颈椎“椎骨错缝”三维有限元模型创建方法的研究

目的:"椎骨错缝"是颈椎病临床发病的主要病理环节之一,同时也是手法临床干预靶点.结合三维有限元分析技术探讨颈椎"椎骨错缝"可视化模型的创建方法.方法:选取颈椎病患者,通过颈椎动静态触诊和X线判定发生"椎骨错缝"的患者1例(男性,28岁,身高176 cm,体重69 kg),CT扫描C1-C7(层厚0.75 mm),基于CT数据,应用特定三维有限元分析软件对"椎骨错缝"节段(C4-6)进行三维有限元模型创建.结果:重建出的颈椎"椎骨错缝"三维模型证实,参照相邻椎体序列,C5椎体发生明显的三维空间位置异常,空间位移是向下平移0.9 mm,绕X轴顺时针旋转4.5°,呈现后仰式错缝,并能对错缝导致关节异常应力进行有限元分析.结论:本研究提出的颈椎"椎骨错缝"的建模思路与方法可靠,为后期手法矫正"椎骨错缝"的机制分析奠定基础.

Study on the method of construct the three-dimensional finite element model of cervical vertebrae semidislocation

Objective: Cervical vertebra semidislocation was one of major pathological aspects of cervical spondylosis,and it was also the target of manipulation to treat cervical spondylosis. The aim of this study was to combine the technology of three dimensional finite element analysis to investigate the method to construct the cervical vertebra semidislocation model. Methods: A cervical spondylosis patient(male,28 years old,176 cm tall,weight 69 kg)was randomly choosed,who was diagnosed cervical vertebra semidislocation by dynamic and static palpation and X-ray,and CT scaned from C₁ to C₇ by 0.75 mm slice thickness. Based on the CT data,the software was used to construct the three dimensional finite element model of cervical vertebra semidislocation(C₄-C₆). Results: The model showed the three dimensional changes of vertebra semidislocation clearly. C₅ had a three-dimensional abnormal position,which was downward translation for 0.9 mm and clockwise rotation for 4.5° around X-axis. So C₅ was diagnosed as hypsokinesis-type semidislocation. Conclusion: The method to construct the three dimensional finite element model of cervical vertebra semidislocation is reliable,which provid a base study to analyse the mechanism of manipulation to treat vertebra semidislocation.