寰椎环形结构完整性和继发性颅底陷入关系的有限元分析

Relation between integrity of atlas ring structure and secondary basilar invagination: A finite element analysis

  • 摘要: 目的 通过建立枕寰枢复合体有限元模型,分析寰椎环形结构完整性对维持枕骨、枢椎之间距离的作用。 方法 建立一个包括骨骼、关节、韧带结构的枕寰枢复合体有限元模型,以尸体试验结果对模型进行验证。建立寰椎环形结构受到破坏的各种模型并施加垂直载荷,分析枕骨、枢椎间距和寰椎侧块移位以及侧块移位程度和寰椎环形结构破坏方式的关系。 结果 本模型试验和尸体试验结果基本一致;垂直加载(60N)时,前、后弓均离断模型和正常模型侧块水平分离距离分别为0.79mm和0.04mm,枕骨与枢椎间垂直距离分别减少0.91mm和0.46mm;施加0.9mm垂直位移载荷时,移位距离最明显的是前后弓均完全离断的模型,其次是前弓离断模型和后弓离断模型,移位距离最小的是前弓未完全离断模型,前、后弓完全离断模型较保持前弓连续性模型侧块移位明显。 结论 鉴于可能出现继发性颅底陷入,建议手术中应尽可能保持寰椎环形结构的连续性。

     

    Abstract: Objective To establish a finite element model of occipitoatlantoaxial complex and analyze the role of atlas ring integrity in maintaining the distance between occipital bone and axis. Methods A finite element model of occipitoatlantoaxial complex consisting of bones,ligaments and joints was established and verified by comparing cadaver experimental data.Models simulating different partial transection of atlas ring were loading under vertical compression.Relation between lateral masses displacement and occipitoaxial compression,displacement severity and different partial transection were evaluated. Results The model correlated cadaver data in most loading modes.With applied 60 Newton vertical load,the lateral masses horizontally separated 0.79mm in model with transection both anterior and posterior arch(ATPT) and 0.04mm in intact one,resulting in 0.91mm and 0.46mm reduction in occipitoaxial vertical distance.With applied 0.9mm vertical load,the maximum lateral masses separation occurred in the model with transection of both anterior and posterior arch(ATPT),followed by anterior arch transection(AT),posterior arch transection(PT).The minimum occurred in the model with only inferior portion of anterior arch transection(part AT).The lateral masses separation was obvious in the model with complete anterior and posterior arch resection(ATPT) than in the one with anterior(only inferior portion) and posterior arch resection(part ATPT). Conclusion Atlas ring continuity should be maintained during surgery since secondary basilar invagination may occur after operation.

     

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