腰椎人工椎間盤之運動軌跡分析

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姓名

錢威廷(Wei-Ting Chien) 查詢紙本館藏

畢業系所

機械工程學系

論文名稱

腰椎人工椎間盤之運動軌跡分析
(Analysis of the Motion Locus of Lumbar Artificial Disc)

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摘要(中)

目前治療椎間盤退化性疾病(DDD: Degenerative Disc Disease)之主要治療方式為在受治療之椎間盤處植入椎籠，希望能造成椎骨間的骨融合(Intervertebral Fusion)，進而恢復塌陷椎間盤之原有高度，但在臨床上已發現術後常會有脫出(Back-out)及位移(Displacement)等併發症的產生，而且由於接受治療之區域發生椎骨間的融合，造成治療區域之椎間盤活動度(ROM: Range of Motion)喪失，其活動度將由鄰近之椎間盤分擔，因而增加了鄰近椎間盤之運動量，造成這些椎間盤發生加速老化的問題(Junctional Problem)，因而發產出活動是人工椎間盤。目前市面上之磨耗型人工椎間盤可分為限制型及非限制型兩種，而各自有其優缺點。
本研究希望設計一種新型磨耗型人工椎間盤，在植入人體後，將可重建塌陷椎間盤的原有高度，同時能提供手術區域之椎間盤自然的運動型式與活動範圍，並能有效限制人工椎間盤活動之範圍，避免於屈曲與伸展及左右側彎時過大的動作所造成之不良影響。

摘要(英)

Nowadays, we know the main treatment of Degenerative Disc Disease that implants cage into the cured intervertebral idsc. We also hope that makes Intervertebral Fusion, and then restores the high of dent one, but it is easy to see that will being back-out and displacement or complications after operations.
According to this situation, those cages are merged in the accepted curing region; it also makes lose ROM(Range of Motion), in the area and the movement is not only shared by both side of intervertebral idsc, but also increasing it’s motion. Due to those points, making intervertebral idsc develops some junctional problems speedy. The last development is Artificial Disc. Wearing type of artificial intervertebral disc on the market can divide into two kinds that are constrained and unconstrained, and have its pluses and minuses each.
We hope to design a new style of Artificial Disc through this research that puts it into internal. It also rebuilds the original height of intervertebral disc and provides the range of intervertebral disc’s movement and exercise in nature way. To limit the move range of Artificial Disc effectively and avoid the counterproductive effect of movement in flexing, stretch and turn right or left.

關鍵字(中)

★ 椎間盤退化性疾病
★ 人工椎間盤
★ 椎間盤活動度
★ 椎骨間的骨融合
★ 椎籠

關鍵字(英)

★ Intervertebral Fusion
★ cage
★ Artificial Disc
★ Degenerative Disc Disease
★ Range of Motion

論文目次

中文摘要 i
英文摘要 ii
致謝 iii
目錄 iv
圖目錄 vii
表目錄 xiii
一、緒論 1
1-1 研究的動機與目的 1
1-2 腰椎之解剖生理學 2
1-2-1 腰椎椎體簡介 3
1-2-2 腰椎椎間盤簡介 4
1-2-3 腰椎小面關節簡介 5
1-2-4 腰椎周圍韌帶簡介 6
1-3 腰椎之病理學與處理方式 7
1-4 腰椎人工植入物介紹 9
1-5 文獻回顧 16
1-5-1 腰椎運動範圍之相關文獻 16
1-5-2 腰椎運動瞬間旋轉軸之相關文獻 21
1-5-3 人工椎間盤之相關文獻 24
1-5-4 臨床報告相關文獻 27
二、材料與方法 29
2-1 腰椎模型與人工椎間盤的電腦輔助設計 29
2-1-1 人體腰椎解剖模型的建立 29
2-1-2 人工椎間盤模型之建立 31
2-2 腰椎運動學的電腦模擬 35
2-2-1 自然椎間盤之動態模擬設定 36
2-2-2 人工椎間盤FreeDisc之動態模擬設定 42
2-2-3人工椎間盤ProDisc之動態模擬設 47
2-2-4 人工椎間盤SB Charitè之動態模擬設定 50
2-3 腰椎之運動軌跡分析參數 56
三、結果 57
3-1 自然情形動態模擬 57
3-1-1 自然情形屈曲與伸展之動態模擬結果 57
3-1-2 自然情形左右側彎之動態模擬結果 59
3-1-3 自然情形軸向旋轉之動態模擬結果 61
3-2 FreeDisc動態模擬 63
3-2-1 FreeDisc屈曲與伸展之動態模擬結果 63
3-2-2 FreeDisc左右側彎之動態模擬結果 64
3-2-3 FreeDisc軸向旋轉之動態模擬結果 66
3-3 ProDisc動態模擬 67
3-3-1 ProDisc屈曲與伸展之動態模擬結果 67
3-3-2 ProDisc左右側彎之動態模擬結果 69
3-3-3 ProDisc軸向旋轉之動態模擬結果 70
3-4 SB Charitè動態模擬 72
3-4-1 SB Charitè屈曲與伸展之動態模擬結果 72
3-4-2 SB Charitè左右側彎之動態模擬結果 73
3-4-3 SB Charitè軸向旋轉之動態模擬結果 75
四、討論 77
4-1 屈曲與伸展之動態模擬結果討論 77
4-2 左右側彎之動態模擬結果討論 83
4-3 軸向旋轉之動態模擬結果討論 88
4-4 FreeDisc改良結果討論 90
五、結論與未來展望 94
5-1 結論 94
5-2 未來展望 94
參考文獻 95

參考文獻

[1] John W. Hole, Jr., Karen A. Koos, Human Anatomy，胡銘一、孫穆乾、陳懿慧等譯，藝軒出版社，民國八十ㄧ年
[2] 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
[3] Martini Bartholomew, Essentials of anatomy & physiology,ch6.
[4] James Watkins, structure and function of the musculoskeletal system.ch3，ch6.
[5] Lindh,M.1989.biomechanics of the lumbar spine. In Basic biomechanics of the musculoskeletal system,eds.M.Nordin and V.H. Frankel.Philadelphia:Lea & Febiger.
[6] Anthony P.Schnuerer,P.A. Julio Gallego, M.D. Cristie Manuel,Anatomy of the Spine & Related Structures.
[7] White III,A. A. ,and Panjabi,M. M,Chinical Biomechanics of the Spine,1990
[8] White III,A. A. ,and Panjabi,M. M.,Spinal kinematics.“The research status of spinal manipulative therapy.”, NINCDS Monograph (No.15). p.93 . 1975
[9] Panjabi M.M., Oxland T.R.,Yamamoto I., Crisco J.J.,“Mechanical behavior of the human lumbar and lumbosacral spine as shown by three-dimensional load-displacement curves,” J. Bone Joint Surg.,Vol.76-A,No.3,1994
[10] Yamamoto I., Panjabi M.M., Crisco J., Bonar S.,“Three-dimensional movements of the whole lumbar spine and lumbosacral joint”, Spine , Vol.14,No.11,pp.1256-1260,1989
[11] Shirazi-Adl A.,“Biomechanics of the lumbar spine in sagittal/lateral moments” , Spine,Vol.19,No.21,pp.2407-2414,1994
[12] Sharma M., Langrana N.A., and Rodriguez J.,“Role of ligaments and facets in lumbar spinal stability”,Spine,Vol.20,No.8,pp.887-900 ,1995
[13] Gertzbein,“Determination of a locus of instantaneous centers of rotation of the lumbar disc by moire fringes :A new technique ”, Spine,Vol.9,No.4,pp.409-413,1984
[14] Pearcy MJ,“Instantaneous axes of rotation of the lumbar intertebral joints”,Spine,Vol.13,No.9,pp1033-1041,1988
[15] Russel C. Huang ，Federico P. Girardi,”The implications of constraint in lumbar total disc replacement .”Journal of Spinal Disorders ＆ Techniques, Vol.16,No.4 ,pp. 412-417,2003
[16] Kanayama,“Phase lag of the intersegmental motion in flexion-extension of the lumbar and lumbosacral spine: An in vivo study”, Spine, Vol.21(12), pp 1416-1422, 15 June 1996
[17] Vincent C.Traynelis,“Spinal arthroplasty”, Neurosurg Focus 13 (2)，Article 10, 2002,
[18] 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
[19] Helmut D. Link, “History, design and biomechanics of the LINK SB Charité artificial disc”, Eur Spine, Suppl.2 ,pp.S98–S105, J (2002) 11
[20] Gregory Schneider, FACP, MmedSc,“Abnormal motion in spondylolytic spondylolisthesis”, Spine Vol 30, No 10, pp 1159–1164,2005
[21] Ee-Chon Teo, Tian-Xia Qiu, Kai Yang, Hong-Wan Ng and Kim-Kheng Lee,“Biomechanical effect of thoracic posterior vertebral elements on patterns of the loci of instantaneous axes of rotation in sagittal plane”, Journal of Musculoskeletal Research, Vol. 7, No. 3 & 4 ,pp191– 200,2003
[22] Tadanori Sakamaki, Shinsuke Katoh, and Koichi Sairyo,“Normal and spondylolytic pediatric spine movements with reference to instantaneous axis of rotation ”, Spine Vol 27, No 2, pp 141–145,2002
[23] Marc-Antoine Rousseau,David S. Bradford,Tamer M. Hadi,Kirk L. Pedersen,Jeffery C. Lotz,“The instant axis of rotation influences facet forces at L5/S1 during flexion/extension and lateral bending”, Eur Spine J 15, pp.299–307,2006
[24] Bryan W.C., Jeffrey D.G., Anton E.D., Nianbin H.M.,and Paul C.M.,“Biomechanical evaluation of total disc replacement arthroplasty：an in vitro human cadaveric model,”Spine,Vol.28,No.20S,pp.S110-S117,2003
[25] Paul C.M., Ira L.F., Samer S., Erin M.S., and Bryan W.C.,“Experimental design of total disk replacement-experience with a prospective randomized study of the SB Charitè,”Spine,Vol.28,No.20S,pp.S153-S162 ,2003
[26] Rick B.D., David M.F., Linda E.A.K., and Hyun B.“ProDisc artificial total lumbar disc replacement：introduction and early results from the united states clinical trial,”Spine,Vol.28,No.20S,2003,pp.S167-S175
[27] Jack E.Z.,“Clinical results with ProDisc：European experience and u.s. investigation device exemption study ”, Spine,Vol.28 , No.20S , pp.S163-S166,2003
[28] Lee, C. K. and Langrana, N. A.,“A review of spinal fusion for degenerative disc disease: need for alternative treatment approach of disc arthroplasty”, The Spine Journal 4(2), pp.173-176S, 2004
[29] Guilhem Denozière,“Numerical modeling of a ligamentous lumbar motion segment ”, Georgia Institute of Technology,May 2004
[30] Botsford D.J., Esses S.I., and Ogilivie-Harris D.J.,“In-vivo diurnal variation in intervertebral disc volume and morphology”, Spine, Vol.l9, No.8, pp.935-940,1994
[31] 陳振昇，“腰椎融合手術之生物力學分析 ”，國立陽明大學醫學工程研究所，博士論文，2001.
[32] 蘇建融，“人工椎間盤之設計與力學分析”，國立台灣大學，碩士論文，2004
[33] 管原璋，“人工椎間盤接觸面之設計與分析”，國立台灣大學機械工程研究所，碩士論文，民國九十四年
[34] http://www.taiwanspinecenter.com/tsc_c/education/spine_anatomy/disc.htm
[35] http://www.cc.nctu.edu.tw/~hcsci/hospital/other/hivd_4.htm
[36] http://www.inglife.com.tw/ohayo/medical/doctor_times/doctor_writings/n_dr_writings_1_xv.asp?DocID=8176&AuthorID=
[37] http://www.cghns.com.tw/content/6c.html
[38] http://www.thaispinecenter.com/webboard/board_posts.asp?FID=14

指導教授

林上智、鄔蜀威
(Shang-Chih Lin、Shu-Wei Wu)

審核日期

2007-7-21

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