Cao Sheng-Nan, Wang Dan-Dan, Wang Cong-An, Shi Bin, Sun Guo-Dong
The Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong, China.
Zhongguo Gu Shang. 2020 Sep 25;33(9):867-72. doi: 10.12200/j.issn.1003-0034.2020.09.015.
To explore the biomechanical characteristics of "three-dimensional balanced manipulation" for the treatment of cervical spondylotic radiculopathy(CSR).
A CSR patient was treated with "three-dimensional balanced manipulation", and the mechanical changes during the manipulation were monitored by mechanical testing system. Using spiral CT to scan the neck of the patient to obtain DICOM data. The three-dimensional finite element model of cervical spondylotic radiculopathy was established by using Mimics software, Geographic Studio software. The "three-dimensional balance manipulation" was simulated and loaded, and the mechanical parameters of each part were replaced into the finite element model, and the finite element analysis was carried out by using ANSYS software to study the internal stress changes and displacement deformation of vertebral body and intervertebral disc under the action of "three-dimensional balance manipulation".
The established C-C finite element model of the CSR patient consisted of 5 vertebrae, 4 intervertebral discs and 3 ligaments, involving 153 471 nodes and 64 978 units. The stress of C-C vertebral body was mainly located in anterior and root of C spinous processes, arch, vertebral arch and the combination of the two after full loading of manipulation, and the maximum stress was 17.781 MPa. The deformation sites were mainly concentrated in articular processes and anterior transverse processes of C, superior articular processes and transverse processes of C, articular processes of C. The stress of C-C intervertebral disc mainly distributed in the anterior part of C intervertebral disc and the nucleus pulposus of C and C. The displace mentextended to the middle and posterior part of C nucleus pulposus, around the nucleus of C and C and anterior part of cervical intervertebral disc.
The establishment of three-dimensional finite element model of C-C cervical spondylotic radiculopathy can simulate the geometry and material properties of cervical spine, and also accurately reflects the biomechanical characteristics of cervical spine, verifys the internal mechanism of "three-dimensional balanced manipulation" on CSR, proves the safety and effectiveness of treatment, guides more standardized manipulation, and avoids medical accidents.
探讨“三维平衡手法”治疗神经根型颈椎病（CSR）的生物力学特性。
对1例CSR患者采用“三维平衡手法”治疗，运用力学测试系统监测手法操作过程中的力学变化。利用螺旋CT扫描患者颈部获取DICOM数据，采用Mimics软件、Geographic Studio软件建立神经根型颈椎病的三维有限元模型。模拟并加载“三维平衡手法”，将各部位力学参数代入有限元模型，运用ANSYS软件进行有限元分析，研究“三维平衡手法”作用下椎体及椎间盘的内部应力变化和位移形变情况。
建立的CSR患者C-C有限元模型由5个椎体、4个椎间盘和3条韧带组成，包含153471个节点和64978个单元。手法充分加载后，C-C椎体应力主要集中于C椎体前缘、棘突根部、椎弓、椎弓根及二者结合部，最大应力为17.781MPa；变形部位主要集中于C关节突及前横突、C上关节突及横突、C关节突。C-C椎间盘应力主要分布于C椎间盘前部及C、C椎间盘髓核，位移延伸至C髓核中后部、C及C髓核周围和颈椎间盘前部。
建立C-C神经根型颈椎病三维有限元模型，能够模拟颈椎几何形状及材料特性，准确反映颈椎生物力学特性，验证“三维平衡手法”治疗CSR的内在机制，证明治疗的安全性和有效性，指导更规范的手法操作，避免医疗事故。
