斜扳法对骶髂关节及髂腰韧带应力及位移的影响
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1.广州中医药大学第二临床医学院;2.广东省中医院老年骨折科;3.广东省中医院骨科生物力学实验室;4.省部共建中医湿证国家重点实验室

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Effect of oblique-pulling manipulation on stress and displacement of sacroiliac joint and iliolumbar ligament
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1.The Second Clinical School of Guangzhou University of Chinese Medicine;2.Department of Geriatric Orthopedics

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    摘要:

    目的:利用有限元方法分析斜扳法对骶髂关节(sacroiliac join, SIJ)及髂腰韧带应力及位移的影响,以探索斜扳法治疗骶髂关节紊乱的生物力学作用机制,以期为临床指导治疗骶髂关节紊乱提供依据。方法:建立正常腰椎-骨盆有限元模型,根据人体真实组织结构对髂腰韧带和关节软骨进行模拟重建。验证模型后,分别模拟垂直压缩、拔伸和斜扳法,分析骶髂关节及髂腰韧带的应力及位移情况。结果:在三种应力加载模式下,斜扳法加载时SIJ关节面的应力(35.174MPa)、位移(0.553mm)及关节活动度(0.62°)均为最大;并且髂腰韧带的总体应力(4.717MPa)及位移(1.6042mm)也均为最大。斜扳法应力加载时,髂腰韧带的总体位移较关节面大,而关节面的最大应力较髂腰韧带大。结论:在三种应力加载模式下,斜扳法对骶髂关节及髂腰韧带产生应力及位移的影响最为明显。推测斜扳法能引起骶髂关节发生轻微的分离和旋转,改变应力分布,但对髂腰韧带的拉伸作用更明显。

    Abstract:

    Objective: To analyze the influence of oblique-pulling manipulation on the stress and displacement of sacroiliac joint (SIJ) and iliolumbar ligament by finite element analysis; and to explore the mechanism of oblique-pulling manipulation in treating sacroiliac joint subluxation. Methods: The finite element lumbar spine-pelvis model was established. The iliolumbar ligament and articular cartilage were reconstructed according to the real tissue structure of human body. Compression, tensile and oblique-pulling tests were performed in order to analyze the stress and displacement of sacroiliac joint and iliolumbar ligament after model validation. Results: When the oblique-pulling manipulation load, the stress(35.174MPa), displacement(0.553mm) and Range of Motion( 0.62°) of SIJ were maximized. And the total stress(4.717MPa) and displacement(1.6042mm) of iliolumbar ligament also happen by oblique-pulling manipulation. Conclusions: The effect of oblique-pulling manipulation on the SIJ and iliolumbar ligament is most obviously in these three modes. We suppose that it can cause slight separation and rotation of SIJ and change the stress distribution, but the tensile effect on iliolumbar ligament is more obvious.

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  • 收稿日期:2025-03-06
  • 最后修改日期:2025-04-22
  • 录用日期:2025-04-22
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