腰椎內固定器之動態型式的生物力學評估

以作者查詢圖書館館藏

、以作者查詢臺灣博碩士

、以作者查詢全國書目

、勘誤回報

、線上人數：18

、訪客IP：18.191.103.144

姓名

張凱強(CHANG-KAI CHIANG) 查詢紙本館藏

畢業系所

機械工程學系

論文名稱

腰椎內固定器之動態型式的生物力學評估
(Biomechanical assessments of the dynamic lumbar fixators)

相關論文

★ 高彎曲度之人工膝關節多軸向動態磨耗試驗機開發	★ 人工髖關節雙軸向動態磨耗試驗平台開發
★ 大型犬人工髖關節之應力分析	★ 人體膝關節之高度彎曲電腦動態實體模型的建立
★ 足型與足壓電腦輔助分析系統開發	★ 超低溫液態氮生物試片儲存槽的研發
★ 腰椎人工椎間盤之運動軌跡分析	★ 表面置換型人工臏股骨關節的設計與分析
★ 二維及三維足型的應用與高跟鞋足壓的量測分析	★ 心血管支架塑性成形的有限元素分析
★ 靜態穿椎弓足內固定器之剛性對腰椎受力之影響	★ 超低溫高安全性生物試片儲存槽與即時監管理系統之開發
★ 超低溫液態氮生物試片儲存系統的硬體研發	★ 拇趾外翻足的鞋內矯正器之設計與評估
★ 表面置換型單髁人工膝關節的設計與分析	★ 髕股骨人工關節之動靜態分析與測試

檔案

[Endnote RIS 格式]

[Bibtex 格式]

[相關文章]

[文章引用]

[完整記錄]

[館藏目錄]

至系統瀏覽論文 ( 永不開放)

摘要(中)

一般來說，人們隨著年齡的增長在椎間盤裡的髓核就會開始退化，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，以致於引發壓迫到神經，造成椎間盤退化性疾病(DDD: Degenerative Disc Disease)，而解決此種症狀的方法手術中使用穿椎弓足固定器、骨融合術與人工椎間盤來恢復塌陷椎間盤之原有高度，進而解決椎間盤退化的問題。本研究為利用SolidWorks建立腰椎模型與動靜態內固定器，先將腰椎模型加入肌肉群力，使分析更接近真實狀態，再透過COSMOSWorks有限元素軟體分析四種不同腰椎模型：正常腰椎、腰椎植入鈦合金靜固定器、腰椎植入Dynesys固定器與腰椎植入動態固定器這四種模型來進行有限元素分析。主要模擬分析腰椎模型椎間盤高度與角度變化、髓核應力、椎弓足應力，所產生的應力分佈情形，以及固定器受力後呈現之應力集中狀態，探討其可能破壞斷裂處並與文獻做比較，了解動靜態內固定器對腰椎周圍醫學組織之生物力學影響。

摘要(英)

Generally speaking, people’s inside the nucleus in the disc will begin to degradation with the growth of age, then resulting the reduction of the thickness to disc, and the hypertrophy in the ligamentum flavum and facet joint. It will lead to oppression in the nerve, resulting in degradation of disc disease(DDD: Degenerative Disc Disease). The Solving methods for these symptoms is using transpedicular fixation, bone fusion and artificial disc to restore the collapse of the original disc height, and then solve the problem of disc degeneration. The purpose of this study uses the SolidWorks software to establish the lunbar models and dynamic and static lumbar fixation. First, we add the lumbar muscle groups on the lumbar to be muscle forces model in order to let the analysis be closer to the true state. And then through COSMOSWorks finite element analysis software analyzing four different lumbar spine model. It contains four kinds of finite element analysis models that be normal lumbar spine, static titanium fixation device on the lumbar spine, Dynesys dynamic fixation device on the lumbar spine, and DSJF dynamic fixation device on spine.
The simulation analysis main discuss the changing of intervertebral disc height, intervertebral disc angles, nucleus stress, pedicle stress and fixators stress for lumbar models. It also must investigate the stress distribution and stress concentration of lumbar models after implanted the fixators. Then we investigate the possible rupture position and compared with the literature to understand the dynamic and static fixation of the lumbar spine medical organizations around the biomechanics of impact.

關鍵字(中)

★ 脊椎內固定器
★ 韌帶
★ 後方骨元件
★ 有限元素分析
★ 小面關節
★ 椎間盤
★ 腰椎
★ 髓核

關鍵字(英)

★ spinal fixation
★ lumbar vertebrae
★ nucleus pulposus
★ disc
★ facet joints
★ the rear component of bone
★ finite element analysis
★ ligament

論文目次

目錄
摘要 ........................................................................................................................ I
ABSTRACT ......................................................................................................... II
致謝 ..................................................................................................................... III
目錄 ..................................................................................................................... IV
圖目錄 ................................................................................................................ VII
表目錄 ............................................................................................................... XV
第1章、緒論 ............................................................................................... 1
1-1 研究背景與目的 ............................................................................... 1
1-2 腰椎之解剖生理學 ........................................................................... 3
1-2-1 腰椎運動單元介紹 ................................................................... 4
1-2-2 腰椎周圍韌帶與肌肉群介紹 ................................................... 6
1-3 腰椎之病理學與手術治療方式 ..................................................... 11
1-4 腰椎動靜態內固定器介紹 ............................................................. 15
1-5 文獻回顧 ......................................................................................... 22
1-5-1 腰椎肌肉群相對三維座標位置建立 ..................................... 22
1-5-2 腰椎動靜態內固定器的有限元素分析 ................................. 28
第2章、材料與方法 ................................................................................. 39
2-1 三維五節腰椎之幾何模型建立 ..................................................... 39
2-1-1 腰椎椎間盤與椎體模型的建立 ............................................. 39
2-1-2 腰椎韌帶模型的建立 ............................................................. 43
2-1-3 腰椎肌肉群模型的建立 ......................................................... 48
2-2 腰椎動靜態內固定器的設計 ......................................................... 54
2-2-1 傳統靜態內固定器的設計 ..................................................... 54
2-2-2 具饒性之動態內固定器的設計 ............................................. 59
2-3 有限元素分析 ................................................................................. 62
2-3-1 材料性質的給定 ..................................................................... 63
2-3-2 受力與邊界條件的給定 ......................................................... 66
2-3-3 接觸型式的設定 ..................................................................... 71
2-3-4 網格設定與分析 ..................................................................... 75
2-4 腰椎模型有限元素分析參數與驗證 ............................................. 77
2-4-1 有限元素分析參數的指標 ..................................................... 77
2-4-2 自然腰椎模型的驗證 ............................................................. 80
第3章、結果 ............................................................................................. 82
3-1 椎間盤高度與角度變化 ................................................................. 82
3-2 椎間盤之髓核壓力的變化 ............................................................. 89
3-3 椎弓足的應力與受力變化 ............................................................. 92
3-4 內固定器的應力變化 ................................................................... 108
第4章、討論 ........................................................................................... 124
4-1 椎間盤高度與角度變化之討論與比較 ....................................... 124
4-2 椎間盤髓核壓力的變化之討論與比較 ....................................... 125
4-3 椎弓足的應力與受力變化之討論與比較 ................................... 126
4-4 內固定之受力變化之討論與比較 ............................................... 127
4-4-1 椎弓足螺絲之受力變化 ....................................................... 127
4-4-2 縱向連接桿之受力變化 ....................................................... 128
第5章、結論 ........................................................................................... 129
5-1 結論 ............................................................................................... 129
5-2 未來展望 ....................................................................................... 129
參考文獻 ........................................................................................................... 130

參考文獻

參考文獻
1. Martini, Bartholomew, Essentials of Anatomy & Physiology, 林自勇、鄧志娟、陳瑩玲等譯，解剖生理學，全威圖書，民國九十二年。
2. James Watkins, 張俊詳等譯，肌肉骨骼系統解剖學:構造與功能，合記圖書，民國九十五年。
3. Anthony P.Schnuerer,P.A. Julio Gallego, M.D. “Cristie Manuel, Anatomy of the Spine & Related Structures”.
4. Kettler A, Schmoelz W, Kast E, Gottwald M, Claes L, Wilke HJ, “In vitro stabilizing effect of a transforaminal compared with two posterior lumbar interbody fusion cages”. [Comparative Study. In Vitro. Journal Article. Research Support, Non-U.S. Gov't] Spine. 30(22):E665-70, 2005 Nov 15.
5. http://www.cc.nctu.edu.tw/~hcsci/hospital/other/backpain.htm
6. 鄭誠功、陳振昇、廖振凱、陳景升，骨科器材生物力學測詴GLP實驗室的建立-脊椎內固定器，國立陽明大學醫學工程研究所，骨科生物力學研究室，行政院衛生署88年下半年及89年度科技研究發展計畫。
7. http://us.synthes.com/Products/Spine/Deformity/Pangea+System.htm
8. http://www.zimmer.com/z/ctl/op/global/action/1/template/HM/id/
9. Wurgler-Hauri CC, Kalbarczyk A, Wiesli M, Landolt H, Fandino J, "Dynamic neutralization of the lumbar spine after microsurgical decompression in acquired lumbar spinal stenosis and segmental instability" SPINE Volume 33, Number 3, pp E66–E72, 2008
10. Grob D, Benini A, Junge A, Mannion AF, “Clinical experience with the Dynesys semirigid fixation system for the lumbar spine: surgical and patient-oriented outcome in 50 cases after an average of 2 years.” SPINE Volume 30, Number 3, pp 324–331, 2005
11. Niosi CA, Zhu QA, Wilson DC, Keynan O, Wilson DR, Oxland TR, "Biomechanical characterization of the three-dimensional kinematic
131
behaviour of the Dynesys dynamic stabilization system: an in vitro study" Eur Spine J (2006) 15: 913–922
12. Panjabi MM, Oxland TR, Yamamoto I,et al, “Mechanical behavior of thehuman lumbar and lumbosacral spineas shown by three-dimensional load–displacement curves”. J Bone Joint SurgAm 76:413–424,1994
13. Fujiwara A, Lim TH, An HS, et al, “The effect of disc degeneration and facet joint osteoarthritis on the segmental flexibility of the lumbar spine. Spine 25:3036–3044, 2000
14. Mimura M, Panjabi MM, Oxland TR,et al “Disc degeneration affects themultidirectional flexibility of the lumbar” spine. Spine 19:1371–1380, 1994
15. Schmoelz W, Huber JF, Nydegger T,et al, Dynamic stabilization of the lumbar spine and its effects on adjacent segments: an in vitro experiment”J Spinal Disord Tech 16:418–23, 2003
16. Yamamoto I, Panjabi MM, Crisco T, Oxland T. “Three-dimensional movements of the whole lumbar spine and lumbosacral joint.” Spine. 14(11):1256-60, Nov. 1989
17. Freudiger S, Dubois G, Lorrain M, “Dynamic neutralisation of the lumbar spine confirmed on a new lumbar spine simulator in vitro. Arch Orthop Trauma Surg 119:127–132, 1999
18. http://www.orthofix.com/products/sfs.asp?cid=35
19. http://www.zimmer.com/z/ctl/op/global/action/1/id/9291/template/IN/ navid/1927
20. http://education.yahoo.com/reference/gray/subjects/subject/115#p399
21. http://pilates101.co.uk/page5.htm
22. http://realbodywork.com/learn/torso/multifidus.htm
23. Kiefer A, Shirazi-Adl A, Parnianpour M “Synergy of human spine in neutral postures.” Eur Spine J 7:471–479,1998
24. Shirazi-Adl, S. Sadouk, M. Parnianpour, D. Pop, M. El-Rich., “ Muscle force evaluation and the role of posture in human lumbar spine under compression ” Eur Spine J, Vol.11,pp. 519–526,2002
25. Bazrgari, B. Shirazi-Adl. Arjmand, N “Analysis of squat and stoop dynamic liftings: muscle forces and internal spinal loads.” Eur Spine J (2007) 16:687–699
26. Rohlmann A, Calisse J, Bergmann G, Weber U, “Internal Spinal Fixator Stiffness Has Only a Minor Influence on Stresses in the Adjacent Discs”Spine , Vol.24, pp. 1192-1196, 1999
27. T. Zander, A. Rohlmann, J. Calisse, G. Bergmann “ Estimation of muscle forces in the lumbar spine during upper- body inclination ” Clinical Bionechanics , Vol.16, pp. S73-S80, 2001
28. Dong Suk Shin , Kunwoo Lee , Daniel Kim “Biomechanical study of lumbar spine with dynamic stabilization device using finite element method”Computer-Aided Design, Vol.39, pp. 559-567, 2007
29. T. Zander, A. Rohlmann, N. K.Burra, G. Bergmann “Effect of a posterior dynamic implant adjacent to a rigid spinal fixator ”Clinical Biomechanics 21 (2006) 767-774
30. Rohlmann A, Burra N.K, Zander T, Bergmann G, “Comparison of the effects of bilateral posterior gynamic and rigid fization devices on the loads in the lumbar spine:a finite element analysis”Eur Spine, Vol.16, pp. 1223-1231, 2007
31. http://www.ithaca.edu/faculty/lahr/LE2000/Back/Jointpage.htm
32. http://www.spine-ctsi.com/Dynesys.htm
33. Goel VK , kim YE , Lim TH, Weinstein JN , “An analytical investigation of the mechanics of spinal instrumentation” Spine,1988,13(9)1003-1011
34. Maruti R. Gudavalli, John J. Triano,“An analytical model of lumbar motion segment in flexion”, Journal of Manipulative and Physiological Therapeutics, Vol22,No4,May 1999
133
35. Srilakshmi Vishnubhotla,”A Biomechanical Evaluation o f Dynamic Stabilization Systems”, Master o f Science in Bioengineering, The University of Toledo, August 2005
36. Wilke HJ. Claes L. Schmitt H. Wolf S. “A universal spine tester for in vitro experiments with muscle force simulation.” European Spine Journal. 3(2):91-7, 1994
37. 實威科技股份有限公司，COSMOSWorks 電腦輔助工程分析入門篇Designer，全華圖書股份有限公司，民國96年。
38. 陳志鏗、李春穎，COSMOS/Works 2006 應用解析－基礎篇，初版，高立圖書有限公司，民國96年。
39. Ishihara H, Osada R, Kanamori M, Kawaguchi Y, Ohmori K, Kimura T, Matsui H, Tsuji H, ”Minimum 10-Year Follow-up Study of Anterior Lumbar Interbody Fusion for Isthmic Spondylolisthesis.” Journal of Spinal Disorders Vol. 14, No. 2, pp. 91–99,2001
40. Lindsey C, Deviren V, Xu Z, Yeh RF and Puttlitz CM, The effects of rod contouring on spinal construct fatigue strength, Spine, 31(15):1680-1687, 2006.

指導教授

林上智(Shang-Chih Lin)

審核日期

2009-7-14

推文