头盆环牵引的最佳牵引量生物力学分析
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国家自然科学基金项目(82260446)


Biomechanical Analysis of Optimal Traction Amount for Halo Pelvic Ring Traction
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    摘要:

    目的 评估头盆环牵引治疗脊柱侧弯的最佳牵引量,为临床手术的评估和康复等提供理论参考。方法 建立包含脊髓的胸腰椎三维模型,并进行模型的有效性验证。对模型施加5组不同的牵引量(10、15、20、25、30 mm),通过模拟不同牵引量下脊柱的生物力学响应,来确定最佳牵引量。结果 随着牵引量的增加,Cobb角逐渐减小,尤其在15~20 mm之间,Cobb角减少量占最大减少量的50%~70.5%,主弯曲处脊柱的应力为最大应力的47.4%~67.5%,脊髓灰质和白质的应力分别为最大应力的70.3%~84.5%和68.8%~83.9%。结论 15~20 mm牵引量是治疗脊柱侧弯的最佳选择。在这一范围内,可以最大化地矫正Cobb角,同时保持较低的应力水平,减少脊柱和脊髓的损伤风险。

    Abstract:

    Objective To evaluate the optimal traction amount for treating scoliosis using halo pelvic ring traction (HPRT) and provide theoretical references for clinical surgical assessment and rehabilitation. Methods A three-dimensional (3D) model of the thoracolumbar spine including the spinal cord was created and validated. Five traction amounts (10, 15, 20, 25, 30 mm) were applied to the model. The biomechanical responses of the spine under different traction conditions were simulated to determine the optimal amount of traction. Results As the traction increased, the Cobb angle decreased progressively. Significantly, in the range of 15–20 mm, the reduction in Cobb angle accounted for 50–70.5% of the maximum reduction. The spinal stress at the main curvature represented 47.4%–67.5% of the maximum stress. Meanwhile, the stresses in the gray and white matter of the spinal cord were 70.3%–84.5% and 68.8%–83.9% of their respective maximum stresses. Conclusions The traction amounts between 15 mm and 20 mm are optimal for treating scoliosis. This range maximizes the Cobb angle correction while maintaining lower stress levels and thereby, reduces the risk of damage to the spine and spinal cord.

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李峰,富荣昌,陈永浩,王 槐.头盆环牵引的最佳牵引量生物力学分析[J].医用生物力学,2024,39(6):1123-1129

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  • 收稿日期:2024-06-30
  • 最后修改日期:2024-07-31
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  • 在线发布日期: 2024-12-25
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