双侧经寰枢关节螺钉及寰椎椎板钩内固定系统的三维有限元研究

目的 探讨双侧经寰枢关节螺钉及寰椎椎板钩内固定系统的生物力学性能.方法 健康男性志愿者,年龄28岁,身高172 cm ,体重60 kg ,X线检查排除枕颈部畸形;对志愿者进行枕骨底到第三颈椎(C0-3)薄层CT扫描,建立具有详细解剖结构的上颈椎(C0-3)有限元模型并验证其有效性.在寰枢椎不稳的上颈椎模型中模拟双侧经寰枢关节螺钉及寰椎椎板钩固定并进行三维有限元对比分析.结果 上颈椎三维非线性有限元模型的仿真性好,可以进行生物力学分析.双侧经寰枢关节螺钉及寰椎椎板钩内固定系统中螺钉在经过寰枢关节部位时应力最大,有良好的生物力学稳定性.结论 双侧经寰枢关节螺钉及寰椎椎板钩固定是一种实用、有效的寰枢椎融合方式.

A finite element investigation of bilateral atlantoaxial trans-articular screws and atlas laminar hooks instrumentation

Objectives To investigate the mechanical properties of bilateral atlantoaxial transarticular screws and atlas laminar hooks instrumentation with finite element method. Methods There was a volunteer with age of 28 years old, body height 172 cm, body weight of 68 kg and without cervical deformity by X rays. The ligamentous, nonlinear, three-dimensional finite element models of normal upper cervical spine (C0-3) was developed and validated. The destabilized model with bilateral atlantoaxial transarticular screws and atlas laminar hooks was evaluated for quasistatic loading. Results The finite element model of upper cervical spine correlated well with experimental data for all load cases and can be used for experiment. The finite element predicted that the maximum Von Mises Stress was in the region in which screws penetrated the atlantoaxial articular facet. The novel instrumentation resulted in sufficient stability. Conclusion The bilateral atlantoaxial transarticular screws and atlas laminar hooks instrumentation is useful and effective for atlantoaxial arthrodesis.