Wang Jing Hospital of China Academy of Chinese Medical Sciences, Beijing 100102, China.
Shenzhen Traditional Chinese Medicine Hospital, Shenzhen 518110, China.
Biomed Res Int. 2021 Jan 2;2021:8239326. doi: 10.1155/2021/8239326. eCollection 2021.
The FSI model, based on MRI data of an atherosclerosis patient, was used to simulate the deformations of the plaque and lumen during the process of two kinds of typical cSMT (the high-speed, low-amplitude spinal manipulation and the cervical rotatory manipulation). The biomechanical parameters were recorded, such as the highest wall shear stress (WSS), the maximum plaque wall stress (PWS), the wall tensile stress (Von mises stress, VWTS), and the strain.
The max_WSS was 33.77 kPa in the most extensive deformation. The highest WSS region on the plaque surface was also the highest PWS region. The max_PWS in a 12% stretch was 55.11 kPa, which was lower than the rupture threshold. The max_VWTS of the cap in 12% stretch which approached the fracture stress level was 116.75 kPa. Moreover, the vessel's max_VWTS values in 10% and 12% stretch were 554.21 and 855.19 kPa. They were higher than the fracture threshold, which might cause media fracture. Meanwhile, the 7% stretched strain was 0.29, closed to the smallest experimental green strains at rupture.
The carotid arteries' higher stretch generated the higher stress level of the plaque. Cervical rotatory manipulation might cause plaque at a high risk of rupture in deformation after 12% stretch and more. Lower deformation of the plaque and artery caused by the high-speed, low-amplitude spinal manipulation might be safer.
基于一位动脉粥样硬化患者的 MRI 数据，使用流固耦合模型来模拟两种典型的颈椎手法治疗（高速低幅脊柱手法治疗和颈椎旋转手法治疗）过程中斑块和管腔的变形。记录生物力学参数，如最高壁面切应力（WSS）、最大斑块壁应力（PWS）、壁张应力（von mises 应力，VWTS）和应变。
在最大变形时，最大壁面切应力（max_WSS）为 33.77kPa。斑块表面的最高 WSS 区域也是最高 PWS 区域。在 12%拉伸时，最大 PWS 为 55.11kPa，低于破裂阈值。在接近骨折应力水平的 12%拉伸时，帽的最大 VWTS 为 116.75kPa。此外，血管在 10%和 12%拉伸时的最大 VWTS 值分别为 554.21kPa 和 855.19kPa，高于断裂阈值，可能导致血管中层断裂。同时，7%拉伸应变值为 0.29，接近破裂时的最小实验绿色应变值。
颈动脉的高拉伸会导致斑块的更高的应力水平。颈椎旋转手法治疗可能会导致斑块在 12%拉伸和更大的变形后处于高破裂风险中。高速低幅脊柱手法治疗引起的斑块和动脉的较小变形可能更安全。
