SU Bao-ke¹ WANG Yong-qing¹ KANG Zhi-jie² WANG Hai-yan³ JIN Feng⁴ LI Xiao-he^3* CAO Zhen-hua^5,6,7 HUO Jia-xuan⁸ ZHU Yong⁹ LI Feng⁶ #br#
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Author information +

文章历史 +

摘要

目的通过对去松质骨化(VCD)截骨术后强直性脊柱炎患者胸椎（T）₁₁~骶骨（S）节段钛棒应力变化分析，为术前钛棒选择、改进提供参考。方法将VCD截骨术后强直性脊柱炎患者连续扫描的断层影像原始数据以DICOM格式导入Mimics 21.0软件，分别重建T₁₁~ S、螺钉和钛棒，导入到3-Matic建立初步几何模型，进行去噪、铺面、平滑等处理，完善后的模型导入Hypermesh10软件进行网格划分，对材料进行属性赋值后导入ANSYS 19.2中显示有限元模型，设定边界和载荷条件，测量螺钉与钛棒连接处应力值。结果在中立位、前屈、侧向弯曲、轴向旋转工况下，钛棒在上端椎（T₁₁）应力最大，顶椎（L₃）应力最小；在后伸工况下，钛棒在下端椎（L₅）应力最大。结论在上、下端椎可考虑增粗钛棒直径，增强钛棒硬度，或改为双棒。

Abstract

Objective To analyze the stress changes of thoracic vertebra (T)11-sacrum (S) titanium rods in patients with ankylosing spondylitis after vertebral column decancellation (VCD) osteotomy, and provide reference for the selection and improvement of titanium rods before surgery. Methods The original data of the continuous scanning tomographic images of patients with ankylosing spondylitis after VCD osteotomy were imported into Mimics 21.0 in DICOM format, and T₁₁-S vertebrae, screws and titanium rods were respectively reconstructed. They were imported into 3-Matic to establish a preliminary geometric modeling, and then processed with noise removal, paving, smoothing, etc. The improved model was imported into Hypermesh 10 software for grid division, and the material was imported into ANSYS 19.2 to display the finite element model after attribute assignment, Set the boundary and load conditions, and measure the stress value at the connection between the screw and the titanium rod. Results Under neutral position, forward bending, lateral bending, and axial rotation conditions, the titanium rod had the highest stress at the upper vertebrae (T₁₁) and the lowest stress at the top vertebrae (L₃); Under the backward extension condition, the titanium rod has the highest stress at the lower end vertebra (L₅). Conclusion In the upper and lower vertebrae, it is possible to consider increasing the diameter of the titanium rod, enhancing its hardness, or changing it to a double rod.

导出引用

苏宝科王永清康志杰王海燕金凤李筱贺曹振华霍佳萱祝勇李峰. 强直性脊柱炎椎骨去松质骨化截骨术后钛棒有限元分析[J]. 解剖学报. 2024, 55(3): 339-344 https://doi.org/10.16098/j.issn.0529-1356.2024.03.012

SU Bao-ke WANG Yong-qing KANG Zhi-jie WANG Hai-yan JIN Feng LI Xiao-he CAO Zhen-hua HUO Jia-xuan ZHU Yong LI Feng. Finite element analysis of titanium rods after vertebral column decancellation osteotomy for ankylosing spondylitis[J]. Acta Anatomica Sinica. 2024, 55(3): 339-344 https://doi.org/10.16098/j.issn.0529-1356.2024.03.012

中图分类号： R3

参考文献

［1］ Malaviya AP, Ostor AJK. Early diagnosis crucial in ankylosing spondylitis［J］. Practitioner, 2011, 255 (1746): 21-24.

［2］ Feng ChSh, Tao HR, Yang K, et al. Retracted: modified closing-opening wedge osteotomy to correct kyphosis in ankylosing spondylitis［J］. Med Sci Monit,2020,26:e923318.

［3］ Marks DS，Qaimkhan SA. The natural history of congenital scoliosis and kyphosis［J］. Spine (Phila Pa 1976)，2009, 34 (17)：1751-1755.

［4］ Hu FQ,VSong K, Hu WH, et al. Improvement of sleep quality in patients with ankylosing spondylitis kyphosis after corrective surgery［J］. Spine (Phila Pa 1976), 2020，45(23):E1596-E1603.

［5］ Qi P, Song K, Zhang YG, et al. The clinical effects of the vertebral bone and the bone of the bone bone of the vertebral arch in the single section of the spine to correct the clinical effect of the convex tenderness of the vertebral bow root bone osteothama ［J］. China’sSpine Spinal Cord Magazine, 2015,25 (9): 775-780.(in Chinese)

齐鹏,宋凯,张永刚,等.单节段脊柱去松质骨截骨与双节段经椎弓根截骨矫正强直性脊柱炎后凸畸形的临床效果比较［J］.中国脊柱脊髓杂志,2015,25(9):775-780.

［6］ Liu Ch, Zheng GQ, Guo Y, et al. Two-level osteotomy for correcting severe ankylosing spondylitis kyphosis: radiologic outcomes of different osteotomy position-selection strategy for different type of patients［J］. Spine Deform,2018,6(3):273-281.

［7］ Shen FH, Samartzis D. Surgical management of lower cervical spine fracture in ankylosing spondylitis［J］. J Trauma, 2006, 61(4):1005-1009.

［8］ Xie J, Guo HL, Li H, et al. The whole spine interception ostelatic bone interception of the tall meta-metastic analysis of the rear liquid surface balance ［J］. China Organization Engineering Research, 2021,25 (33): 5259-5264. (in Chinese)

谢江,郭惠丽,李辉,等.全脊椎截骨重建强直性脊柱后凸矢状面平衡的有限元分析［J］.中国组织工程研究,2021,25(33):5259-5264.

［9］ Li H, Zhang P, Shang J, et al. Elite bone cutting and whole spine bone cutting treatment to treat ankylosing spondylitis［J］. Journal of Shanxi Medical University, 2019，50（3): 368-372. (in Chinese)

李辉,张鹏,尚俊,等.去松质骨截骨术与全脊柱截骨术治疗强直性脊柱炎后凸畸形有限元分析［J］.山西医科大学学报,2019,50(3):368-372.

［10］ Xie J, Zhang YK, Li L, et al. Finite element analysis of trabecular ostectomy and total spinal osteotomy for the treatment of kyphosis in ankylosing spondylitis［J］. Chinese Journal of Tissue Engineering Research, 2018, 22(7):1102-1107. (in Chinese)

谢江,张玉坤,李栎,等.去松质骨截骨与全脊柱截骨治疗强直性脊柱炎后凸畸形的有限元分析［J］.中国组织工程研究,2018,22(7):1102-1107.

［11］ Duan YJ, Chen X, Zhou YQ, et al., Double section, single section remove looping bone bone cut and full spinal bone bone bone straight straighten spinal relaxation of relaxation ［J］. Chinese Organization Engineering Studies, 2020,24 (27): 4285-4290. (in Chinese)

段延辑,陈晓,周永强,等.双节段、单节段去松质骨截骨与全脊柱截骨强直性脊柱后凸矫形策略的有限元分析［J］.中国组织工程研究,2020,24(27):4285-4290.

［12］ Duan YJ. The postponement of an analgesic spine post-convex segment VCD and VCR bone interception stability analysis ［D］. Urumqi: Xinjiang Medical University, 2018. (in Chinese)

段延辑. 强直性脊柱后凸单节段VCD与VCR截骨位移稳定性的有限元分析［D］. 乌鲁木齐: 新疆医科大学,2018.

［13］ Ma Y, Sri L, Ou Y, et al., Etc. Fix different bone interception methods to repair the finite element analysis of tumor deformity after ankylosing spondylitis ［J］. China Organization Engineering Research, 2017,21 (19) : 3038-3043. (in Chinese)

马涌, 斯刊达尔·斯依提, 欧勇,等.不同截骨方式修复强直性脊柱炎后凸畸形的有限元分析［J］.中国组织工程研究,2017,21(19):3038-3043.

［14］ Xia C, Yang S, Liu J, et al. Finite element study on whether posterior upper wall fracture is a risk factor for the failure of short-segment pedicle screw fixation in the treatment of L1 burst fracture［J］. Injury, 2021, 52(11): 3253-3260.

［15］ Lu H, Zhang QCh, Ding F, et al. Establishment and validation of a T12L2 3D finite element model for thoracolumbar segments［J］. Am J Transl Res, 2022, 14(3): 1606-1615.

［16］ Beyer B,Feipel V,Dugailly P .Biomechanics of the upper cervical spine ligaments in axial rotation and flexion-extension: Considerations into the clinical framework［J］.J Craniovertebr Junction Spine,2020,11(3):217-225.

［17］ Hu WH. New three -pillar bone cutting surgery for the treatment of backlapal deformedness and the safety and effectiveness of rear rear malformations ［D］. Beijing:Chinese People’s Liberation Army Medical College, 2018. (in Chinese)

胡文浩. 新型三柱截骨术治疗脊柱后凸畸形及侧后凸畸形的安全性和有效性研究［D］.北京：中国人民解放军医学院,2018.

［18］ Zhao ShZh. Ankylosing spondylitis The risk factors of the risk factors of near -end bangs and broken sticks after the tangoosteoplasty orthopedic orthopedic orthopedic orthopedics ［D］. Nanjing: Nanjing University, 2019. (in Chinese)

赵师州. 强直性脊柱炎胸腰椎后凸畸形截骨矫形术后发生近端交界性后凸和断棒的危险因素分析［D］.南京：南京大学,2019.

［19］ Yamato Y, Hasegawa T, Kobayashi S, et al. Treatment strategy for rod fractures following corrective fusion surgery in adult spinal deformity depends on symptoms and local alignment change［J］.JNeurosurg Spine,2018,29(1):59-67.

［20］ Wang YQ, Su BK, Wang W, et al. The adolescent spinal bump Lenke5-type chest and waist section after the road orthopedic, titanium rod finite element analysis ［J］. Chinese Contemporary Medicine, 2021,28 (6): 4-7, 16, 241-242. (in Chinese)

王永清,苏宝科,王威, 等.青少年特发性脊柱侧凸Lenke5型胸腰段后路矫形后钛棒有限元分析［J］.中国当代医药,2021,28(6):4-7,16, 241-242.

［21］ Wang H, Li ChH, Liang X, et al. Young women’s spine and thoracic and waist section of the upper end of the upper end of the upper end fixing the closure of the intervertebral disc stricial analysis ［J］. Chinese Disaster Rescue Medicine, 2021,9 (10):1265-1270. (in Chinese)

王辉,李朝辉,梁晓,等.青年女性脊柱胸腰段后凸矫形术后上端固定椎近端椎间盘应力分布的有限元分析［J］.中华灾害救援医学,2021,9(10):1265-1270.

［22］ Chen LQ. Leenke 6 special spine biometer research on biomechanical research ［D］: Changsha: Zhongnan University, 2010. (in Chinese)

陈凌强.Lenke 6型特发性脊柱侧凸有限元建模及后路三维矫形的生物力学研究［D］.长沙：中南大学,2010.

基金

2022年度自治区卫生健康科技计划项目;内蒙古自治区自然科学基金项目;内蒙古医科大学2020年度“成果转化”项目;内蒙古医科大学重点项目;自治区高等学校创新团队发展计划项目;内蒙古自然科学基金;内蒙古自治区“草原英才”工程青年创新创业人才项目;内蒙古医科大学后续科研项目;内蒙古科技计划项目;2021年内蒙古自治区蒙医药协同创新中心科学研究项目