刘慧,沈国权,张喜林,周楠,杨晓伟,黄文杰,周思涵.肌肉加载下腰椎间盘突出的有限元研究[J].医用生物力学,2019,34(5):493-499
肌肉加载下腰椎间盘突出的有限元研究
Finite Element Study of Lumbar Disc Herniation Loaded with Muscle Force
投稿时间:2018-08-12  修订日期:2018-11-11
DOI:
中文关键词:  腰椎间盘突出症  肌肉  有限元分析
英文关键词:lumbar disc herniation (LDH)  muscle  finite element analysis
基金项目:国家自然科学基金项目(81173358),上海市科委自然基金项目(13ZR1442900),上海市科委创新课题(14YZ060)
作者单位
刘慧 青岛大学附属医院 中医内科 
沈国权 上海中医药大学附属岳阳中西医结合医院 推拿科 
张喜林 上海中医药大学附属岳阳中西医结合医院 推拿科 
周楠 上海中医药大学附属岳阳中西医结合医院 推拿科 
杨晓伟 上海中医药大学附属岳阳中西医结合医院 推拿科 
黄文杰 上海硅步科学仪器有限公司 
周思涵 上海中医药大学附属岳阳中西医结合医院 推拿科 
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中文摘要:
      目的 通过观察腰椎间盘突出症(lumbar disc herniation,LDH)患者肌肉加载下腰椎有限元模型的应力变化,探讨LDH患者肌肉功能对结构应力的影响。方法 选取正常志愿者、LDH患者各1名,采集CT数据建立相应的正常、LDH腰椎-骨盆三维有限元模型,同时采集其步态数据驱动AnyBody仿真肌骨模型,得到附着在腰椎骨盆周围肌肉的肌力及髋关节力作为加载条件,分别进行自身加载和正常模型加载LDH肌肉力,比较两种加载情况下L4、L5椎间盘及骶髂关节两侧应力变化。结果 正常模型加载LDH肌肉力后,自身加载时的双峰曲线消失,代之以异常的单峰曲线,与LDH模型自身加载后的时间-应力曲线变化趋势一致。LDH患者肌肉力加载于正常模型后,L4、L5椎间盘及骶髂关节两侧应力差值较LDH模型自身加载后的应力差值减小。结论 LDH患者腰椎骨盆肌肉功能异常会引起腰椎及骶髂关节应力异常,结构失衡本身可导致应力失衡,而肌肉作为动力因素是导致结构动态应力异常的重要原因,由此可导致关节运动模式的异常。临床治疗LDH要重视对周围肌肉功能失衡的评估。
英文摘要:
      Objective To investigate the effect of muscle function on structural stress in patient with lumbar disc herniation (LDH), by observing the stress changes in LDH lumbar-pelvis finite element model loaded with muscle force. Methods One normal healthy volunteer and one LDH patient were selected. Their CT data were collected to establish two corresponding normal and LDH lumbar-pelvis finite element models, and their gait data were also simultaneously collected to drive the AnyBody musculoskeletal model. The muscle force around the lumbar and pelvis as well as the hip-joint force were obtained as the loading condition. Self-loading of the normal and LDH model as well as the normal model loaded with LDH muscle forces were conducted seperately. Then the stress changes in L4 and L5 intervertebral discs and sacroiliac joints under two above loading conditions were compared. Results The stress curve of normal model loaded with LDH muscle force showed a unimodal stress curve, instead of a bimodal curve, and such trend of stress-time curve was as same as the trend of the LDH model during self-loading. But the stress difference in L4 and L5 intervertebral discs and sacroiliac joint of the normal model loaded with LDH muscle force was smaller than that in the LDH model during self-loading. Conclusions Abnormal muscle function of LDH could lead to abnormal joint stress of the intervertebral discs and sacroiliac joint. Structural imbalance itself could lead to stress imbalance, and muscle as a driving factor was an important cause of anomaly structural dynamic stress, thus leading to abnormal joint motion patterns. Therefore, attention should be paid to assessment of the imbalance of peripheral muscle function in clinical treatment of LDH.
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