二步加载分步求解在手法治疗腰椎间盘突出症有限元分析中的应用
|
摘要
目的:应用有限元技术模拟直腰旋转手法治疗腰椎间盘突出症,分析两种不同加载求解方式下腰椎间盘位移与应力结果。方法:利用正常青年志愿者腰骶部CT数据,使用Mimics,Geomagic Studio,Ansys等软件建立L4～5正常三维有限元模型,假定腰椎间盘突出症发生于椎间盘左后方,模拟右向直腰旋转手法,分别应用传统一步加载求解与笔者提出的二步加载分步求解方式计算L4～5椎间盘左后方节点的应力与位移,对两种求解方式所得结果进行统计学比较。结果:一步加载求解L4～5椎间盘左后方位移为(-1.264 0±0.171 5)mm,应力为(0.032 5±0.032 4)MPa;二步加载分步求解所得位移为(-1.566 0±0.169 5)mm,应力为(-0.004 5±0.030 4)MPa.两种加载求解所得L4～5左后方节点位移与应力比较,差异均有统计学意义(P<0.05)。结论:二步加载分步求解方式用于手法治疗腰椎间盘突出症有限元研究,其计算结果更准确地反映了手法作用对腰椎间盘的力学影响。
Objective:To simulate lumbar erection-rotation manipulation for treating lumbar disc herniation using finite element technique and analyze the displacement and stress in lumbar intervertebral disc under two different loading and solving methods.Methods:A normal three-dimensional finite element model of L4～5 was established using software's of Mimics,Geomagic Studio,and Ansys based on the lumbosacral CT data of a normal young volunteer.Lumbar disc herniation was assumed to occur in the left rear of the intervertebral disc,and then lumbar erection-rotation manipulation was simulated rightward,and traditional one-step loading and solving method and two-step loading and solving method were used to calculate the stress and displacement of the nodes in the left rear of L4～5 intervertebral disc,respectively.A statistical comparison was carried out to evaluate the results of two methods.Results:Based on the one-step loading and solving method,the displacement in the left rear of L4～5 intervertebral disc was(-1.264 0±0.171 5)mm,the stress value was(0.032 5±0.032 4)MPa,and based on the two-step loading and solving method,the displacement was(-1.566 0±0.169 5)mm,the stress value was(-0.004 5± 0.030 4)MPa.There were significant differences in displacement(P<0.05)and stress(P<0.05)between the two loading and solving methods.Conclusion:In finite element study on lumbar disc herniation treated using Chinese manipulation,the calculation results of two-step loading and solving method were more accurate in revealing the mechanical effect of manipulation on lumbar intervertebral disc.
Objective:To simulate lumbar erection-rotation manipulation for treating lumbar disc herniation using finite element technique and analyze the displacement and stress in lumbar intervertebral disc under two different loading and solving methods.Methods:A normal three-dimensional finite element model of L4～5 was established using software's of Mimics,Geomagic Studio,and Ansys based on the lumbosacral CT data of a normal young volunteer.Lumbar disc herniation was assumed to occur in the left rear of the intervertebral disc,and then lumbar erection-rotation manipulation was simulated rightward,and traditional one-step loading and solving method and two-step loading and solving method were used to calculate the stress and displacement of the nodes in the left rear of L4～5 intervertebral disc,respectively.A statistical comparison was carried out to evaluate the results of two methods.Results:Based on the one-step loading and solving method,the displacement in the left rear of L4～5 intervertebral disc was(-1.264 0±0.171 5)mm,the stress value was(0.032 5±0.032 4)MPa,and based on the two-step loading and solving method,the displacement was(-1.566 0±0.169 5)mm,the stress value was(-0.004 5± 0.030 4)MPa.There were significant differences in displacement(P<0.05)and stress(P<0.05)between the two loading and solving methods.Conclusion:In finite element study on lumbar disc herniation treated using Chinese manipulation,the calculation results of two-step loading and solving method were more accurate in revealing the mechanical effect of manipulation on lumbar intervertebral disc.
引文
[1]李宏涛.腰椎定点旋转复位法联合胸椎压冲复位法治疗腰椎间盘突出症临床探讨[J].颈腰痛杂志,2017,38(5):451-454.
[2]杜红根,魏晖,蒋忠,等.三种不同脊柱旋转手法治疗腰椎间盘突出症的病例对照研究[J].中国骨伤,2016,29(5):444-448.
[3]徐帮杰,杨楠,白伟杰,等.坐位定点旋转整复法治疗腰椎间盘突出症的疗效观察[J].中医正骨,2015,27(11):17-19.
[4]赵犹太,朱先龙,李伟.中医骨伤手法结合独活寄生汤加减治疗腰椎间盘突出症疗效观察[J].现代中西医结合杂志,2017,26(1):57-59.
[5]王志鹏,张晓刚,赵文韬,等.有限元分析在腰椎手法治疗中的生物力学研究进展[J].医用生物力学,2017,32(3):293-298.
[6]吴山,张美超,李义凯,等.两种坐位旋转手法腰椎应力及位移的有限元分析[J].广东医学,2010,31(8):992-994.
[7]徐海涛,李松,刘澜,等.腰椎斜扳手法时椎间盘的有限元分析[J].中国组织工程研究与临床康复,2011,15(13):2335-2338.
[8]SHU X N,MU W Z,CHEN J F,et al.Comparison of biomechancal effect between obligue Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position for lumbar intervertebral disc herniation[J].Journal of Acupuncture and Tuina Science,2017,15(5):317-321.
[9]MASNIAZIAN,TANAKA M.Biomechanical investigation on the influence of the regional material degeneration of an intervertebral disc in a lower lumbar spinal unit:a finite element study[J].Computers in Biology&Medicine,2018,98:26-38.
[10]SU X,SHEN H,SHI W,et al.Dynamic characteristics of osteoporotic lumbar spine under vertical vibration after cement augmentation[J].American Journal of Translational Research,2017,9(9):4036-4045.
[11]DENOZIERE G,KU D N.Biomechanical comparison between fusion of two vertebrae and implantation of an artificial intervertebral disc[J].Journal of Biomechanics,2006,39(4):766-775.
[12]ELMASRY S,ASFOUR S,TRAVASCIO F.Effectiveness of pedicle screw inclusion at the fracture level in short-segment fixation constructs for the treatment of thoracolumbar burst fractures:a computational biomechanics analysis[J].Computer Methods in Biomechanics and Biomedical Engineering,2017,20(13):1412-1420.
[13]HEUER F,SCHMIDT H,KLEZL Z,et al.Stepwise reduction of functional spinal structures increase range of motion and change lordosis angle[J].Journal of Biomechanics,2007,40(2):271-280.
[14]SCHMIDT H,KETTLER A,HEUER F,et al.Intradiscal pressure,shear strain,and fiber strain in the intervertebral disc under combined loading[J].Spine,2007,32(7):748-755.
[15]毕胜,李义凯,赵卫东,等.腰部推拿手法生物力学和有限元比较研究[J].中华物理医学与康复杂志,2002,24(9):525-528.
[2]杜红根,魏晖,蒋忠,等.三种不同脊柱旋转手法治疗腰椎间盘突出症的病例对照研究[J].中国骨伤,2016,29(5):444-448.
[3]徐帮杰,杨楠,白伟杰,等.坐位定点旋转整复法治疗腰椎间盘突出症的疗效观察[J].中医正骨,2015,27(11):17-19.
[4]赵犹太,朱先龙,李伟.中医骨伤手法结合独活寄生汤加减治疗腰椎间盘突出症疗效观察[J].现代中西医结合杂志,2017,26(1):57-59.
[5]王志鹏,张晓刚,赵文韬,等.有限元分析在腰椎手法治疗中的生物力学研究进展[J].医用生物力学,2017,32(3):293-298.
[6]吴山,张美超,李义凯,等.两种坐位旋转手法腰椎应力及位移的有限元分析[J].广东医学,2010,31(8):992-994.
[7]徐海涛,李松,刘澜,等.腰椎斜扳手法时椎间盘的有限元分析[J].中国组织工程研究与临床康复,2011,15(13):2335-2338.
[8]SHU X N,MU W Z,CHEN J F,et al.Comparison of biomechancal effect between obligue Ban-pulling manipulation and lumbar erection-rotation manipulation in sitting position for lumbar intervertebral disc herniation[J].Journal of Acupuncture and Tuina Science,2017,15(5):317-321.
[9]MASNIAZIAN,TANAKA M.Biomechanical investigation on the influence of the regional material degeneration of an intervertebral disc in a lower lumbar spinal unit:a finite element study[J].Computers in Biology&Medicine,2018,98:26-38.
[10]SU X,SHEN H,SHI W,et al.Dynamic characteristics of osteoporotic lumbar spine under vertical vibration after cement augmentation[J].American Journal of Translational Research,2017,9(9):4036-4045.
[11]DENOZIERE G,KU D N.Biomechanical comparison between fusion of two vertebrae and implantation of an artificial intervertebral disc[J].Journal of Biomechanics,2006,39(4):766-775.
[12]ELMASRY S,ASFOUR S,TRAVASCIO F.Effectiveness of pedicle screw inclusion at the fracture level in short-segment fixation constructs for the treatment of thoracolumbar burst fractures:a computational biomechanics analysis[J].Computer Methods in Biomechanics and Biomedical Engineering,2017,20(13):1412-1420.
[13]HEUER F,SCHMIDT H,KLEZL Z,et al.Stepwise reduction of functional spinal structures increase range of motion and change lordosis angle[J].Journal of Biomechanics,2007,40(2):271-280.
[14]SCHMIDT H,KETTLER A,HEUER F,et al.Intradiscal pressure,shear strain,and fiber strain in the intervertebral disc under combined loading[J].Spine,2007,32(7):748-755.
[15]毕胜,李义凯,赵卫东,等.腰部推拿手法生物力学和有限元比较研究[J].中华物理医学与康复杂志,2002,24(9):525-528.