臺灣博碩士論文加值系統

在過去的研究中椎間盤內壓常作為脊椎研究的一項重要參考數據，當一健康椎間盤受負載時，椎間盤內壓會以等比例上升，因此透過量測內壓可以用來探討椎間盤的生理力學現象。在過去的研究中應變規式的針型壓力感測器已成為當前量測所用的主流，其具有良好的精準度且價格便宜，缺點為尺寸過大，因此容易造成椎間盤損傷，導致實驗數值有所誤差。本研究目的為開發出一套製程化的流程，製作出三種類型的18G針型壓力感測器，經靜態測試評估出性能最佳之類型，並透過不三種的插入方式實際量測椎間盤內壓，藉由所得之內壓結果與其靈敏度的的變化探討出最佳的插入量測方式。
研究流程主要分為四個部分。針型壓力感測器的製作:將18G針透過線切割加工出所需的外形，再使用黏貼治具將應變規黏貼於針之凹槽，進行封裝與防水測試。靜態壓力校正測試:靜態壓力校正測試參考規範ASTM D5720，測試範圍採通過防水測試之壓力值，計算出壓力感測器的線性、遲滯與重現性誤差精確度。椎間盤內壓量測:以三種方式插入壓力感測器，進行內壓實驗。檢測感測器與內壓比較:將實驗後之壓力感測器再次進行靜態壓力校正測試，藉由測試結果與內壓結果評估出最佳的量測方式。
防水結果顯示，第一類型的防水性能約在1.5MPa，而其它兩種類型則皆能至3MPa。靜態測試結果顯示僅第一類型符合所需，其具良好之靈敏度，其各項誤差精確度皆小於10%，製作時間也最短。椎間盤內壓結果，第一與第三種量測方式的結果皆符合於過去文獻範圍。從內壓實驗前後的靜態測試結果顯示，第三種量測方式對於壓力感測器的影響最小，其誤差精確度於實驗後仍符合需求，且其靈敏度的變異降最低為1.5%。

In previous studies, intradiscal pressure was used as an important reference data measure in spine biomechanics research. When a healthy intervertebral disc is under loading, the intradiscal pressure will be increased proportionally with loading. We can investigate the physiological mechanics of disc by measuring the intradiscal pressure. In previous studies, strain gage needle-type of pressure sensor was used as the mainstream method for the measurement of intradiscal pressure. The advantage of this sensor is its accuracy and inexpensive to fabricate, but the disadvantage is that its size is still too large to be used on the intervertebral disc. The strain gage needle-type pressure sensor may compromise the disc easily during insertion and lead to experimental errors. The purpose of this study is to develop a standardized procedure to produce three kinds of 18G needle-type pressure sensors. Then the three sensor types were assessed and the performance for each type of sensor was evaluated by a static test protocol, and the intradiscal pressure were measured using three different insertion methods. Finally, the best insertion method was found by evaluating the intradiscal pressure values and the sensitivity of different pressure sensor types.
The current study was divided into four parts. 1. Needle-type pressure sensor fabrication: 18G of needle was fabricated to the desired shape by using wire electrical discharge machining (EDM) techniques, and the strain gage was adhered to the grooves of the needle by using a specially-designed device. Then the needle was encapsulated and underwent a waterproof test. 2. Static pressure calibration test: a static pressure calibration test was performed on the needle sensor according to the ASTM D5720 standard. The pressure range for the static test was obtained by using the max pressure value that a needle sensor passed the waterproof test. From the static test, the linear, hysteresis repeatability, and accuracy of the pressure sensor were calculated. 3. Intradiscal pressure measurement: pressure sensor was inserted using different methods to measure the intradiscal pressure. 4. Inspection of the pressure sensor and comparison of the intradiscal pressure measured: the pressure sensors were inspected again using the static pressure calibration test again following the measurement of intradiscal pressure. The best measurement method was found by evaluating the sensitivity of static pressure calibration test and the intradiscal pressure results.
The results of waterproof test showed that the waterproof performance of the first sensor type was about 1.5MPa, while the other two sensor types were about 3MPa. The results from the static pressure calibration test showed that only the first sensor type with good sensitivity and the measurement error is less than 10% and the production time is the shortest as compared to other types of sensor. From the results of intradiscal pressure, the first and the third measurement methods are consistent with the measurement range of the past literature. The results of static pressure calibration test before and after the intradiscal pressure experiment showed that the third measurement method has less influence on for the pressure sensors and the accuracy of the pressure sensor is still good after the intradiscal pressure experiment and the variation of sensitivity is 1.5%.

目錄
摘要 i
ABSTRACT iii
誌謝 vi
目錄 vii
第一章　緒論 1
1-1前言 1
1-2研究背景 2
1-2-1椎間盤解剖構造 2
1-2-1-1軟骨終板 2
1-2-1-2髓核 3
1-2-1-3環狀纖維 3
1-2-2椎間盤內壓 4
1-2-3髓核壓力量測 5
1-2-4壓力感測器的原理與應用 7
1-3文獻回顧 11
1-3-1椎間盤力學測試 11
1-3-2 ASTM D5720-95 土力工程之電子式壓力傳感器量測系統的靜態校正標準規範 14
1-3-2-1靜態校正測試 14
1-4研究動機與目的 15
第二章 材料方法 16
2-1研究流程 16
2-2應變規黏貼治具 17
2-3針型壓力感測器所需之材料 18
2-4針型壓力感測器製作流程 18
2-4-1針型壓力感測器 19
2-4-2原型針加工 19
2-4-3黏貼應變規 20
2-4-4防水膠封裝 21
2-4-5防水測試 23
2-4-6偏移測試 23
2-5針型壓力感測器的靜態測試 24
2-5-1靜態校正設備 25
2-5-2資料擷取設備 27
2-5-3靜態測試:第一次與第二次 28
2-5-4導線延長加工 29
2-5-5靜態校正測試結果評估 31
2-6椎間盤內壓量測試驗 33
2-6-1試片處理 33
2-6-2實驗流程 34
第三章 結果 37
3-1防水測試結果 37
3-2偏移測試結果 37
3-3各類型壓力感測器的靜態測試結果 38
3-3-1靜態測試-第一類型壓力感測器 39
3-3-2靜態測試-第二類型壓力感測器 40
3-3-3靜態測試-第三類型壓力感測器 41
3-4豬椎間盤內壓量測結果 41
3-5檢測壓力感測器 42
第四章 討論 43
4-1製程化討論 43
4-1-1應變規黏貼治具 43
4-1-2防水膠封裝 44
4-1-3防水的性能 44
4-2校正測試 45
4-2-1校正機台 45
4-2-2靜態測試:第一次 46
4-2-2-1有無基底的影響 46
4-2-3靜態測試:第二次 47
4-3豬椎間盤內壓量測 47
4-3-1三種量測方式的優缺點 48
4-4三種壓力感測器的優缺點 48
4-5實驗限制 49
4-6未來展望 49
第五章 結論 50
參考文獻 51、表目錄
表1.1、不同姿勢與運動狀態下的椎間盤內壓數值[5] 6
表2.1、靜態測試儀器 25
表2.2、InstruNet資料擷取系統設備 28
表2.3、InstruNet資料擷取軟體設定 29
表2.4、校正計算用公式 31
表2.5、簡易測試報告表 32
表3.1、各類型防水測試結果表 37
表3.2、各類型壓力感測器性能測試結果 39
表3.3、內壓量測結果與量測前之壓力感測器性能 41
表3.4、實驗後的平均靜態測試結果與靈敏度變異量 42
表4.1、三種類型壓力感測器的優缺點 48、圖目錄
圖1.1、椎間盤構造圖[34] 2
圖1.2、椎間盤俯視圖[35] 3
圖1.3、環狀纖維環[36] 4
圖1.4、應變規[37] 8
圖1.5、壓力感測器[2] 8
圖1.6、壓阻式壓力感測器[3] 9
圖1.7、突變式與漸進式光纖[38] 10
圖1.8、光纖式壓力感測器[4] 10
圖2.1、研究流程 16
圖2.2、應變規黏貼治具(1)黏貼擋塊;(2)應變規置放塊 17
圖2.3、針型壓力感測器製作流程 18
圖2.4、針型壓力感測器類型 19
圖2.5、原型針與線切割加工圖。(1)18G手術鋼針(2)線切割加工 20
圖2.6、原型針加工類型 20
圖2.7、應變規 21
圖2.8、黏貼示意圖 21
圖2.9、防水膠塊的製作 22
圖2.10、防水膠層的製作 22
圖2.11、壓力感測器之完成圖(第一類型) 22
圖2.12、壓力感測器測試的標準化流程 24
圖2.13、靜態測試儀器架設圖 26
圖2.14、InstruNet資料擷取系統示意圖 27
圖2.15、TF-17端子 30
圖2.16、導線加工流程圖 30
圖2.17、靜態測試結果示意圖 31
圖2.18、內壓量測的流程 33
圖2.19、椎間盤俯視圖 34
圖2.20、包埋椎間盤 34
圖2.21、感測器插入方式與施加負載流程圖 35
圖2.22、特殊穿刺針。由兩段式16G外套筒加上18G穿刺針所組合而成。 35
圖2.23、實際量測圖 36
圖3.1、第一類型偏移測試結果圖 38
圖3.2、性能測試之平均靈敏度比較圖 38
圖3.3、第一類型壓力感測器第一次靜態測試之壓力-應變關係圖 39
圖3.4、第一類型壓力感測器第二次靜態測試之壓力-應變關係圖 40
圖3.5、第二類型壓力感測器第一次靜態測試之壓力-應變關係圖 40
圖3.6、第三類型壓力感測器第一次靜態測試之壓力-應變關係圖 41
圖3.7、內壓結果圖 42
圖4.1、初始黏貼治具 44
圖4.2、第一類型壓力感測器受力圖 45
圖4.3、第一類型壓力感測器的漏水位置 45

1.M. Adams, D. McNally, and P. Dolan, &;quot;‘STRESS’DISTRIBUTIONS INSIDE INTERVERTEBRAL DISCS THE EFFECTS OF AGE AND DEGENERATION,&;quot; Journal of Bone &; Joint Surgery, British Volume, vol. 78, 1996, pp. 965-972.
2.D. McNally, M. Adams, and A. Goodship, &;quot;Development and validation of a new transducer for intradiscal pressure measurement,&;quot; Journal of biomedical engineering, vol. 14, 1992, pp. 495-498.
3.D. L. Glos, F. E. Sauser, I. Papautsky, and D. I. Bylski-Austrow, &;quot;Implantable MEMS compressive stress sensors: Design, fabrication and calibration with application to the disc annulus,&;quot; Journal of biomechanics, vol. 43, 2010, pp. 2244-2248.
4.C. R. Dennison, P. M. Wild, D. R. Wilson, and P. A. Cripton, &;quot;A minimally invasive in-fiber Bragg grating sensor for intervertebral disc pressure measurements,&;quot; Measurement Science and Technology, vol. 19, 2008, pp. 1-12.
5.H. J. Wilke, P. Neef, M. Caimi, T. Hoogland, and L. E. Claes, &;quot;New in vivo measurements of pressures in the intervertebral disc in daily life,&;quot; Spine, vol. 24, 1999, pp. 755-762.
6.W. T. Edwards, N. Ordway, Y. Zheng, G. McCullen, Z. Han, and H. A. Yuan, &;quot;Peak stresses observed in the posterior lateral anulus,&;quot; Spine, vol. 26, 2001, pp. 1753-1759.
7.P. Cripton, G. Dumas, and L.-P. Nolte, &;quot;A minimally disruptive technique for measuring intervertebral disc pressure in vitro: application to the cervical spine,&;quot; Journal of biomechanics, vol. 34, 2001, pp. 545-549.
8.J. L. Wang, Y. W. Kuo, C. C. Chang, and B. D. Yang, &;quot;Interference in intradiscal pressure measurement using a needle‐type pressure transducer,&;quot; Journal of the Chinese Institute of Engineers, vol. 30, 2007, pp. 149-153.
9.D. A. Agard and J. W. Sedat, &;quot;Three-dimensional architecture of a polytene nucleus,&;quot; Nature, vol. 302, 1983, pp. 676-681.
10.W. T. Edwards, Y. Zheng, L. A. Ferrara, and H. A. Yuan, &;quot;Structural features and thickness of the vertebral cortex in the thoracolumbar spine,&;quot; Spine, vol. 26, 2001, pp. 218-225.
11.J. P. Urban, S. Smith, and J. C. Fairbank, &;quot;Nutrition of the intervertebral disc,&;quot; Spine, vol. 29, 2004, pp. 2700-2709.
12.H. Crock and M. Goldwasser, &;quot;Anatomic studies of the circulation in the region of the vertebral end-plate in adult Greyhound dogs,&;quot; Spine, vol. 9, 1984, pp. 702-706.
13.A. Vogel and D. P. Pioletti, &;quot;Damping properties of the nucleus pulposus,&;quot; Clinical Biomechanics, vol. 27, 2012, pp. 861-865.
14.J. C. Iatridis, L. A. Setton, M. Weidenbaum, and V. C. Mow, &;quot;Alterations in the mechanical behavior of the human lumbar nucleus pulposus with degeneration and aging,&;quot; Journal of Orthopaedic Research, vol. 15, 1997, pp. 318-322.
15.J. Meakin and D. Hukins, &;quot;Effect of removing the nucleus pulposus on the deformation of the annulus fibrosus during compression of the intervertebral disc,&;quot; Journal of biomechanics, vol. 33, 2000, pp. 575-580.
16.P. J. Roughley, &;quot;Biology of intervertebral disc aging and degeneration: involvement of the extracellular matrix,&;quot; Spine, vol. 29, 2004, pp. 2691-2699.
17.S. Ebara, J. C. Iatridis, L. A. Setton, R. J. Foster, V. C. Mow, and M. Weidenbaum, &;quot;Tensile properties of nondegenerate human lumbar anulus fibrosus,&;quot; Spine, vol. 21, 1996, pp. 452-461.
18.A. Nachemson, &;quot;In vivo discometry in lumbar discs with irregular nucleograms. Some differences in stress distribution between normal and moderately degenerated discs,&;quot; Acta Orthopaedica Scandinavica, vol. 36, 1964, pp. 418-434.
19.R. Quinnell, H. Stockdale, and D. Willis, &;quot;Observations of pressures within normal discs in the lumbar spine,&;quot; Spine, vol. 8, 1983, pp. 166-169.
20.A. Nachemson, &;quot;Lumbar intradiscal pressure: experimental studies on post-mortem material,&;quot; Acta Orthopaedica, vol. 31, 1960, pp. 1-104.
21.M. Adams, D. McNally, J. Wagstaff, and A. Goodship, &;quot;Abnormal stress concentrations in lumbar intervertebral discs following damage to the vertebral bodies: a cause of disc failure?,&;quot; European spine journal, vol. 1, 1993, pp. 214-221.
22.M. Adams, D. McMillan, T. Green, and P. Dolan, &;quot;Sustained loading generates stress concentrations in lumbar intervertebral discs,&;quot; Spine, vol. 21, 1996, pp. 434-438.
23.R. E. Gay, B. Ilharreborde, K. D. Zhao, L. J. Berglund, G. Bronfort, and K.-N. An, &;quot;Stress in lumbar intervertebral discs during distraction: a cadaveric study,&;quot; The Spine Journal, vol. 8, 2008, pp. 982-990.
24.A. Naylor and D. Smare, &;quot;Fluid content of the nucleus pulposus as a factor in the disk syndrome,&;quot; British medical journal, vol. 2, 1953, pp. 975-976.
25.M. Panjabi, M. Brown, S. Lindahl, L. Irstam, and M. Hermens, &;quot;Intrinsic disc pressure as a measure of integrity of the lumbar spine,&;quot; Spine, vol. 13, 1988, pp. 913-917.
26.K. Takahashi, S. Inoue, S. Takada, H. Nishiyama, M. Mimura, and Y. Wada, &;quot;Experimental Study on Chemonucleolysis: With Special Reference to the Change of Intradiscal Pressure,&;quot; Spine, vol. 11, 1986, pp. 617-620.
27.W. Merriam, R. Quinnell, H. Stockdale, and D. WILLS, &;quot;The effect of postural changes on the inferred pressures within the nucleus pulposus during lumbar discography,&;quot; Spine, vol. 9, 1984, pp. 405-408.
28.H. Okushima, &;quot;Study on hydrodynamic pressure of lumbar intervertebral disc,&;quot; Nihon geka hokan. Archiv für japanische Chirurgie, vol. 39, 1970, pp. 45-57.
29.A. L. Nachemson, &;quot;Disc pressure measurements,&;quot; Spine, vol. 6, 1981, pp. 93-97.
30.A. A. El-Bohy, K.-H. Yang, and A. I. King, &;quot;Experimental verification of facet load transmission by direct measurement of facet lamina contact pressure,&;quot; Journal of biomechanics, vol. 22, 1989, pp. 931-941.
31.C. R. Dennison, P. M. Wild, P. W. Byrnes, A. Saari, E. Itshayek, D. C. Wilson, Q. A. Zhu, M. F. Dvorak, P. A. Cripton, and D. R. Wilson, &;quot;Ex vivo measurement of lumbar intervertebral disc pressure using fibre-Bragg gratings,&;quot; Journal of biomechanics, vol. 41, 2008, pp. 221-225.
32.J. Kim, J. Lee, and B. Choi, &;quot;Fabrication and characterization of strain gauge integrated polymeric diaphragm pressure sensors,&;quot; International Journal of Precision Engineering and Manufacturing, vol. 14, 2013, pp. 2003-2008.
33.C. R. Dennison, P. M. Wild, M. F. Dvorak, D. R. Wilson, and P. A. Cripton, &;quot;Validation of a novel minimally invasive intervertebral disc pressure sensor utilizing in-fiber Bragg gratings in a porcine model: an ex vivo study,&;quot; Spine, vol. 33, 2008, pp. 589-594.
34.http://www.nature.com/nmat/journal/v8/n12/fig_tab/nmat2577_F1.html
35.http://taiwanspinecenter.com.tw/web/00_anatomy/01anatomy_10.htm
36.https://ittcs.files.wordpress.com/2010/05/img_0178.jpg
37.http://www.chiefsi.com.tw/pro.php?link_id=56
38.https://zh.wikipedia.org/wiki/%E5%85%89%E5%B0%8E%E7%BA%96%E7%B6%A D#/media/File:Optical_fiber_types.svg