Zhu Lei, Zhang Chi, Peng Li, Cheng Zifei, Liang Xiuwen
Department of Orthopedics, Hulunbeir People's Hospital, Hulunbuir, China.
Department of Endocrinology, Hulunbeir People's Hospital, Hulunbuir, China.
Front Bioeng Biotechnol. 2023 Sep 12;11:1220102. doi: 10.3389/fbioe.2023.1220102. eCollection 2023.
By assessing a case of ankylosing spondylitis (AS) after thoracic lumbar protrusion deformity in a digital model and verifying its effectiveness after surgery for orthopaedic surgery process simulation, a finite element model was established for biomechanical experiments. A 56-year-old patient with AS underwent preoperative thoracic lumbar spine computed tomography. The data were reconstructed using MIMICS16.0 software and modelled to design and measure the nailing parameters. A three-dimensional model was established using ANSYS14.0 software, and the actual surgical procedure was simulated using biomechanical experiments. The model was verified by comparing the X-ray films obtained from patients during preoperative forward bending, stretching and lateral flexion, with the model further tested using the Hueter-Volkmann principle. On comparing the measurements across three different load cases (forward bending, after stretching and lateral flexion) in patients with AS after thoracic lumbar protrusion deformity and the original X-ray images, no difference was found between the model of deformation and real patient movement displacement across the vertebral body. On simulating the stress distribution, the measured T10-L4 vertebral body stress values at every point in the injured vertebrae were, on the whole, directed at both the upper and lower ends and exhibited a decreasing trend, and the stress distribution gradually decreased from the injured vertebrae (T12 and L1) to the upper and lower ends. The accuracy of the research model is high, the geometric similarity is good and relevant applied anatomy can be undertaken using the model parameter measurement. This study provides a successful example of the application of digital technology in the field of spinal deformity and a novel idea for the treatment of AS-related kyphosis.
通过在数字模型中评估一例胸腰椎后凸畸形后的强直性脊柱炎(AS)病例,并在骨科手术过程模拟中验证其手术后的有效性,建立了用于生物力学实验的有限元模型。一名56岁的AS患者接受了术前胸腰椎计算机断层扫描。使用MIMICS16.0软件重建数据并进行建模以设计和测量钉扎参数。使用ANSYS14.0软件建立三维模型,并通过生物力学实验模拟实际手术过程。通过比较患者术前前屈、伸展和侧屈时获得的X线片对模型进行验证,并使用休特-福尔克曼原理对模型进行进一步测试。比较胸腰椎后凸畸形的AS患者在三种不同负荷情况下(前屈、伸展后和侧屈)的测量结果与原始X线图像,发现椎体变形模型与真实患者运动位移之间没有差异。在模拟应力分布时,受伤椎骨各点处测得的T10-L4椎体应力值总体上指向上下两端并呈下降趋势,应力分布从受伤椎骨(T12和L1)向上下两端逐渐降低。研究模型准确性高,几何相似性好,可利用模型参数测量进行相关应用解剖学研究。本研究为数字技术在脊柱畸形领域的应用提供了成功范例,为AS相关驼背的治疗提供了新思路。
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