生长棒不同固定术式治疗早发性脊柱侧凸的生物力学分析
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北京航空航天大学

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Biomechanical analysis of different methods of growing rod fixation for early-onset scoliosis
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    摘要:

    目的 研究生长棒技术治疗早发性脊柱侧凸过程中不同的上固定节段选择对术后脊柱生物力学特性的影响。方法 利用有限元技术分别建立同一患者行生长棒术前、术后固定T1-L4、术后固定T2-L4、术后固定T3-L4共4个脊柱模型(C6-S1节段),在C6上表面分别施加7 Nm力矩载荷和1 rad角位移载荷,分析上固定椎体邻近结构的生物力学特性。结果 生长棒术后脊柱整体活动度显著下降,固定T2-L4节段时,脊柱活动受限最大,邻近椎体代偿性活动显著增加,椎间盘应力增大最明显。结论 生长棒上固定选择T2节段时,发生交界性胸椎后凸和脊柱退行性病变的风险最高,在临床手术中应加以避免。

    Abstract:

    Objective To study the biomechanical characteristics of the spine when the growing rod technique is used to treat early-onset scoliosis with different segments fixed. Methods Using the finite element method to establish four spine models of one patient: before operation, T1-L4 segments fixed , T2-L4 segments fixed , and T3-L4 segments fixed, then perform 7 Nm torque control loading and 1 radian angle control loading to analysis the biomechanical characteristics of the adjacent structure of the fixed vertebral body. Results The spinal motion decreased significantly after operation. When the T2-L4 segment was fixed, the spine was most restricted, and the compensatory activity of the adjacent vertebrae increased significantly, and the intervertebral disc stress increased. Conclusion When the upper instrumented segment is T2, the risk of proximal junctional kyphosis and spinal degeneration is the highest, which should be avoided in clinical surgery.

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  • 收稿日期:2021-01-05
  • 最后修改日期:2021-03-04
  • 录用日期:2021-03-09
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