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椎板成形术的开口大小取决于槽口大小:一项数值研究。

The opening size of the laminoplasty is dependent on the groove size: A numerical study.

机构信息

Third Faculty of Medicine, Charles University, Prague, Ruska 2411/87, 100 00 Praha 10-Vinohrady, Czech Republic; Regional Hospital in Liberec, Husova 10, Liberec 46001, Czech Republic.

Third Faculty of Medicine, Charles University, Prague, Ruska 2411/87, 100 00 Praha 10-Vinohrady, Czech Republic; Colleague of Polytechnics Jihlava, Tolsteho 1556, Jihlava 58601, Czech Republic.

出版信息

Clin Biomech (Bristol). 2021 Oct;89:105479. doi: 10.1016/j.clinbiomech.2021.105479. Epub 2021 Sep 11.

Abstract

BACKGROUND

The expansion of the cervical vertebrae lamina appears to be crucial to related surgical procedures. The dimensions of the groove influence the strain concentration within the lamina of the vertebra and, thus, the potential success or failure of respective surgical procedure. The aim of this computational study is to clarify both the role of the size of the groove with concern to both the open door and the double door laminoplasty techniques.

METHODS

Finite element models were created via computer tomography with varying lamina groove dimensions. Displacements were applied to the models at the open side of the vertebral arch and the vertebral body was constrained prior to movement along all the axes. The maximal opening size measured on the inner side of the lamina and the percentage increase in the initial spinal areas were subsequently analyzed.

FINDINGS

The elastic strain concentration value was observed for the groove in all cases, while the maximal principal elastic strain concentration value was observed at the opposite side to the groove cut into the lamina, also in all cases. The maximal area increase related to the 4 mm groove accompanied by the preservation of the ventral cortex of the bone.

INTERPRETATION

The study suggested three conclusions a) the wider the groove, the greater is the opening potential, b) the maximal opening size following laminoplasty is not dependent on the depth of the bone cut for this type of groove, c) no benefit accrues in terms of the opening size following the cutting of a supplementary groove at the beginning of the lamina.

摘要

背景

颈椎板的扩展似乎对相关的手术过程至关重要。槽的尺寸影响了椎板内的应变集中,从而影响了各自手术的成功或失败的潜力。本计算研究的目的是阐明槽的大小对开门和双开门椎板成形术技术的影响。

方法

通过计算机断层扫描创建有限元模型,对椎弓根和椎体进行了不同的板槽尺寸的有限元模型的创建,在椎弓根的开口侧对模型施加位移,然后在所有轴上对椎体进行约束。随后分析了内侧板的最大开口尺寸和初始脊柱区域的百分比增加。

发现

在所有情况下,在槽内观察到弹性应变集中值,而在所有情况下,在板上切槽的另一侧观察到最大主弹性应变集中值。与保留骨的腹侧皮质相关的 4 毫米槽的最大面积增加。

解释

研究得出了三个结论:a)槽越宽,开口的潜力越大;b)对于这种类型的槽,在骨切开的深度上,椎板成形术后的最大开口尺寸并不依赖;c)在板的起始处切割补充槽不会增加开口尺寸。

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