[1]邓真 詹红生 李国中 廉由之 商海滨 王玉鹏 王辉昊△.颈椎旋扳法对“骨错缝”颈椎应力作用的有限元分析[J].中国中医骨伤科杂志,2021,29(10):37-42.
　DENG Zhen ZHAN Hongsheng LI Guozhong LIAN Youzhi SHANG Haibin WANG Yupeng WANG Huihao.A Finite Element Analysis of Cervical Rotation Manipulation onthe Pathological Cervical with Joint Subluxation[J].Chinese Journal of Traditional Medical Traumatology & Orthopedics,2021,29(10):37-42.
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颈椎旋扳法对“骨错缝”颈椎应力作用的有限元分析()
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《中国中医骨伤科杂志》[ISSN:1005-0205/CN:42-1340/R]

卷:
第29卷
期数:
2021年10期
页码:
37-42
栏目:
临床研究
出版日期:
2021-10-15

文章信息/Info

Title:
A Finite Element Analysis of Cervical Rotation Manipulation onthe Pathological Cervical with Joint Subluxation
文章编号:
1005-0205(2021)10-0037-06
作者:
邓真1; 2 詹红生2; 3 李国中1 廉由之1; 2 商海滨1 王玉鹏3 王辉昊2; 3△
1上海市宝山区中西医结合医院/上海中医药大学附属曙光医院宝山分院(上海,201999)2詹红生上海市名老中医学术经验研究工作室3上海中医药大学附属曙光医院
Author(s):
DENG Zhen1; 2 ZHAN Hongsheng2; 3 LI Guozhong1 LIAN Youzhi1; 2 SHANG Haibin1 WANG Yupeng3 WANG Huihao2; 3△
1Shanghai Baoshan Hosptial of Intergated Traditional Chinese and Western Medicine,Shanghai 201999,China; 2Zhan Hongsheng Studio of Academic Experience of Shanghai Famous Doctors in TCM,Shanghai 201203,China; 3Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China.
关键词:
颈椎;  旋扳法;  骨错缝;  整骨;  应力;  有限元分析
Keywords:
cervical spine;  cervical rotation manipulation;  joint subluxation;  osteopathic;  stress;  finite element analysis
分类号:
R681.5
文献标志码:
A
摘要:
目的:观察颈椎旋扳法对“骨错缝”颈椎有限元模型应力作用的影响。方法:基于已经验证的,可靠、有效的正常人全颈椎有限元模型研究平台,结合1例颈椎棘突偏歪的“骨错缝”颈椎病患者全颈椎CT扫描数据,构建“骨错缝”颈椎有限元模型。在正常人模型和“骨错缝”模型上加载相同的头颅质量载荷,观察对比两种模型颈椎应力的区别和差异; 在“骨错缝”模型上加载采集的颈椎旋扳手法力学参数,模拟单侧颈椎旋扳法,观察模型骨性结构、小关节软骨和椎间盘等主要结构的应力特征和改变。结果:与正常模型比较,“骨错缝”模型增加了病理部位以下颈椎在椎体、椎弓根、小关节和椎间盘的应力; 病理颈椎的活动度改变明显,只在右侧弯时,颈椎各椎体之间活动度增大,在前屈、后伸、左侧弯、左旋转和右旋转时,颈椎各椎体之间活动度均明显减小; 旋扳法加载瞬时,目标椎体及相邻上下棘突应力显著增大,颈椎左侧小关节应力下降,右侧小关节应力上升,目标椎体上位椎间盘的纤维环前部应力减小,后部应力略增大,但髓核应力减小,其下位椎间盘纤维环和髓核后部应力均明显增大。结论:颈椎旋扳法可以调整“骨错缝”模型骨性结构、小关节软骨和椎间盘的异常应力状态,降低目标椎体上位颈椎结构应力,但会增加目标椎体下位颈椎结构应力。
Abstract:
Objective:To observe the efficacy of cervical rotation manipulation on the stress of pathological cervical finite element model with joint subluxation.Methods:Based on the verified,reliable and effective finite element model research platform of the whole cervical spine of normal people,we constructed the pathological cervical spine finite element model by the whole cervical CT data of a patient with cervical spondylosis of joint subluxation.The same head weight load was loaded on the normal human model and pathological model to observe and compare the difference of cervical stress between two models.The mechanical parameters of cervical wrench method were loaded on the pathological model to simulate unilateral cervical wrench method,and the stress characteristics and changes of main structures such as bone structure,facet cartilage and intervertebral disc of pathological model were observed.Results:Compared with the normal model,the pathological model increased the stress of cervical spine below the pathological site in vertebral body,pedicle,facet joint and intervertebral disc.The ROM of pathological cervical vertebrae changed obviously.The range of motion between cervical vertebrae increased only when bending on the right side,but decreased obviously when bending on the left side,bending on the left side,rotating on the left side and rotating on the right side.At the moment of rotation manipulation loading,the stress of the target vertebral body and its adjacent upper and lower spinous processes increased significantly increased.Besides,the stress of the left facet joint of cervical spine decreased,while that of the right facet joint increased.Moreover,the stress in the anterior annulus fibrosus of the upper disc of the target vertebral body decreased,and the stress in the posterior disc increased slightly,but the stress in the nucleus pulposus decreased.Furthermore,the stress of annulus fibrosus and posterior nucleus pulposus in the target vertebral body was significantly increased.Conclusion:Cervical rotation manipulation can adjust the abnormal stress state of bone structure,facet cartilage and intervertebral disc in the pathological model of joint subluxation and reduce the stress of the upper cervical structure of the target vertebral body,but increase the stress of the lower cervical structure of the target vertebral body.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金项目(81804114,81973871)
上海市卫计委临床行业面上项目(201840004)
上海市人才发展资金资助项目(2019101)
上海市卫计委詹红生上海市名老中医学术经验研究工作室建设项目(SHGS-2017025,SZYMYGZS4013)
上海市中医诊疗模式创新试点建设项目(ZY2018-2002-FWTX-6003)
△通信作者 E-mail:wanghuihao@126.com
更新日期/Last Update: 1900-01-01