目的建立腰3-4节段的后路经椎弓根螺钉内固定的有限元模型,评估固定前后系统的应力变化,探讨后路内固定对腰椎和内固定器械的力学影响。方法利用Pro/E三维建模软件模拟脊柱后路的钉棒内固定系统,MIMICS软件模拟手术实际操作,建立后路经椎弓根螺钉固定前后的腰3-4节段三维实体,导入有限元软件ABAQUS中建立三维有限元模型。采用腰4椎体做收敛性分析,建立5种不同网格划分数目的腰4模型进行验证。分析椎体和螺钉系统在0.5mPa轴向压力下的力学变化。结果在均布压力下,腰4模型位移为0.00125815mm,与基准位移的误差只有0.8167%,模型收敛性好。在轴向压力作用下,固定后的椎体、椎间盘和内固定的应力发生明显变化,椎间盘的应力集中部位由后外侧转向前外侧,固定椎体产生的应力明显减小,应力遮挡效应明显。螺钉根部的上下方,存在着明显的应力集中,且上一椎体固定的螺钉要比下一椎体的螺钉承受应力大。结论利用计算机辅助系统和有限元分析结合的方法,可以模拟腰34节段后路椎弓根内固定手术,较直观地观察脊柱后路固定前后系统的力学变化。
Objective To evaluate the mechanical response of L3-L4 segment after posterior interfixation with a transpedicle screw system. Methods Spiral CT machine was used to conduct continuous parallel scan on the L3-L4 section of a 40-year-old healthy male Chinese. The image data thus obtained were introduced into MIMICS software to reconstruct the 2-D data into volume data and obtain 3-D models of every element.. Pro/3-D model construction software system was used to simulate the 3-D entity of L3-L4 fixed by screw robs through spinal pedicle via posterior approach that was introduced into the finite element software ABAQUS to construct a 3-D finite element model. The stress changes on the vertebrae and screw under the axial pressure of 0.5 mPa was analyzed. Results Under the evenly distributed pressure the displacement of the L4 model was 0. 00125815 mm, with an error of only 0. 8167% from the datum displacement. The convergence of the model was good. The stress of the fixed vertebral body, intervertebral disc, and internal fixators changed significantly. The stress concentration zone of the intervertebral disc turned from the posterolateral side to anterolateral side. The stress produced by the fixed vertebral bodies decreased significantly. Obvious stress concentration existed in the upper and lower sides of the base of screw and the fixed screw at the upper vertebral body bore greater stress than the lower vertebral body. Conclusions Integration of computer aided device and finite element analysis can successfully stimulate the internal fixation of L3-L4 visa posterior approach and observe the mechanic changes in the vertebral column more directly.