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经椎间孔腰椎体间融合的生物力学研究：三维有限元分析。

The Biomechanical Study of Extraforaminal Lumbar Interbody Fusion: A Three-Dimensional Finite-Element Analysis.

机构信息

Department of Spine, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Shanghai 200120, China.

Department of Traumatology, Shanghai East Hospital, Tongji University School of Medicine, No. 150 Jimo Road, Shanghai 200120, China.

出版信息

J Healthc Eng. 2017;2017:9365068. doi: 10.1155/2017/9365068. Epub 2017 Sep 26.

DOI:10.1155/2017/9365068
PMID:29081940
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5634568/
Abstract

OBJECTIVE

Finite-element method was used to evaluate biomechanics stability of extraforaminal lumbar interbody fusion (ELIF) under different internal fixation.

METHODS

The L3-L5 level finite-element model was established to simulate decompression and internal fixation at L4-L5 segment. The intact finite model was treated in accordance with the different internal fixation. The treatment groups were exerted 400 N load and 6 N·m additional force from motion to calculate the angular displacement of L4-L5.

RESULTS

The ROMs were smaller in all internal fixation groups than those in the intact model. Furthermore, the ROMs were smaller in ELIF + UPS group than in TLIF + UPS group under all operating conditions, especially left lateral flexion and right rotation. The ROMs were higher in ELIF + UPS group than in TLIF + BPS group. The ROMs of ELIF + UPS + TLFS group were much smaller than those in ELIF + UPS group, and as compared with TLIF + BPS group, there was no significant difference in the range of experimental loading.

DISCUSSION

The biomechanical stability of ELIF with unilateral pedicle screw fixation is superior to that of TLIF with unilateral pedicle screw fixation but lower than that of TLIF with bilateral pedicle screws fixation. The stability of ELIF with unilateral fixation can be further improved by supplementing a translaminar facet screw.

摘要

目的

采用有限元法评估不同内固定方式下经椎间孔腰椎体间融合术（ELIF）的生物力学稳定性。

方法

建立 L3-L5 节段有限元模型，模拟 L4-L5 节段减压和内固定。根据不同的内固定方式对完整有限元模型进行处理。对治疗组施加 400 N 的载荷和 6 N·m 的附加力，从运动方向计算 L4-L5 的角位移。

结果

所有内固定组的 ROM 均小于完整模型。此外，在所有操作条件下，ELIF+UPS 组的 ROM 均小于 TLIF+UPS 组，尤其是在左侧侧屈和右侧旋转时。ELIF+UPS 组的 ROM 高于 TLIF+BPS 组。ELIF+UPS+TLFS 组的 ROM 明显小于 ELIF+UPS 组，与 TLIF+BPS 组相比，在实验加载范围内无显著差异。

讨论

单侧椎弓根螺钉固定的 ELIF 的生物力学稳定性优于单侧椎弓根螺钉固定的 TLIF，但低于双侧椎弓根螺钉固定的 TLIF。通过补充经椎板关节突螺钉固定可进一步提高单侧固定的 ELIF 的稳定性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/5c93d9811356/JHE2017-9365068.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/0d0acd7ca939/JHE2017-9365068.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/ae8b2f223c90/JHE2017-9365068.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/6a7059078b62/JHE2017-9365068.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/3541336a31e5/JHE2017-9365068.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/5c93d9811356/JHE2017-9365068.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/0d0acd7ca939/JHE2017-9365068.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/ae8b2f223c90/JHE2017-9365068.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/6a7059078b62/JHE2017-9365068.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/3541336a31e5/JHE2017-9365068.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e09/5634568/5c93d9811356/JHE2017-9365068.005.jpg

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