骨质疏松对融合腰椎振动特性的影响

doi:10.12068/j.issn.1005-3026.2025.20239070

摘要/Abstract

摘要：

基于有限元方法，从临床角度以应力、节段前凸角以及椎间盘高度等指标解释了骨质疏松在振动条件下对融合腰椎术的影响.通过研究发现：当人体处于振动环境下，实施腰椎融合术的节段可能会导致其他节段的椎骨处于不稳定的环境，而这将导致其他节段患病、融合器失效、固定器失效以及腰椎稳定性降低的风险大幅增加.从腰椎融合术的效果来看，骨质疏松导致融合节段的骨细胞处于更加恶劣的振动生长环境，进而导致更差的融合结果.

关键词: 并发症, 融合结果, 腰椎间融合术, 骨质疏松, 振动

Abstract:

Based on the finite element method， the effect of osteoporosis on lumbar fusion surgery under vibration conditions was explained from a clinical perspective using such indicators as stress， segmental lordosis angle， and intervertebral disc height. It was found that when the human body is exposed to a vibrating environment， the segments undergoing lumbar fusion surgery may cause other vertebral segments to become unstable. This instability significantly increases the risk of other segments developing diseases， failure of the fusion device， failure of the fixation device， and reduced lumbar stability. From the perspective of the effectiveness of lumbar fusion surgery， osteoporosis leads to bone cells in the fusion segments being exposed to a more adverse vibrational growth environment， resulting in poorer fusion outcomes.

Key words: complication, fusion outcome, lumbar interbody fusion surgery, osteoporosis, vibration

中图分类号:

R 681.5

王庆东, 张宇, 李永健, 郭立新. 骨质疏松对融合腰椎振动特性的影响[J]. 东北大学学报（自然科学版）, 2025, 46(5): 95-102.

Qing-dong WANG, Yu ZHANG, Yong-jian LI, Li-xin GUO. Effect of Osteoporosis on Vibration Characteristics of the Fused Lumbar Spine[J]. Journal of Northeastern University(Natural Science), 2025, 46(5): 95-102.

图/表 8

图1 TLIF有限元模型（a）—融合椎骨未骨质疏松的TLIF腰椎模型；（b）—融合椎骨患有骨质疏松的TLIF腰椎模型.

Fig.1 TLIF finite element models

表1 模型材料属性

Table 1 Material properties of the models

结构	单元类型	弹性模量/MPa	泊松比	密度/(mg·mm^-3）
松质骨	C3D4	健康:100;骨质疏松:34(减少66%)	0.2	健康：1.1;骨质疏松：0.37(减少66%)
皮质骨	C3D8	健康:12 000;骨质疏松:8 040(减少33%)	0.3	健康：1.7;骨质疏松：1.14(减少66%)

图2 边界与负载条件（a）—负载类型；（b）—边界条件.

Fig.2 Boundary and load conditions

图3 模型中相邻节段的动态特性（a）—椎间盘形变最大值；（b）—椎间盘形变振幅；（c）—椎间盘应力最大值；（d）—椎间盘应力振幅.

Fig.3 Dynamic characteristics at the adjacent segments in the models

图4 模型中融合节段终板应力的动态响应（a）—L4下终板；（b）—L5上终板.

Fig.4 Dynamic response of the stress at the fused segments in the models

图5 融合器和固定器中最大应力的动态响应（a）—融合器最大应力动态响应；（b）—融合器最大应力和振幅；（c）—固定器最大应力动态响应；（d）—固定器最大应力和振幅；（e）—固定器应力分布.

Fig.5 Dynamic response of the maximum of the cage and bilateral pedicle screw fixator

图6 模型中L4-L5融合节段椎间盘高度和节段前凸角的动态响应（a）—椎间盘高度；（b）—节段前凸角.

Fig.6 Dynamic response of disk height and segmental lordosis at L4-L5 fused segments in the models

图7 模型中融合器和终板界面处压应力的动态响应（a）—L4下终板；（b）—L5上终板；（c）—压应力最大值；（d）—压应力振幅.

Fig.7 Dynamic response of the compressive stress at the interface between cages and end plates in the models

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