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基于有限元法的凹侧横突间韧带松弛对青少年特发性脊柱侧弯腰椎应力的影响

The Effect of Concave-Side Intertransverse Ligament Laxity on the Stress of AIS Lumbar Spine Based on Finite Element Method.

作者信息

Zhang Linjie, Zhang Qiaolin, Zhang Yan, Arthur Musinguzi, Teo Ee-Chon, Bíró István, Gu Yaodong

机构信息

Faculty of Sports Science, Ningbo University, Ningbo 315211, China.

School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 639798, Singapore.

出版信息

Bioengineering (Basel). 2022 Nov 23;9(12):724. doi: 10.3390/bioengineering9120724.

Abstract

(1) Background: Scoliosis has the mechanical characteristic of asymmetric stress distribution, which is one of the reasons for the aggravation of scoliosis. Bracing therapy is the best treatment for AIS, but it is difficult and costly to operate. Is it possible to reduce pressure in the concave side by relaxing the ITL in the concave side of scoliosis, so as to improve the abnormal stress distribution of scoliosis? In this paper, a finite element method was used to simulate the effect of the relaxation of concave-side ITL on the stress of a lumbar spine with scoliosis, which provides some guidance for the treatment of scoliosis. (2) Methods: Using CT images of a patient with scoliosis whose Cobb Angle was 43° and Lordosis Angle was 45, a scoliosis lumbar was established, and Young's modulus of the ITL of the concave-side lumbar spine was reduced by 95% to simulate ligament relaxation. By comparing the stress condition of the model vertebral body with no ligament relaxation, the effect of concave-side ITL relaxation on the mechanical characteristics of scoliosis lumbar spine was explored. (3) Results: An effective and complete model of the lumbar spine was established. The concave ITL relaxed, which only had a great impact on the bending loads. After the ligament was relaxed, the stability of the spine was reduced. Stress concentration on the concave side of vertebrae and the IVD was aggravated. Under loads on the convex side, the maximum stress on the vertebral body and the IVD increased significantly, making lumbar vertebrae more vulnerable to injury. (4) Conclusions: Laxity of the ITL on the concave side of the AIS lumbar only affects the bending load. Laxity of the concave-side ligament will reduce the stability of the lumbar, aggravate the uneven stress distribution of scoliotic lumbar vertebrae, increase the risk of IVD injury, and be unfavorable for the scoliotic lumbar spine. Relaxation of the concave ITL alone is not an effective way to treat scoliosis.

摘要

(1) 背景:脊柱侧弯具有应力分布不对称的力学特性,这是脊柱侧弯加重的原因之一。支具治疗是青少年特发性脊柱侧弯(AIS)的最佳治疗方法,但操作困难且成本高昂。通过放松脊柱侧弯凹侧的髂胫束(ITL)来降低凹侧压力,从而改善脊柱侧弯异常的应力分布是否可行?本文采用有限元方法模拟凹侧ITL放松对脊柱侧弯腰椎应力的影响,为脊柱侧弯的治疗提供一些指导。(2) 方法:利用一名Cobb角为43°、腰椎前凸角为45°的脊柱侧弯患者的CT图像,建立脊柱侧弯腰椎模型,并将凹侧腰椎ITL的杨氏模量降低95%以模拟韧带松弛。通过比较未进行韧带松弛的模型椎体的应力状况,探讨凹侧ITL放松对脊柱侧弯腰椎力学特性的影响。(3) 结果:建立了有效且完整的腰椎模型。凹侧ITL放松,仅对弯曲载荷有较大影响。韧带松弛后,脊柱稳定性降低。椎体和椎间盘凹侧的应力集中加剧。在凸侧载荷作用下,椎体和椎间盘上的最大应力显著增加,使腰椎更容易受伤。(4) 结论:AIS腰椎凹侧ITL松弛仅影响弯曲载荷。凹侧韧带松弛会降低腰椎稳定性,加重脊柱侧弯腰椎椎体应力分布不均,增加椎间盘损伤风险,对脊柱侧弯腰椎不利。单纯放松凹侧ITL不是治疗脊柱侧弯的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/197b/9774201/d44c0b2a9735/bioengineering-09-00724-g001.jpg

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