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研究生:鍾政成
研究生(外文):Zheng-Cheng Zhong
論文名稱:腰椎椎間融合器之設計與生物力學評估
論文名稱(外文):Biomechanical Evaluation and Design of the Interbody Fusion Cage in Lumbar Spine
指導教授:陳振昇陳振昇引用關係
指導教授(外文):Chen-Sheng Chen
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:復健科技輔具研究所
學門:醫藥衛生學門
學類:復健醫學學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
論文頁數:78
中文關鍵詞:椎間融合器有限元素法生物力
外文關鍵詞:fusion cagefinite element methodbiomechanics
相關次數:
  • 被引用被引用:6
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  • 下載下載:86
  • 收藏至我的研究室書目清單書目收藏:0
腰椎退化性不穩定近幾年因骨科植入物的改善,已可以有效治療不穩定的問題。尤其是外力造成的椎間盤狹窄已可透過椎間融合器治療。椎間融合器的目的是代替退化椎間盤去支撐椎體。但是,大部分的椎間融合器是從不同國家進口進來,因此國內病人必須付出更高的醫療成本去治療退化性脊椎。為減少醫療成本的支出,本研究的目的,即開發出一個新的椎間融合器,並評估它的生物力學功能,以作為國人治療用的植入物。
為進行生物力學的分析與設計,本研究透過軟體ANSYS 6.0建構出三度空間腰椎有限元素模型,包括L1椎體到L3椎體,並以拓樸最佳化分析新椎間融合器的外形。而新設計椎間融合器和現有的RF融合器分別被放在L2-L3的運動肢段中,來比較它的生物力學特色,如鄰近椎間盤應力、骨頭與融合器之間的接觸壓力、下陷量、移位量和運動範圍。因此,總計建立出三個模型,包括正常腰椎模型、脊椎植入雙顆RF融合器模型、脊椎植入雙顆新設計融合器模型。而力量的負荷條件是給予10N-m的前彎、後彎、側彎及扭轉力矩於L1椎體上,L3椎體底部所有節點完全固定住。
研究結果指出新設計融合器可以獲得脊椎穩定度,即與正常脊椎相較之下,它的運動範圍可以減少61%到82%,但新設計與現有RF融合器比較下,體積減少36%。而所有有融合器的模型,皆有較少的下陷量及位移情形,最大僅達0.089和0.215mm。關於臨近固定端椎間盤應力,與正常腰椎相較之下,植入雙顆RF融合器和新設計融合器的模型兩者增加相同,在前彎時皆增加77%的應力。但新設計融合器的應力,卻是所有植入融合器模型中最高的。
本研究已開發出一個新的椎間融合器,並且已由雕刻機Modela20製造出實體模型。而新設計融合器與現有市面RF融合器有相對等的比較,即新設計融合器幾乎和現有RF融合器有相近的性能,包括下陷量、位移情形、鄰近椎間盤應力。新椎間融合器不僅具有增加較多空間放置補骨的優點,而且與市售RF融合器具有相近的穩定度,並可減少材料使用成本。
Degenerative spinal instability was effectively treated by means of improved orthopaedic device in recent years. Spinal deformity imposed from external force such as disc herniation or narrowing was also managed since the cage was developed. The spinal cage aimed to support the vertebral body instead of degenerated disc. However, most of the spinal cages were imported from different countries. The patients in Taiwan must pay more for the health cost to implant the spinal cage for treating degenerative spine. To reduce the health cost, the purposes of this study developed a new cage and evaluate its biomechanical function.
To undergo biomechanical design and analysis, a three-dimensional finite element model (FEM) of the lumbar spine L1-L3 was constructed by a commercial software ANSYS 6.0 and employed the topology optimization to design a new cage. The RF cage and new cage were respectively inserted into FEM of lumbar spine in L2-L3 motion segment for comparing the biomechanical features, such as stress of adjacent disc, contact pressure of interface between cancellous bone and cage, subsidence, dislodgement and range of motion. Therefore, a total of three models, included intact lumbar spine, spine with double RF cages, and spine with double new cages, were established in this study. The loading condition was that the 10 N-m flexion, extension, lateral bending, and torsion were respectively subjected to the L1 vertebral body. The bottom of the L3 vertebral body was completely fixed.
This study indicated that the new cage was able to achieve spinal stability, which the range of motion was reduced from 61% to 82% when comparing with the intact FEM. Volume of the new cage less 36% than RF cage. All of the models with cages had low subsidence and dislodgement, maximally reached 0.089 and 0.215 mm, respectively. As to the adjacent disc, the spine with two RF cages and two new cages also increased stress about 77% than the intact model
in flexion. The stress of new cage was greatest than that of the double RF cages.
This study concluded that the new cage was developed and manufactured to a solid prototype from an engraving machine Modela20. The new cage had comparative features with the current RF cage. Also, the new cage almost had same performance with RF cages such as subsidence, dislodgement, and stress of adjacent disc. Additionally, new cage increased more space to place bone graft, decreased cost of material and had similar stability with current RF cage.
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