目的 探讨13～18岁正常与青少年腰椎间盘突出症（ALDH）关节突关节不对称对腰椎生物力学的影响。  方法 联合应用软件MIMICS 21.0、3-Matic Medical 13.0、Geomagic Wrap 2017、HYPERMES 2019和有限元软件ABAQUS 2021建立下腰椎正常与ALDH三维有限元模型，根据关节突关节左右之差，选择13~18岁正常青少年和ALDH患者资料各3例，共计6例，分析比较施加不同力矩载荷下（中立位、侧屈和旋转工况）椎间盘应力大小。  结果 1.建立6例男性正常与ALDH患者的L3～L5节段三维有限元模型，获得中立位、前屈、后伸、侧屈和旋转工况正常与ALDH应力、位移云图；2. 正常青少年关节突关节角左右对称在中立位时，L4～5纤维环后侧应力增大；3.不同工况下，椎间盘应力纤维环均大于髓核，纤维环应力前屈＞中立位＞后伸；4. ALDH患者下腰椎关节突关节左侧大于右侧10°模型，后伸工况L4～5节段纤维环后侧应力明显增大。侧屈工况下，左侧屈纤维环左侧应力与右侧屈纤维环右侧应力比较，t=1.575，P＜0.05，差异有统计学意义，右侧屈纤维环右侧应力大于左侧屈纤维环左侧应力。旋转工况，纤维环左右两侧应力＞后侧应力。  结论 1. 正常与ALDH患者对比，不同姿态下，椎间盘应力均增大，可能导致椎间盘剪切力负荷增加，加剧椎间盘退变的进程。2. 在关节突关节左右不对称度数大于10°时，度数小的一侧应力大。关节突关节不对称会导致椎体、椎间盘负荷过重，导致脊柱失稳。3.后伸时椎间盘应力小于中立位、前屈时的应力，后伸动作可以缓解椎间盘压力，对ALDH患者的恢复起到辅助作用。

Objective To investigate the effect of facet joint asymmetry on lumbar biomechanics in normal and patients with adolescent lumbar disc herniation (ALDH).   Methods Mimics 21.0, 3-Matic Medical 13.0, Geomagic Wrap 2017, HyperMesh 2019 and finite element software ABAQUS 2021 were combined to establish three-dimensional finite element models of normal lower lumbar spine and adolescent lumbar disc herniation. According to the difference between the left and right facet joints, three cases of normal and ALDH  patients aged 13-18 years old were selected, with a total of 6 cases. The stress of intervertebral disc under different torque loads (neutral position, lateral flexion and rotation) was analyzed and compared.   Results 1. Three dimensional finite element models of L3-L5 segments were established in 6 male normal and adolescent patients with lumbar disc herniation, and the stress and displacement nephogram of lumbar disc herniation in normal neutral position, flexion, extension, lateral flexion and rotation were obtained; 2. The stress of L4-5 annulus fibrosus increased when the facet joint angle of normal adolescents was symmetrical in the neutral position; 3. The stress of annulus fibrosus was greater than that of nucleus pulposus under different conditions, and the stress of annulus fibrosus was flexion > neutral position > extension; 4. In patients with ALDH, the left side of the facet joint was larger than the right 10 ° model, and the stress in the posterior side of the annulus fibrosus of L4-5 segment increased significantly under extension condition. Under lateral flexion condition, the left stress of the left annulus fibrosus was compared with the right stress of the right annulus f  ibrosus, t=1.575, P<0.05, the difference was statistically significant, the right stress of the right annulus fibrosus was greater than the left stress of the left annulus fibrosus. Under the rotating condition, the stress on the left and right sides of the fiber ring was greater than that on the back side.   Conclusion 1. Compared with normal and patients with ALDH, the stress of intervertebral disc increases under different postures, which may increase the shear load of intervertebral disc and aggravate the process of intervertebral disc degeneration; 2. When the degree of left-right asymmetry of facet joint is more than 10 degrees, the stress on the side with small degree is greater. Facet joint asymmetry can lead to the overload of vertebral body and intervertebral disc, leading to spinal instability; 3. The stress of intervertebral disc in extension is less than that in neutral position and flexion. Extension can relieve the pressure of intervertebral disc and play an auxiliary role in the recovery of patients with ALDH.