[1]苏少亭,周红海△,韦贵康,等.腰椎定点旋转手法不同旋扳动作对椎间盘的应力-应变效应[J].中国中医骨伤科杂志,2025,33(06):63-70+74.[doi:10.20085/j.cnki.issn1005-0205.250611]
　SU Shaoting,ZHOU Honghai,WEI Guikang,et al.The Stress-Strain Effect of Different Wrench Movements of Lumbar Fixed Point Rotation on Intervertebral Disc[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2025,33(06):63-70+74.[doi:10.20085/j.cnki.issn1005-0205.250611]
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腰椎定点旋转手法不同旋扳动作对椎间盘的应力-应变效应()

《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第33卷
期数:
2025年06期
页码:
63-70+74
栏目:
临床论著
出版日期:
2025-06-15

文章信息/Info

Title:
The Stress-Strain Effect of Different Wrench Movements of Lumbar Fixed Point Rotation on Intervertebral Disc
文章编号:
1005-0205(2025)06-0063-08
作者:
苏少亭1; 2; 3; 周红海1; 2; 3△; 韦贵康1; 2; 3; 田君明1; 2; 3; 陆延1; 2; 3; 刘粮酺1; 2; 3
1广西中医药大学骨伤学院(南宁,530001) 2国医大师韦贵康学术思想与临床诊疗传承发展研究中心 3广西中医骨伤科生物力学与损伤修复重点实验室
Author(s):
SU Shaoting1; 2; 3; ZHOU Honghai1; 2; 3△; WEI Guikang1; 2; 3; TIAN Junming1; 2; 3; LU Yan1; 2; 3; LIU Liangpu1; 2; 3
1School of Orthopaedics and Traumatology,Guangxi University of Chinese Medicine,Nanning 530001,China; 2Research Center for Academic Thought and Clinical Diagnosis and Treatment Inheritance and Development of Chinese Medical Master Wei Guikang,Nanning 530001,China; 3Guangxi Key Laboratory of Biomechanics and Injury Repair in Traditional Chinese Medicine Orthopedics and Traumatology,Nanning 530001,China.
关键词:
腰椎;  手法;  生物力学;  应力;  应变;  有限元
Keywords:
lumbar vertebrae;  manipulation;  biomechanics;  stress;  strain;  finite element
分类号:
R681.5
DOI:
10.20085/j.cnki.issn1005-0205.250611
文献标志码:
A
摘要:
目的:观察腰椎定点旋转手法不同旋扳动作对椎间盘的应力-应变效应。方法:将90名健康志愿者随机分为腰椎定点旋转手法上提旋扳、水平旋扳、下压旋扳三组,采用运动捕捉系统和穿戴式力学测量手套采集手法的运动力学参数。然后以腰椎-骨盆三维有限元模型为研究平台,分别模拟腰椎定点旋转手法三种不同旋扳动作,观察其对腰椎各节段椎间盘的应力-应变效应。结果:成功采集腰椎定点旋转手法中上提、水平、下压旋扳三种操作的运动力学参数并进行定量分析,结果显示施术者双手操作差异无统计学意义(P>0.05)。在模拟右侧旋扳条件下,三种旋扳手法诱导椎间盘纤维环产生不同的位移与应力分布变化:在L3/4至L5S1节段,手法引起的位移分量更为显著。上提旋扳手法主要引起轴向拉伸,下压旋扳手法导致矢状面位移向下,水平旋扳手法则在横断面引发显著位移变化。局部分析显示,下压旋扳手法的位移矢量更大,尤其在L5S1节段左前外侧的向上位移尤为显著。纤维环的应力在左右后外侧区域最高,下压旋扳手法引起最大Von Mises应力,应变分量同样在下压旋扳下达到最高,其中L4/5节段表现出最大应变,呈现应力与应变的再分配特性。结论:该研究可为腰椎定点旋转手法的临床安全应用及针对不同病理特征的个性化手法选择提供参考依据。
Abstract:
Objective:To observe the stress-strain effect of different wrench movements of lumbar fixed point rotation manipulation on intervertebral disc.Methods:A total of 90 healthy volunteers were randomly divided into three groups of lumbar fixed point rotation manipulation:lifting and rotation group,horizontal rotation group and downward rotation group.The motion mechanical parameters of the manipulation were collected by motion capture system and wearable mechanical measuring gloves.Then,based on the verified lumbar-pelvis three-dimensional finite element model as the research platform,three different rotation maneuvers of lumbar fixed point rotation were simulated to observe the stress-strain effect on the lumbar intervertebral disc of each segment.Results:The kinematic mechanics parameters of the three operations of lumbar fixed point rotation manipulations were successfully collected and quantitatively analyzed.The results showed that there was no significant difference between the two hands of the operators.Under the simulated right side rotation condition,three kinds of rotation manipulations induced different displacement and stress distribution changes in the intervertebral disc annulus.At L3/4 to L5S1 segments,the displacement component caused by manipulation was more significant.The lifting and twisting manipulation mainly caused the axial stretch,the pressing and twisting manipulation caused the sagittal displacement downward,and the horizontal wrench rule caused significant displacement changes in the transverse plane.The local analysis showed that the displacement vector of the downward pressure rotation manipulation was larger,especially the upward displacement in the left anterolateral part of the L5S1 segment.The maximum Von Mises stress was found in the left and right posterolateral regions of the annulus fibrosus.The maximum Von Mises stress was found in the L4/5 segment,and the maximum strain was found in the L4/5 segment,showing the redistribution of stress and strain.Conclusion:This study provides a scientific basis for the safe clinical application of lumbar fixed point rotation manipulation and personalized manipulation selection according to different pathological characteristics.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81360552,81660800)
广西高校中青年教师科研基础能力提升项目(2025KY0384)
△通信作者 E-mail:1310803699@qq.com
更新日期/Last Update: 2025-06-15