解剖学报

解剖学报 ›› 2024, Vol. 55 ›› Issue (1): 88-97.doi: 10.16098/j.issn.0529-1356.2024.01.013

• 解剖学 • 上一篇    下一篇

 切除不同范围钩突后颈椎椎间盘的有限元分析

 杨洋1 史君2 李琨3,4 马渊4  张少杰3,4 侯二飞3  王超群5  陈杰3 王星3,4*  李志军3,4*    

  1. 1.内蒙古医科大学研究生院，呼和浩特 010110; 2.内蒙古医科大学基础医学院生理学教研室，呼和浩特 010110; 3.内蒙古医科大学基础医学院解剖学教研室，呼和浩特 010110;  4.内蒙古医科大学基础医学院数字医学中心，呼和浩特 010059; 5.内蒙古医科大学附属医院影像科，呼和浩特 010050

  • 收稿日期:2022-05-23 修回日期:2022-08-27 出版日期:2024-02-06 发布日期:2024-02-06
  • 通讯作者: 王星 李志军 E-mail:wangxing197911@163.com
  • 基金资助:
    颈椎钩椎关节发育特征的基础与临床应用解剖学

 Finite element analysis of cervical intervertebral discs after removing different ranges of uncinate processes

 YANG  Yang1  SHI Jun2  LI Kun3,4  MA Yuan4  ZHANG Shao-jie3,4  HOU Er-fei3  WANG Chao-qun5, CHEN Jie3  WANG Xing3,4*  LI  Zhi-jun3,4*   

  1. 1.Graduate School, Inner Mongolia Medical University, Hohhot 010110, China;   2.Physiology Teaching and Research Section, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, China;  3.Human Anatomy Teaching and Research Section, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010110, China;  4.Digital Medicine Center, School of Basic Medicine, Inner Mongolia Medical University, Hohhot 010059, China;   5.Department of Imaging, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China
  • Received:2022-05-23 Revised:2022-08-27 Online:2024-02-06 Published:2024-02-06
  • Contact: WANG Xing LI Zhi-jun E-mail:wangxing197911@163.com

PDF

摘要：

 目的  通过建立C0~T1全颈椎三维有限元模型，探讨切除不同范围钩突后颈椎椎间盘的应力变化特点，为临床手术治疗提供实验依据。 
  方法  对1例全颈椎进行CT扫描后建立正常颈椎三维模型，同时设计切除左侧50%、100%的钩突和切除双侧100%的钩突模型，加载相同力矩后比较4种模型在前屈、后伸、左右侧屈及左右旋转等6种工况下的受力变化（应力、位移）。   结果  随着钩突不同范围的切除，椎间盘应力和位移值集中位于C5/6处，随后渐呈递减趋势。椎间盘在切除左侧C5钩突50%后其应力值仅在C5处存在侧别间差异，但在左侧或双侧切除100% C5钩突后其应力值出现了侧别间差异。   结论  切除不同范围钩突（50%、100%）后可影响颈椎稳定性，且切除范围越大越影响颈椎稳定性。临床在该区手术切除时应尽可能选择最优原则，以最少切除而达到治疗效果为最佳。

关键词:   钩突, 椎间盘, 钩椎关节, 颈椎, 有限元, 力学变化, 解剖学, 三维重建, 人

Abstract:

Objective  To study the stress change characteristics of the cervical disc after removing different ranges of the uncinate process by establishing a three-dimensional finite element model of the C0-T1 whole cervical spine to provide a theoretical basis for clinical and surgical treatment.    Methods  After a CT scan of one case of the whole cervical spine, we established a three-dimensional model of the normal cervical spine and designed the model to excise 50% and 100% of the uncinate process on the left side and 100% of the uncinate process on both sides at the same time. The four models’ stress changes (stress and displacement) were compared after loading the same torque under six working conditions, forward flexion, back extension, left and right lateral flexion, and left and right rotation.    Results  With the removal of different ranges of the uncinate process, the stress and displacement values of the disc were concentrated at C5/6 and then gradually decreased. Interlateral differences in disc stress values were found only at C5 after removing 50% of the left C5 uncinate process, and interlateral differences were found at all disc stress values after removing 100% of the C5 uncinate process on the left or both sides.    Conclusion  Removal of different ranges of the uncinate process (50% and 100%) can affect cervical spine stability, and the larger the range of resection is the more it affects cervical spine stability. The best clinical principle is to choose the best possible surgical resection in this area that can achieve the least resection and the best therapeutic effect.

Key words:   Uncinate process, Intervertebral disc, Uncovertebral joint, Cervical spine, Finite element, Mechanical change, Anatomy, Three-dimensional reconstruction, Human

中图分类号: