腰椎內固定器之動態型式的生物力學評估

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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)

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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

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指導教授

林上智(Shang-Chih Lin)

審核日期

2009-7-14

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