聚醚醚酮/羟基磷灰石/碳纤维复合材料的生物力学分析

目的利用有限元分析法比较聚醚醚酮/羟基磷灰石/碳纤维复合材料（75PEEK/10HA/15CF）与钛合金的生物力学。方法建立C4～C6有限元模型,于C5～C6间植入75PEEK/10HA/15CF或钛合金人工椎间盘和椎间融合器,计算在前屈、后伸、侧弯和旋转时临近椎体、椎间盘的wonMises应力变化和C5～C6节段的活动度及植入物上的应力分布。结果在正常情况下,钛合金人工椎间盘置换模型在前屈时C5椎体、C4~5椎间盘平均won Mises应力改变率分别为75PEEK/10HA/15CF人工椎间盘模型的1.50倍和1.67倍;在侧弯时C6椎体的平均won Mises应力改变率为75PEEK/10HA/15CF人工椎间盘置换模型的1.33倍。融合器模型,在前屈时C5椎体、C4~5椎间盘应力改变率前者为后者的1.48倍和1.87倍;在侧弯时C6椎体应力改变率,前者为后者的1.67倍。钛合金植入物的最大应力为75PEEK/10HA/15CF的4.5倍,并出现应力集中。结论与钛合金相比,75PEEK/10HA/15CF能更好地将负荷传递,增加融合率,能有效地减少临近椎体的应力,减少植入物沉降的发生。     

Evaluation of the role of ligaments, facets and disc nucleus in lower cervical spine under compression and sagittal moments using finite element method.

Cervical spinal instability due to ligamentous injury, degenerated disc and facetectomy is a subject of great controversy. There is no analytical investigation reported on the biomechanical response of cervical spine in these respects. Parametric study on the roles of ligaments, facets, and disc nucleus of human lower cervical spine (C4-C6) was conducted for the very first time using noninvasive finite element method.A three-dimensional (3D) finite element (FE) model of the human lower cervical spine, consisted of 11,187 nodes and 7730 elements modeling the bony vertebrae, articulating facets, intervertebral disc, and associated ligaments, was developed and validated against the published data under three load configurations: axial compression; flexion; and extension. The FE model was further modified accordingly to investigate the role of disc, facets and ligaments in preserving cervical spine motion segment stability in these load configurations. The passive FE model predicted the nonlinear force displacement response of the human cervical spine, with increasing stiffness at higher loads. It also predicted that ligaments, facets or disc nucleus are crucial to maintain the cervical spine stability, in terms of sagittal rotational movement or redistribution of load. FE method of analysis is an invaluable application that can supplement experimental research in understanding the clinical biomechanics of the human cervical spine.     

颈椎人工椎间盘置换有限元分析

目的　建立C4~5节段PrestigeTM-LP颈椎人工椎间盘植入后的三维有限元模型,进行手术节段的运动分析。 方法 采用对成年男性的新鲜尸体的颈椎标本进行CT三维扫描方法建立C4~5节段和PrestigeTM-LP人工间盘有限元,模拟完成C4~5人工椎间盘置换手术。测量生理加载下手术节段前屈/后伸、侧弯及轴向旋转运动角度。结果 有限元模型对颈椎的结构,包括椎体间韧带、颈椎关节突关节、钩椎关节等均进行了精确的重建,并较好地模拟手术操作进行PrestigeTM-LP人工间盘植入。运动加载后运动角度,前屈5.7°,后伸3.5°,侧弯5.0°,旋转11.3°,与文献报道结果较为接近。 结论　有限元模型具有精确度高,手术模拟真实的特点,可作为颈椎人工椎间盘生物力学研究的一种较好途径。PrestigeTM-LP颈椎人工椎间盘置换可较好地保留手术节段的运动功能。     

颈椎椎体次全切除，钛网植骨钢板固定三维有限元模型的建立

目的 探讨利用螺旋 CT建立颈椎椎体次全切除减压植骨固定的三维有限元模型的高度数字化方法,为研究颈椎减压手术的生物力学实验提供标准模型。方法 对健康成年男性志愿者进行CT 扫描,获得C4～C7节段的断层图片,将数据保存为Dicom格式,导入Mimics 9.1 软件进行三维几何模型重建,形成三维图像,利用Freeform 软件进行模型修改和表面划分,以IGES格式转入有限元软件Ansys 9.0完成颈椎骨性模型的建立。利用有限元软件Ansys 9.0,在颈椎骨性模型的基础上,补建终板、补充建立终板、 椎间盘、 髓核、 前纵韧带、 后纵韧带、 黄韧带、 棘间韧带、 棘上韧带等结构。然后模拟颈椎椎体次全切除,将C5椎体、前纵韧带、上下椎间盘切除,将建立的钛网、钢板实体模型添加到减压区。采用合适的材料性质和实体单元类型对模型进行有限元网格划分。结果 颈椎脊柱三维模型有限元网格划分结果：利用三维重建软件Mimics 和有限元软件Ansys 9.0 , 成功进行椎体次全切除减压钛网植骨钢板固定三维模型有限元网格划分。整个模型共有138995个节点和94039个单元,建成后的三维有限元模型与实体组织具有良好的几何相似性。结论 建立的椎体次全切除植骨固定手术三维有限元模型接近真实的生物力学标本,可以进行临床和实验研究。     

半限制型人工颈椎间盘置换与植骨融合术后下颈椎生物力学的有限元分析

目的 研究Discover、Prodisc-C人工椎间盘置换术与植骨融合术后下颈椎活动度（range of motion, ROM）、椎间盘应力、韧带张力的生物力学特性以及植入假体力学性能的改变。方法 建立C5~6椎间盘退变3种手术方案：Discover、Prodisc-C人工椎间盘置换和自体髂骨植骨融合有限元模型,同时建立C4~7节段下颈椎原始模型。分析术后下颈椎C4~7节段在矢状面、冠状面及横断面上椎体的生物力学特性变化。结果 术后手术节段关节ROM变化：Discover模型增加12.7%~73.1%,Prodisc-C模型增加74%~98%,植骨融合模型下降55.8%~71.8%。Discover置换后上邻近椎间盘应力无明显增加,下邻近椎间盘应力在前屈、后伸、轴向旋转工况下减少33.2%~54.2%,囊韧带张力增幅比Prodisc-C置换后减少30%~40%。Discover假体最大应力（36.72 MPa）出现在前屈工况下,小于Prodisc-C假体的最大应力（42.66 MPa）。结论 人工椎间盘置换术可以保留手术节段的运动性能,Discover作为新一代人工椎间盘假体,在减少韧带负担和维持脊柱稳定性方面有所进步。研究结果可为颈椎前路融合手术和人工颈椎间盘置换术的临床研究提供理论依据。     

人工颈椎间盘的假体结构及应用特点

背景：目前人工颈椎间盘假体设计和使用都得到了很大的发展,主要有低磨擦滑动面、弹簧系统、橡胶制成的人工颈椎间盘及其他各种弹性假体。 目的：总结人工颈椎间盘假体结构特点及在骨科的应用现状。 方法：由第一作者以“人工颈椎间盘;假体;椎间盘突出症”和“Artificial Cervical Disc;prosthesis ; intervertebral disc herniation;the surgical therapy”为关键词,分别在CNKI(2000至2013年)和PubMed数据库(1960至2013年)http://www.ncbi.nlm.nih.gov/PubMed)检索近年文献,检索内容为人工颈椎间盘假体在骨科的应用。计算机在CNKI数据库检索出200篇文献,在PubMed数据库检索出56篇文献,阅读标题和摘要进行筛选,保留符合纳入标准的40篇归纳总结。 结果与结论：人工颈椎间盘假体类似椎间盘生理功能,材料具有耐磨损、耐疲劳、抗腐蚀等特点,它类似于人体椎间盘的生理和生物力学载荷功能,保持了脊柱的稳定和运动功能,避免了邻近节段的退变加速。文章重点对Bryan、Mobi-C、PCM、Prodisc-C、Prestige及CerviCore人工颈椎间盘结构做了介绍。人工颈椎间盘置换的短期疗效已得到认可,但是它不能完全替代颈前路植骨融合内固定,是治疗颈椎退变性椎间盘疾病的又一主要手段。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

颈椎半椎板切除后小关节部位的应力分析

根据CT数据建立了颈椎C4-C6功能节段的三维非线性有限元完整模型,并在此模型基础上建立了椎板切除模型。考察了椎板半切除术对小关节的生物力学影响。将C6椎体下表面固定作为边界条件,采用三种加载模式,即于C4椎体上表面施加1.8Nm分别沿矢状面、冠状面、轴面方向的纯弯矩。通过计算得到了C5半椎板切除后小关节部位的应力变化。结果表明,半椎板切除手术对各加载模式下小关节面的Von Mises应力有较大的影响,应力变化最大处应力上升了187.5%。评价颈椎半椎板切除术不能忽视手术对小关节的影响。     

Cervical spine biomechanics following implantation of a disc prosthesis

This study presents a finite element model of the C4-C7 segment in healthy conditions and after implantation of a disc prosthesis at a single level, in order to investigate of the influence of disc arthroplasty on the biomechanics of the cervical spine. A nonlinear finite element model of the C4-C7 segment in intact conditions was developed and run in flexion and extension. A detailed model of the Bryan disc prosthesis, including contacts between the different components of the device, was built and positioned at C5-C6. The calculated segmental motion resulted preserved after disc arthroplasty, with respect to the model of the intact spine, in both flexion and extension. A general preservation of the forces transmitted through the facet joints was obtained; a minor force increase at the implanted level was detected. The analysis of the instantaneous centers of rotation (ICR) in flexion-extension showed the preservation of a physiological kinematics. The mechanical behaviour showed an asymmetry between flexion and extension, probably due to the removal of the anterior longitudinal ligament and the anterior part of the annulus fibrosus, and the preservation of the posterior structures. In general, the disc prosthesis showed to be able to reproduce a nearly physiological motion. However, other important mechanical aspects, such as the possible micromotion at the bone-implant interface and the possible degenerative conditions of the spine, need to be evaluated before drawing a conclusion about total disc arthroplasty from an engineering point of view.     

正常颈椎有限元模型建立及有效性验证

目的：建立颈椎C2～C7节段三维有限元模型,分析模型的生物力学特征,进行有效性验证。方法：招募一名健康志愿者为建模对象,利用64排螺旋CT进行颈椎连续性断层扫描,扫描区域设定为枕骨至C7椎体节段。将获得的图像数据DICOM文件导入至Mimics图像分割软件中,对颈椎骨性结构进行分割提取。在Geomagic studio软件中对获得的颈椎骨性结构模型进行去噪、光顺、修补填充等处理,拟合曲面实体,并偏移分割生成皮质骨与松质骨,将模型保存为STEP文件。在Solidworks软件中完成椎间盘髓核、纤维环及关节软骨结构的建立与模型的组装匹配。ANSYS Workbench软件中添加材料属性、接触关系、边界条件及载荷,测量颈椎在前屈、后伸、左右侧弯、左右旋转6种应力作用下位移变化。结果：成功建立颈椎C2～C7节段有限元模型,颈椎C2～C3屈伸、侧屈、旋转角度位移分别为7.2°、8.2°、5.3°,颈椎C3～C4屈伸、侧屈、旋转角度位移分别为7.2°、8.1°、6.2°,颈椎C4～C5屈伸、侧屈、旋转角度位移分别为8.1°、7.9°、7.8°,颈椎C5～C6屈伸、侧屈、旋转角度位移分别为6.9°、...     

人工颈椎间盘置换术后异位骨化三维有限元模型的建立与意义

目的建立包含完整下颈椎(C_3-C_7)的C_(5/6)节段人工颈椎间盘置换(cervical disc replacement,CDR)术后异位骨化(heterotopic ossification,HO)三维有限元模型,为CDR术后HO生物力学相关研究提供基础模型。方法将健康志愿者颈椎CT的DICOM格式数据依次使用Mimics 16.0、Geomagic 12.0及Pro/Engineer 5.0软件构建包含C_3-C_7颈椎的C_(5/6)节段CDR术后HO三维有限元模型,并观察HO对手术节段活动度和小关节压力的影响。结果本研究建立了CDR术后HO三维有限元模型,共包含394 198个单元和765 411个节点。运动加载结果显示HO发生后手术节段活动度有不同程度的下降,曲伸、侧弯及旋转活动较无HO模型减少分别20.6%、14.3%及11.3%;手术节段后方小关节应力在HO发生后在不同工况下有不同程度的下降,后伸、左侧弯、右侧弯、左旋转及旋转活动较无HO模型减少分别4.1%、3.7%、10.7%、26%及12.1%。结论本研究成功构建了包含C_3-C_7下颈椎的C_(5/6)节段CDR术后HO三维有限元模型,为CDR术后HO的生物力学相关研究提供了基础模型。     

Prestige LP和Discover人工颈椎间盘的生物力学有限元分析

目的探讨人工颈椎间盘的结构设计对人工颈椎间盘置换前后生物力学变化的影响。方法基于中国可视化人研究项目的首例男性CT扫描数据图像建立人体颈椎C5-C6节段的有限元模型,使用已有文献数据验证该模型以确保计算结果准确。选用PrestigeLP和Discover分别作为不固定旋转中心和固定旋转中心结构的代表建模,在之前所建的双节段颈椎模型上模拟人工颈椎间盘置换术,对置换前后颈椎在常见运动情况下的颈椎生物力学变化进行计算和分析。结果人工椎间盘置换后,手术节段运动范围有所增大,活动度随之上升,过度运动会给后部小关节带来压力,同时导致韧带张力增加,远期可能导致脊柱失稳和手术节段退变。结论不固定旋转中心的假体运动范围大于固定旋转中心的假体,适当限制运动范围可能更有益于人工椎间盘置换后的远期疗效。     

Biomechanical comparison between lumbar disc arthroplasty and fusion

The artificial disc is a mobile implant for degenerative disc replacement that attempts to lessen the degeneration of the adjacent elements. However, inconsistent biomechanical results for the neighboring elements have been reported in a number of studies. The present study used finite element (FE) analysis to explore the biomechanical differences at the surgical and both adjacent levels following artificial disc replacement and interbody fusion procedures. First, a three-dimensional FE model of a five-level lumbar spine was established by the commercially available medical imaging software Amira 3.1.1, and FE software ANSYS 9.0. After validating the five-level intact (INT) model with previous in vitro studies, the L3/L4 level of the INT model was modified to either insert an artificial disc (ProDisc II; ADR) or incorporate bilateral posterior lumbar interbody fusion (PLIF) cages with a pedicle screw fixation system. All models were constrained at the bottom of the L5 vertebra and subjected to 150N preload and 10Nm moments under four physiological motions. The ADR model demonstrated higher range of motion (ROM), annulus stress, and facet contact pressure at the surgical level compared to the non-modified INT model. At both adjacent levels, ROM and annulus stress were similar to that of the INT model and varied less than 7%. In addition, the greatest displacement of posterior annulus occurred at the superior-lateral region. Conversely, the PLIF model showed less ROM, less annulus stress, and no facet contact pressure at the surgical level compared to the INT model. The adjacent levels had obviously high ROM, annulus stress, and facet contact pressure, especially at the adjacent L2/3 level. In conclusion, the artificial disc replacement revealed no adjacent-level instability. However, instability was found at the surgical level, which might accelerate degeneration at the highly stressed annulus and facet joint. In contrast to disc replacement results, the posterior interbody fusion procedure revealed possibly accelerative degeneration of the annulus and facet joint at both adjacent levels.     

Biomechanical effect of anterior cervical spine fusion on adjacent segments.

The biomechanical effects of superior (C4-C5) and inferior (C5-C6) level fusions with different graft materials on the adjacent unaltered components were quantified using an anatomically accurate and experimentally validated C4-C5-C6 finite element model. Smith-Robinson and Bailey-Badgley fusion procedures were analyzed with five different types of inter-body fusion materials with varying stiffnesses. Intact and surgically altered finite element models were subjected to physiologic compression, flexion, extension and lateral bending. The external axial and angular stiffness, and the internal unaltered intervertebral disc (C5-C6 for the superior and C4-C5 for inferior fusion) and C5 vertebral body stresses were determined. The superior level fusion resulted in the highest increase in external response in lateral bending for all implant materials in both surgical procedures. In contrast, the inferior level fusion produced a higher increase in the C4-C5 disc and C5 vertebral body stresses in compression than the superior level fusion in both surgical procedures. The increased internal stress responses reflecting the changes in the load-sharing following inferior level fusion may explain clinical observations such as enhanced degeneration subsequent to surgery. Because of the inclusion of three levels in the present multi-segment finite element model, it was possible to determine these responses in the unaltered adjacent components of the cervical spine.     

人工椎间盘置换腰椎节段有限元模型的建立

目的：建立UL节段正常及人工腰椎间盘置换的三维有限元模型，用于进一步的腰椎生物力学研究。方法：取新鲜成人腰椎标本，通过螺旋CT扫描、图像数字化处理、三维图像重建技术及自由造型系统进行图像表面光滑处理，再对表面图像矢量化，转入有限元软件，建立L4／L5腰椎节段和SMH人工腰椎间盘的有限元模型，模仿腰椎前路椎间盘除术，建立人工腰椎间盘置换的三维有限元模型，用不同的材料参数仿真腰椎和人工椎间盘各结构特性。结果：建立了L4/L5节段人工腰椎间盘置换的有限元模型，模型由皮质骨、松质骨、椎间盘、韧带和人工椎间盘等结构组成。模型分为53452个单元，86329个结点，其中包括53408个固体单元，44个缆绳单元。结论：通过CT扫描可以获得准确的腰椎几何构型数据，并可在此基础上建立高仿真脊柱节段有限元模型。     

颈前路融合与人工椎间盘置换治疗颈椎病

背景：目前临床上有关颈前路椎间盘切除减压植骨融合及人工椎间盘置换治疗颈椎病的效果尚未得出一致的结论。 目的：对比颈前路融合与人工椎间盘置换治疗颈椎病的效果。 方法：回顾性分析郑州大学第一附属医院骨科收治的颈椎病患者106例,其中19例行Bryan人工椎间盘置换(置换组),87例行单节段颈前路椎间盘切除减压植骨融合(融合组)。 结果与结论：所有患者均获得随访,随访时间36~48个月。①两组患者随访时神经功能均得到明显恢复,末次随访时两组目测类比疼痛评分、JOA评分差异无显著性意义(P > 0.05)。②融合组患者治疗后6个月植骨全部骨性融合,内固定无松动、脱落、断裂发生。置换组患者置换后无假体移位、脱落等并发症发生。③置换组置换后颈椎活动范围和置换节段活动范围与置换前相比差异无显著性意义(P > 0.05)。全部患者均无严重并发症发生。提示单节段人工椎间盘置换后早期并发症少,Bryan人工颈椎间盘置换治疗颈椎病在取得满意临床疗效的同时能保留置换节段和颈椎的活动范围。     

不同方式颈椎融合手术对上颈椎Jefferson骨折稳定效果的影响

目的建立人体上颈椎C0～3节段Jefferson骨折有限元模型,分析后路寰枢椎融合(posterior atlantoaxial fusion,PSF)和枕颈融合(occipitocervical fusion,OCF)对颈椎椎体生物力学特性和钉棒系统力传导特性的影响。方法基于CT图像建立人体上颈椎C0～3节段Jefferson骨折模型,依据临床手术方案实施PSF、OCF1和OCF2内固定术,施加50 N集中力和1.5 N·m力矩于枕骨底部,研究上颈椎C0～3节段在前屈、后伸、侧屈和旋转运动时,颈椎椎体的应力分布和关节活动度(range of motion,ROM)、钉棒系统最大应力以及椎间盘的应力分布情况。结果 OCF1和OCF2椎体ROM较PSF增加,钉棒应力减少,OCF具有较好的固定效果。结论 PSF、OCF1、OCF2固定术式均可减少上颈椎ROM,重建上颈椎的稳定性,使椎体和椎间盘应力分布趋向正常水平。研究结果可为临床手术方案提供理论依据。     

Application of an asymmetric finite element model of the C2-T1 cervical spine for evaluating the role of soft tissues in stability

Different finite element models of the cervical spine have been suggested for evaluating the roles of ligaments, facet joints, and disks in the stability of cervical spine under sagittal moments. However, no comprehensive study on the response of the full cervical spine that has used a detailed finite element (FE) model (C2-T1) that considers the asymmetry about the mid-sagittal plane has been reported. The aims of this study were to consider asymmetry in a FE model of the full cervical spine and to investigate the influences of ligaments, facet joints, and disk nucleus on the stability of the asymmetric model during flexion and extension. The model was validated against various published in vitro studies and FE studies for the three main loading planes. Next, the C4-C5 level was modified to simulate different cases to investigate the role of the soft tissues in segmental stability. The FE model predicted that excluding the interspinous ligament (ISL) from the index level would cause excessive instability during flexion and that excluding the posterior longitudinal ligament (PLL) or the ligamentum flavum (LF) would not affect segmental rotation. During extension, motion increased when the facet joints were excluded. The model without disk nucleus was unstable compared to the intact model at lower loads and exhibited a similar rotation response at higher loads.     

颈椎动态稳定器置入非融合颈椎的生物力学分析

背景：颈椎动态稳定器的解剖型设计与正常椎间盘应具有相似的生物力学特点,其动态性设计具有轴向顺应性以及震荡吸收功能,而前缘倒齿嵌入上下椎体可获得足够的轴向稳定性。 目的：比较颈椎前路融合内固定和颈椎动态稳定器置入非融合后颈椎相关生物力学指标变化。 方法：将6具新鲜人C2~C7颈段脊柱标本随机分为3组,在完整颈椎测试后分别行C5、6前路减压颈椎动态稳定器DCI置入,C5、6前路减压单纯Cage融合内固定,C5、6前路减压颈椎前路一体化钢板椎间融合器融合内固定。检测各组标本前屈、后伸、左右侧屈不同生理运动工况并施加2.0 N•m纯力偶矩,颈椎标本C5~6上下邻近节段手术前后活动度大小。 结果与结论：3种内固定后C5~6上下邻近节段较正常颈椎标本前屈、后伸和左右侧屈关节活动度值均有所增加,且表现出良好的即时稳定性,但颈椎动态稳定器置入组最接近正常值;3组间C5~6上下邻近节段关节活动度差异无显著性意义。表明颈椎动态稳定器置入后对邻近节段椎体活动度无明显影响或影响甚小,在一定程度上减小假体与其邻近椎体轴向应力,有效地维持颈椎活动。     

Influence of surgical treatment for disc degeneration disease at C5–C6 on changes in some biomechanical parameters of the cervical spine

A detailed three-dimensional solid model of the full cervical spine (C1–C7 levels) and the finite element analysis method were used to investigate the extent of changes in various biomechanical properties brought about when surgical methods are used to treat condition(s) caused by or are a sequela of disc degeneration disease at the C5–C6 level. The surgical methods simulated were anterior cervical discectomy and fusion, with interbody fusion achieved using a notional brick-shaped graft only; anterior cervical discectomy alone; percutaneous nucleotomy; and three variants of nucleus replacement. The control case was a model of an intact, healthy, adult spine. Each of these seven models was subjected to (1) flexion moment, extension moment, left lateral bending moment, right lateral bending moment, clockwise-acting axial rotation moment, and counterclockwise-acting axial rotation moment, with a compression pre-load applied simultaneously with each of these loadings and (2) an axial compression force (applied as a uniform pressure) only. For each combination of model and applied loading, the maximum von Mises stress and the maximum strain energy density were determined for tissues at the treated level, at one level above the treated level, and at one level below the treated level and (2) the total principal rotation angles at each of the intersegmental positions of the entire model. In addition, for each of the study cases, we obtained the longitudinal displacement of each of the models when subjected to the axial compression force only.We found markedly fewer changes (relative to the results when the intact, healthy spine model was used) in each of the above-mentioned biomechanical parameters above a specified threshold in the case of the simulated percutaneous nucleotomy and simulated nucleus replacement models, on one hand, compared to the simulated fusion and simulated discectomy models, on the other. This finding is in consonance with the evolving clinical practice of using minimally invasive surgical methods for treating problem(s) such as soft cervical disc herniations.     

杂交术治疗多节段颈椎病后生物力学有限元分析

目的　有限元分析法探讨应用Mobi-C假体的颈人工椎间盘置换（artificial cervical disc 　replacement, ACDR）联合椎间植骨融合术（Anterior cervical decompression and fusion,ACDF）治疗多节段颈椎病的生物力学特点。 方法　在已验证的下颈椎有限元模型基础上,对模型施加了头颅预载荷74 N及1.8 Nm纯力矩,模拟2组行C-ADR联合ACDF手术方式及1组行三节段ACDF手术方式,在各工况下分析术后2组杂交术式假体各部件的应力特点和3组重建模型各节段关节突关节的应力改变。 结果　⑴杂交术式重建模型中Mobi-C假体上终板应力均高于下终板应力;⑵终板应力分布主要集中在终板中央偏后,最高值分别为M1组79.4Mpa,M2组为70.9Mpa;内衬应力分布集中于中央两翼,最高值分别为M1组11.6Mpa,M2组为14.4Mpa;⑶三处理组与正常组相比,行C-ADR节段的关节突关节应力增加;行ACDF节段的关节突关节应力降低;而三节段融合组邻段关节突关节应力较正常组及杂交术式组明显增高。 结论　应用Mobi-C假体的杂交术式治疗多节段颈椎病,假体不易出现下沉,较多节段融合术式能更好的维持邻段关节突关节应力。