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胸廓对脊柱侧弯静态特征的影响。

Influence of Rib Cage on Static Characteristics of Scoliotic Spine.

作者信息

Lin Liying, Jia Shaowei, Yang Hufei, Li Ye, Zhang Shunxin, Fan Jie, Han Li

机构信息

School of Medical Imaging, Tianjin Medical University, Tianjin 300203, China.

Key Laboratory for Biomechanics and Mechanobiology of Ministry of Education, School of Biological Science and Medical Engineering, Beihang University, Beijing 100083, China.

出版信息

Appl Bionics Biomech. 2020 Oct 19;2020:8858686. doi: 10.1155/2020/8858686. eCollection 2020.

DOI:10.1155/2020/8858686
PMID:33133237
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7591979/
Abstract

BACKGROUND

Scoliosis is a three-dimensional (3D) deformity of the spine, which affects the patient's appearance and may lead to abnormal heart and lung function. The rib cage is a structure composed of ribs, sternum, and costal cartilage, which plays a vital role in stabilising the thoracolumbar spine. This study investigates the influence of the rib cage on the static characteristics of the scoliotic spine.

METHODS

Two types of 3D finite element (FE) models with or without rib cage (from T1 to S) were established and analysed based on computed tomography (CT) images, to determine the effects of the rib cage on the static characteristics of the scoliotic spine. The FE software, ABAQUS, was used to analyse the static behaviours of scoliotic spine models under a range of loading conditions, including left side bending, right side bending, front tilt, rear supine, and vertical compression. The changes in the von Mises stress (VMS) within the intervertebral discs of spine models with or without rib cage were studied and compared.

RESULTS

After including the rib cage, the maximum VMS at the stress concentrations of the normal and scoliotic spine effectively reduced. The VMS in normal intervertebral discs was gentler than that of scoliotic ones. However, the scoliotic spine was more likely to produce large stress concentration in the intervertebral discs of scoliotic segments.

CONCLUSIONS

Under the common postures, intervertebral discs of scoliotic segments are more susceptible to generate stress concentrations compared with the normal spine. The rib cage could effectively keep the intervertebral discs of scoliotic segments from further injuries. These results are of great significance for the prevention and treatment of the scoliotic spine.

摘要

背景

脊柱侧弯是脊柱的三维畸形，会影响患者外观，并可能导致心肺功能异常。胸廓是由肋骨、胸骨和肋软骨组成的结构，在稳定胸腰椎方面起着至关重要的作用。本研究调查胸廓对脊柱侧弯静态特征的影响。

方法

基于计算机断层扫描（CT）图像建立并分析了两种有无胸廓（从T1至S）的三维有限元（FE）模型，以确定胸廓对脊柱侧弯静态特征的影响。使用有限元软件ABAQUS分析脊柱侧弯模型在一系列加载条件下的静态行为，包括左侧弯曲、右侧弯曲、前倾斜、后仰卧和垂直压缩。研究并比较了有无胸廓的脊柱模型椎间盘内冯·米塞斯应力（VMS）的变化。

结果

纳入胸廓后，正常和脊柱侧弯脊柱应力集中处的最大VMS有效降低。正常椎间盘内的VMS比脊柱侧弯的更平缓。然而，脊柱侧弯的脊柱在侧弯节段的椎间盘更易产生较大应力集中。

结论

在常见姿势下，与正常脊柱相比，脊柱侧弯节段的椎间盘更容易产生应力集中。胸廓可有效防止脊柱侧弯节段的椎间盘进一步损伤。这些结果对脊柱侧弯的预防和治疗具有重要意义。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0833/7591979/c4cefdb5fdf0/ABB2020-8858686.013.jpg
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