Chen Hongyu, Wu Tianchi, Pan Shengfa, Zhang Li, Zhao Yanbin, Chen Xin, Sun Yu, Lu William W, Zhou Feifei
Department of Orthopaedics, Peking University Third Hospital, Beijing, China.
Engineering Research Center of Bone and Joint Precision Medicine, Beijing, China.
Front Bioeng Biotechnol. 2025 Sep 1;13:1594207. doi: 10.3389/fbioe.2025.1594207. eCollection 2025.
To compare the biomechanical characteristics of axial traction and suspensory traction in the process of preoperative correction of cervical kyphosis.
An intact three-dimensional finite element digital model of C2-T2 with cervical kyphosis was established. The head gravity and moment were applied to the finite element model to simulate the force of skull traction and the force of suspensory traction. The changes of cervical kyphotic angle, the length of cervical spinal canal and the stress distribution of each vertebral body were analyzed under two traction modes.
The kyphotic angles of the kyphotic segments were reduced by both tractions. The C2-C5 kyphotic angle was 41° before traction, and decreased to 32° and 26° after axial traction and suspensory traction, respectively. The length of C3-C7 cervical spinal canal was 61.3 mm before traction. After axial traction, the length of C3-C7 cervical spinal canal increased to 61.8 mm; after suspensory traction, it decreased to 59. 6 mm. The high stress area of each vertebral body was located in the anterior longitudinal ligament attachment area of the vertebral body during both two kinds of traction. The maximum Mises stress of C2-C7 vertebral body in suspensory traction is generally small relative to axial traction.
Compared with axial traction, suspensory traction has better kyphotic corrective effect, while reduces the length of the cervical spinal canal and the stress on the cervical vertebral body, which decreases the possibility of nerve damage and iatrogenic fracture during traction from a biomechanical point of view.
比较颈椎后凸畸形术前矫正过程中轴向牵引与悬吊牵引的生物力学特性。
建立完整的伴有颈椎后凸畸形的C2-T2三维有限元数字模型。将头部重力和力矩施加于有限元模型，以模拟颅骨牵引的力和悬吊牵引的力。分析两种牵引方式下颈椎后凸角、颈椎管长度及各椎体应力分布的变化。
两种牵引方式均使后凸节段的后凸角减小。牵引前C2-C5后凸角为41°，轴向牵引和悬吊牵引后分别减小至32°和26°。牵引前C3-C7颈椎管长度为61.3mm。轴向牵引后，C3-C7颈椎管长度增加至61.8mm；悬吊牵引后，其长度减小至59.6mm。两种牵引过程中各椎体的高应力区均位于椎体前纵韧带附着区。悬吊牵引时C2-C7椎体的最大米塞斯应力相对于轴向牵引总体较小。
与轴向牵引相比，悬吊牵引具有更好的后凸矫正效果，同时缩短了颈椎管长度并减轻了颈椎椎体的应力，从生物力学角度降低了牵引过程中神经损伤和医源性骨折的可能性。
