腰椎脊突起間撐開器的有限元素分析

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姓名

洪一智(Yi-Jhih Hong) 查詢紙本館藏

畢業系所

機械工程學系

論文名稱

腰椎脊突起間撐開器的有限元素分析
(Finite Element Analysis of the Lumbar Interspinous Process Distractor)

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摘要(中)

一般來說，人們隨著年齡的增長椎間盤裡的髓核就會開始乾枯退化，造成椎間盤的厚度減少，進而造成黃韌帶及小面關節的肥大，以致於引發所謂的腰椎狹窄症，造成身體產生神經間歇性跛行的症狀，而解決此種症狀的方法有分為手術及非手術的治療，非手術的治療例如物理性的治療，但往往成效不佳，而手術的方法又可以分為傳統手術及微創手術二種，傳統的手術方法就是將造成腰椎狹窄症的黃韌帶及小面關節去除，此種手術不但傷口大且手術時間長，故風險相對的比較大，而新型的微創手術是在背上開一個小傷口，並植入脊突起間撐開器，進而解決腰椎狹窄症的問題。
而本研究所使用的模型是腰椎第三節及第四節，而模型中包含了硬質骨、鬆質骨、後方骨元件、韌帶，而分析的方法是在脊突起間施加強迫位移，再量測椎孔直徑、椎孔面積、神經根通道寬度、椎間盤高度的恢復情形，之後再判斷脊突起間撐開器是否有明顯的功效。

摘要(英)

In general, the nucleus pulposus in intervertebral disc will begin to dry up and degenerate with age. That can also reduce the thickness of intervertebral disc and hypertrophy of ligamentum flavum as well as facet joint. Thus, it provokes so-called lumbar spinal stenosis and bringing out the body symptom of neurogenic intermittent claudication. The methods of solving this symptom were divided into operative and non-operative treatments. However, the effect of the latter such as physical treatment is not so successful. The operative method can also divide into traditional operation and minimally operation. The traditional operation is to remove the ligamentum flavum and facet joint that would cause lumbar spinal stenosis. It only causes obvious incision wound but also takes long time for the operation. Therefore, the risk is relatively higher. The new minimally operation is by opening a small wound and embedding an interspinous processes distractor to solve the problem.
In this study, we use the models of the 3rd and 4th lumbar, including cortical bone, cancellous bone, posterior element and ligament. The way for analyzing is to exert a force displacement on interspinous processes, and we measure the recovery process for the canal diameter, canal area, subarticular diameter and intervertebral disc height. Then we ascertain that if the interspinous processes distractor has the obvious effect.

關鍵字(中)

★ 有限元素分析
★ 脊突起間撐開器
★ 韌帶
★ 後方骨元件
★ 硬質骨
★ 鬆質骨
★ 髓核
★ 腰椎
★ 神經間歇性跛行
★ 腰椎狹窄症
★ 小面關節
★ 黃韌帶
★ 椎間盤

關鍵字(英)

★ ligament
★ cortical bone
★ cancellous bone
★ posterior element
★ lumbar
★ nucleus pulposus
★ intervertebral disc
★ finite element analysis
★ interspinous processes distractor
★ neurogenic intermittent claudication
★ lumbar spinal stenosis
★ facet joint
★ ligamentum flavum

論文目次

摘要 i
Abstract ii
誌謝 iii
目錄 iv
圖目錄 vii
表目錄 xiv
一、緒論 1
1-1 研究的動機與目的 1
1-2 脊椎之解剖生理學 2
1-2-1 腰椎椎體之生物力學特性 3
1-2-2 腰椎椎間盤之生物力學特性 4
1-2-3 腰椎小面關節之生物力學特性 5
1-2-4 腰椎周圍韌帶之生物力學特性 6
1-3 腰椎之病理學 8
1-4 腰椎人工植入物介紹 13
1-5 文獻回顧 20
1-5-1 脊突起間撐開器的介紹 20
1-5-2 脊突起間撐開器的臨床應用 23
1-5-3 脊突起間撐開器的分析與測試 31
1-5-4 現有脊突起間撐開器的缺點 41
二、材料與方法 42
2-1 腰椎模型與脊突起間撐開器的電腦輔助設計 42
2-1-1 腰椎模型的建立 42
2-1-2 脊突起間撐開器模型建立 46
2-2 脊突起間撐開器的有限元素分析 48
2-2-1 材料性質的給定 48
2-2-2 受力邊界條件的給定 49
2-2-3 接觸型式的設定 50
2-2-4 網格化與分析 52
2-3 腰椎模型有限元素分析參數 63
2-3-1 腰椎模型分析參數位置圖 63
2-3-2 不同椎間盤位置突出的分析 64
2-3-3 改變模型的機械材料性質的分析 65
三、結果 66
3-1 不同椎間盤位置突出的分析結果 66
3-2 不同的機械材料性質的分析結果 68
3-2-1 椎間盤後側方突的結果 68
3-2-2 椎間盤正後方突的結果 70
四、討論 72
4-1 不同椎間盤位置突出的分析結果討論 72
4-2 不同的機械材料性質分析結果討論 76
4-2-1 椎間盤後側方突的結果討論 76
4-2-2 椎間盤正後方突的結果討論 80
五、結論與未來展望 84
5-1 結論 84
5-2 未來展望 85
參考文獻 86

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指導教授

黃衍任、林上智
(Yean-Ren Hwang、Lin-Shang,Jhih)

審核日期

2008-1-6

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