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利用有限元模拟对患有L4-L5腰椎间盘突出症且腰椎生理曲度变直的举重运动员对称弯曲和举重行为的生物力学研究。

Biomechanical Study of Symmetric Bending and Lifting Behavior in Weightlifter with Lumbar L4-L5 Disc Herniation and Physiological Straightening Using Finite Element Simulation.

作者信息

Zhang Caiting, Song Yang, Zhang Qiaolin, Teo Ee-Chon, Liu Wei

机构信息

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

Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong 999077, China.

出版信息

Bioengineering (Basel). 2024 Aug 12;11(8):825. doi: 10.3390/bioengineering11080825.

Abstract

BACKGROUND

Physiological curvature changes of the lumbar spine and disc herniation can cause abnormal biomechanical responses of the lumbar spine. Finite element (FE) studies on special weightlifter models are limited, yet understanding stress in damaged lumbar spines is crucial for preventing and rehabilitating lumbar diseases. This study analyzes the biomechanical responses of a weightlifter with lumbar straightening and L4-L5 disc herniation during symmetric bending and lifting to optimize training and rehabilitation.

METHODS

Based on the weightlifter's computed tomography (CT) data, an FE lumbar spine model (L1-L5) was established. The model included normal intervertebral discs (IVDs), vertebral endplates, ligaments, and a degenerated L4-L5 disc. The bending angle was set to 45°, and weights of 15 kg, 20 kg, and 25 kg were used. The flexion moment for lifting these weights was theoretically calculated. The model was tilted at 45° in Abaqus 2021 (Dassault Systèmes Simulia Corp., Johnston, RI, USA), with L5 constrained in all six degrees of freedom. A vertical load equivalent to the weightlifter's body mass and the calculated flexion moments were applied to L1 to simulate the weightlifter's bending and lifting behavior. Biomechanical responses within the lumbar spine were then analyzed.

RESULTS

The displacement and range of motion (ROM) of the lumbar spine were similar under all three loading conditions. The flexion degree increased with the load, while extension remained unchanged. Right-side movement and bending showed minimal change, with slightly more right rotation. Stress distribution trends were similar across loads, primarily concentrated in the vertebral body, increasing with load. Maximum stress occurred at the anterior inferior margin of L5, with significant stress at the posterior joints, ligaments, and spinous processes. The posterior L5 and margins of L1 and L5 experienced high stress. The degenerated L4-L5 IVD showed stress concentration on its edges, with significant stress also on L3-L4 IVD. Stress distribution in the lumbar spine was uneven.

CONCLUSIONS

Our findings highlight the impact on spinal biomechanics and suggest reducing anisotropic loading and being cautious of loaded flexion positions affecting posterior joints, IVDs, and vertebrae. This study offers valuable insights for the rehabilitation and treatment of similar patients.

摘要

背景

腰椎的生理曲度变化和椎间盘突出可导致腰椎出现异常生物力学反应。关于特殊举重运动员模型的有限元(FE)研究有限,然而了解受损腰椎的应力对于预防和治疗腰椎疾病至关重要。本研究分析了一名腰椎变直且L4-L5椎间盘突出的举重运动员在对称弯曲和举重过程中的生物力学反应,以优化训练和康复方案。

方法

基于举重运动员的计算机断层扫描(CT)数据,建立了一个FE腰椎模型(L1-L5)。该模型包括正常椎间盘(IVD)、椎体终板、韧带以及退变的L4-L5椎间盘。弯曲角度设定为45°,并使用了15kg、20kg和25kg的重量。理论计算了举起这些重量时的屈曲力矩。在Abaqus 2021(达索系统Simulia公司,美国罗德岛州约翰斯顿)中将模型倾斜45°,L5在所有六个自由度上受到约束。将相当于举重运动员体重的垂直载荷和计算出的屈曲力矩施加到L1上,以模拟举重运动员的弯曲和举重行为。然后分析腰椎内的生物力学反应。

结果

在所有三种加载条件下,腰椎的位移和活动范围(ROM)相似。屈曲程度随载荷增加而增加,而伸展保持不变。右侧运动和弯曲变化最小,右侧旋转略多。不同载荷下的应力分布趋势相似,主要集中在椎体,随载荷增加而增加。最大应力出现在L5的前下缘,后关节、韧带和棘突处有明显应力。L5后部以及L1和L5的边缘承受高应力。退变的L4-L5 IVD在其边缘出现应力集中,L3-L4 IVD也有明显应力。腰椎内的应力分布不均匀。

结论

我们的研究结果突出了对脊柱生物力学的影响,并建议减少各向异性载荷,同时要谨慎对待影响后关节、IVD和椎体的负重屈曲姿势。本研究为类似患者的康复和治疗提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ea3c/11351717/545aeb7d27bf/bioengineering-11-00825-g001.jpg

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