骶骨部分切除术后骨盆重建的三维有限元分析
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Three-dimensional Finite Element Analysis of Reconstructed Pelvic after Sacrectomy
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    摘要:

    目的 研究骶骨部分切除术后骨盆重建的生物力学特征。方法 分别构建完整骨盆。经S1、S2之间施行骶骨部分切除术后的缺损骨盆和重建骨盆的三维有限元模型。模拟人体坐位时的负荷,研究3种模型的位移与应力分布变化。结果 得到了三个模型中骶岬前方参考点在垂直方向的位移值及整个模型和重建器械的应力分布情况。结论 骶髂关节部位的重建可以增强骶骨部分切除术后骨盆的稳定性,并改变骨盆应力分布,降低骶器关节应力峰值,减少术后骨盆破坏的风险。L5椎弓根螺钉与髂骨钉之间的钛棒发生断裂的风险较大,提示术中应当重视弯棒操作,避免钛棒过度成角,防止应力过度集中,减少断棒的危险。

    Abstract:

    Objective To investigate the biomechanics changes of the reconstructed pelvis after sacrectomy. Methods Three three-dimensional finite element pelvic models were established: (1)a normal pelvic model, (2)a defective pelvic model on which sacrectomy was operated between S1 and S2 sacral vertebrae, and(3)a reconstructed pelvic model. Sitting posture was stimulated under the load of body weight, and the stress and displacement distributions of these models were calculated and compared. Results The displacement of anchor point on the sacral promontory, the stress distributions of the pelvis and the reconstruction instruments of the three models were all obtained. Conclusion Sacroiliac joint reconstruction can increase the stiffness of the defective pelvic and decrease the maximum stress around the sacroiliac joint, thus reducing the breakdown risk of the defective pelvis. Part of titanium sticks between L5 pedicle screw and iliac screw is the weakest region in the instrument. It is suggested that the bending of titanium sticks should be conducted carefully without forming acute angle and significant stress concentration on the titanium sticks so as to reduce the risk of sticks breakdown.

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李全,蔡郑东,都承斐,佟大可,丁祖泉.骶骨部分切除术后骨盆重建的三维有限元分析[J].医用生物力学,2008,23(1):47-51

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