靜態穿椎弓足內固定器之剛性對腰椎受力之影響

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：20

、訪客IP：3.133.157.133

姓名

蕭兆閔(Chao-Min Hsiao) 查詢紙本館藏

畢業系所

機械工程學系

論文名稱

靜態穿椎弓足內固定器之剛性對腰椎受力之影響
(Effects of implant stiffness of the static transpedicular fixation on the lumbar spine)

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
★ 腰椎內固定器之動態型式的生物力學評估	★ 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動態固定器與靜態固定器，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，透過COSMOSWORKS有限元素軟體分析三種不同腰椎模型：正常腰椎、腰椎植入鈦合金靜固定器、腰椎植入316L不鏽鋼靜固定器定器三種模型來進行有限元素分析。主要模擬分析正常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，將正常腰椎植入兩種靜態固定器透過有限元素分析，了解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,the marrow of intervertebral disk was begun degenerating by increasing age of human.This degenerating reduces the thickness of an intervertebral disk & hypertrophy of ligament & facet joint,so that it gives rise to stress the nerve and resulted in DDD. The solution for this kind of case is that we use the static fixation to recover the initial thickness of intervertebral disk by a surgical operation, so that we can solve the problem of degeneration of intervertebral disk. This research utilizes the "SolidWork" to construct the model of lumbar vertebra & static fixation.Firstly, we put the muscle force into the model of lumbar vertebra to make this analysis close to the status of reality. It analyzes three different kinds of model of lumbar vertebra via cosmosworks’’s software of limited element : the normal lumbar vertebra、the lumbar vertebra with implanting an alloy of titanium,the lumbar vertebra with implanting 316L Stainless Steel fixation,there are three kinds of model to proceed the analysis of limited element. The majorly simulation is to analyze the height,change of angle,stress of nucleus pulposus,stress of pedicle of the model of lumbar vertebra and the status of stress distribution.

關鍵字(中)

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

關鍵字(英)

★ lumbar
★ nucleus pulposus
★ intervertebral disc
★ face

論文目次

摘要 i
致謝文 iii
目錄 iv
表目錄 xvii
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 3
1-2-1 腰椎運動單元簡介 4
1-2-2 腰椎周圍韌帶與肌肉群簡介 7
1-3 腰椎之病理學與手術治療方式 9
1-4 腰椎內動靜態內固定器介紹 11
1-5 文獻回顧 15
1-5-1 腰椎肌肉群之三維參數的建立 15
1-5-2 腰椎固定器之有限元素分析 22
二、材料與方法 34
2-1 三維五節腰椎之模型的建立 34
2-1-1 三維五節腰椎與椎間盤模型的建立 34
2-1-2 三維五節腰椎之韌帶建立 39
2-1-3 三維五節腰椎之肌肉群建立 42
2-2 腰椎動靜態內固定器的設計 48
2-2-1 傳統靜態內固定器的設計 48
2-3 有限元素分析 51
2-3-1 材料性質的給定 51
2-3-2 受力邊界條件的給定 53
2-3-3 接觸型式的設定 57
2-3-4 網格化與分析 60
2-4 腰椎模型有限元素分析參數與驗證 64
2-4-1 有限元素分析參數的指標 64
2-4-2 自然腰椎模型的驗證 66
三、結果 69
3-1 椎間盤角度與高度變化 69
3-2 椎間盤髓核應力變化 74
3-3 椎弓足的應力變化 77
3-4 內固定器的應力變化 80
3-4-1 鈦合金椎弓釘與連接桿應力變化 80
3-4-2 316L椎弓釘與連接桿應力變化 91
四、討論 102
4-1 椎間盤角度與高度變化討論 102
4-2 椎間盤之隨核應力變化討論 104
4-3 椎弓足的應力變化討論 107
4-4 內固定器的應力變化討論 111
五、未來展望 124
5-1 結論 124
5-2 未來展望 125

參考文獻

[1] Spine clinic.http://floridaspinesurgery.com/ed_treatment.htm
[2] Synthes.http://us.synthes.com/Products/Spine/Deformity
[3] Martini Bartholomew, Essentials of anatomy & physiology,ch6.
[4] James Watkins, structure and function of the musculoskeletal system.ch3，ch6.
[5] 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。
[6] 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。
[7] Anthony P.Schnuerer,P.A. Julio Gallego, M.D. Cristie anuel,Anatomy of the Spine & Related Structures.
[8] 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.
[9] Bandhayoga.http://bandhayoga.com/images/psoas_9_lg.gif
[10] Realbodywork.http://www.realbodywork.com/learn/torso/multifidus.jpg.
[11] 新竹市脊椎髓損傷者協會，http://www.cc.nctu.edu.tw/~hcsci/hospital/other/hivd_4.htm
[12] 鄭誠功、陳振昇、廖振凱、陳景升，「骨科器材生物力學測試GLP實驗室的建立-脊椎內固定器」，國立陽明大學，研究報告，1999。
[13] Orthofix.http://www.orthofix.com/products/sfs.asp?cid=35
[14] Bandhayoga.http://bandhayoga.com/images/psoas_9_lg.gif
[15] Realbodywork.http://www.realbodywork.com/learn/torso/multifidus.jpg.
[16] Inglife,Inc.http://www.inglife.com.tw/ohayo/medical/doctor_times/doctor_writings/n_dr_writings_1_xv.asp?DocID=8176&AuthorID=
[17] 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。
[18] 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.
[19] Frank Kandziora, MD, Philip Schleicher, MD, Matti Scholz, MD,Robert Pflugmacher, MD,Tanja Eindorf, DVM, Norbert P. Haas, MD,and Paul W. Pavlov, MD，“Biomechanical Testing of the Lumbar Facet Interference Screw”Spine Volume 30, Number 2, pp E34–E39，c2005, Lippincott Williams & Wilkins, Inc.
[20] Kiefer A, Shirazi-Adl A, Parnianpour M“Synergy of human spine in neutral postures.”Eur Spine J 7:471–479,1998.
[21] 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.
[22] Bazrgari, B. Shirazi-Adl. Arjmand, N “Analysis of squat and stoop dynamic liftings: muscle forces and internal spinal loads.” Eur Spine J 16:687–699,2007.
[23] A. Rohlmann, J. Calisse, G. Bergmann, U. Weber “Internal Spinal Fixator Stiffness Has Only a Minor Influence on Stresses in the Adjacent Discs”Spine , Vol.24, pp. 1192-1196, 1999.
[24] T. Zander，A. Rohlmann，J.Calisses，G. Bergmann”Estimation of muscle force in the lumbar spine during upper-body inclination.”Clinical Biomechanics Vol. 1 pp. S73-S80,2001.
[25] 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.
[26] T. Zander, A. Rohlmann, N. K.Burra, G. Bergmann “Effect of a posterior dynamic implant adjacent to a rigid spinal fixator ”Clinical Biomechanics 21 767-774,2006.
[27] A. Rohlmann , N. K.Burra , T. Zander, G. Bergmann “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.
[28] Lali Sekhon, MD, PhD,“Posterior Cervical Foraminotomy: A Surgical Technique to Reduce Pain” 1999-2009 SpineUniverse.com
[29] 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.
[30] Sasidhar Vadapalli, MS, Koichi Sairyo, MD, Vijay K. Goel, PhD, Matt Robon, MD,Ashok Biyani, MD, Ashutosh Khandha, MS, and Nabil A. Ebraheim, MD, “Biomechanical Rationale for Using Polyetheretherketone(PEEK) Spacers for Lumbar Interbody Fusion–A FiniteElement Study”, Spine Volume 31, Number 26, pp E992–E998c2006, Lippincott Williams & Wilkins, Inc.
[31] Q.H. Zhang, S.H. Tan, S.M. Chou,“Investigation of fixation screw pull-out strength on human spine”, Journal of Biomechanics 37 (2004) 479–485.
[32] Srilakshmi Vishnubhotla,”A Biomechanical Evaluation of Dynamic Stabilization Systems”, Master of Science in Bioengineering, The University of Toledo, August 2005.
[33] 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。
[34] 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。
[35] Cholewicki，Jacek，Crisco，Joseph，Qxland，Thomas r，Yamamoto，isao，Panjabi Manohar M” Mechanical Behavior of the Human Lumbar and Lumbosacral Spine as Shown by Three-Dimensional Load-Displacement.”Biomechanic Vol.76‧pp. 413-424.
[36] Hirokazu Ishihara, Ryusuke Osada, Masahiko Kanamori, Yoshiharu Kawaguchi, Kazuo Ohmori,Tomoatsu Kimura, Hisao Matsui, and Haruo Tsuji”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.
[37] 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

2009-7-13

推文