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新型 S 型动力 cage 的生物力学分析——基于教学法优化算法的实验与有限元研究。

Biomechanical analysis of the novel S-type dynamic cage by implementation of teaching learning based optimization algorithm - An experimental and finite element study.

机构信息

Bio-Mechanics Laboratory, Department of Mechanical Engineering, College of Engineering and Technology, SRM Institute of Science and Technology, Kattankulathur, Tamilnadu, 603203, India.

Department of Computer Science & Application, Institute of Engineering & Management, Kolkata-700091, West Bengal, India.

出版信息

Med Eng Phys. 2023 Feb;112:103955. doi: 10.1016/j.medengphy.2023.103955. Epub 2023 Feb 7.

Abstract

Anterior Cervical Discectomy and Fusion (ACDF) is the most popular and effective procedure for patients with intervertebral disc degeneration, where the degenerated disc is replaced with an interbody implant (widely known as cage). The design of the cage plays a vital role since it has to provide stability for the anterior cervical column without any side-effects. We designed a novel S-type dynamic cage for C4-C5 level, using Polyetheretherketone (PEEK) material considering four different shapes namely: square, circle, rectangle and elliptical, for the central window to occupy bone graft. The major design constrain for a successful cage is minimized cage stress, in order to avoid subsidence. Finite Element (FE) analysis results revealed that the cage stress values obtained during the physiological motion varied depending upon the shape of the central window provided for bone graft. The objective of this study is to optimize the central window shape using the Teaching Learning Based Optimization (TLBO) algorithm. It was found that square and elliptical shape bone graft cavity resulted in better outcomes. Additional experimental study was also conducted with a six-axis spine simulator. Based on the optimization results, we manufactured two PEEK cage models with square and elliptical shaped central window using additive manufacturing. A prototype model of the C4-C5 level made of Polyvinylchloride (PVC) was used for experiment due to the existing constraints for using a cadaveric model. The experimental results were cross-verified using FE analysis. Thus, we would like to conclude that square and elliptical shape of the central window were the better design factor for our novel dynamic cage.

摘要

颈椎前路椎间盘切除术和融合术(ACDF)是治疗椎间盘退变患者最常用且有效的方法,该手术将退变的椎间盘用椎间植入物(通常称为 cage)替代。 cage 的设计至关重要,因为它必须在不产生任何副作用的情况下为颈椎前柱提供稳定性。我们设计了一种新型 S 型颈椎前路椎间融合器(C4-C5 节段),采用聚醚醚酮(PEEK)材料,考虑了四种不同形状的中央窗口,即:方形、圆形、矩形和椭圆形,用于容纳骨移植物。 Cage 成功的主要设计约束是最小化 cage 应力,以避免下沉。有限元(FE)分析结果表明,在生理运动过程中获得的 cage 应力值取决于为骨移植物提供的中央窗口的形状。本研究的目的是使用基于教学的优化算法(TLBO)优化中央窗口的形状。结果发现,方形和椭圆形骨移植物腔的结果更好。还使用六轴脊柱模拟器进行了额外的实验研究。根据优化结果,我们使用增材制造制造了两种具有方形和椭圆形中央窗口的 PEEK cage 模型。由于使用尸体模型存在限制,因此使用聚氯乙烯(PVC)制造了 C4-C5 节段的原型模型进行实验。使用 FE 分析对实验结果进行了交叉验证。因此,我们可以得出结论,方形和椭圆形的中央窗口形状是我们新型动态 cage 的更好设计因素。

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