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系統識別號 U0026-0907201420572900
論文名稱(中文) 以有限元素法分析多節頸椎退化性椎間盤疾病採用人工椎間盤合併椎間融合器對鄰近節之生物力學影響
論文名稱(英文) Finite Element Analysis of Biomechanical Responses of the Adjacent Segments for the Surgical Treatment of Multi-level Degenerative Cervical Disease Using Artificial Disc Replacement or Cage Insertion
校院名稱 成功大學
系所名稱(中) 土木工程學系
系所名稱(英) Department of Civil Engineering
學年度 102
學期 2
出版年 103
研究生(中文) 謝孟樸
研究生(英文) Meng-Pu Hsieh
學號 N66011037
學位類別 碩士
語文別 中文
論文頁數 120頁
口試委員 指導教授-胡宣德
共同指導教授-黃國淵
口試委員-郭青松
口試委員-吳致平
口試委員-鍾興陽
中文關鍵字 有限元素法  頸椎人工椎間盤  椎間融合器  生物力學 
英文關鍵字 finite element method  cervical artificial disc  cage  biomechanics 
學科別分類
中文摘要 人體脊椎因年紀、磨損或其它各種原因導致椎間盤損壞時,椎間盤中髓核(Nucleus Pulposus)可能就會被擠壓而突出穿過纖維外環並壓迫到神經,導致頸背疼痛、上肢麻痛或感覺異常,這種症狀稱為退化性椎間盤疾病(Degenerative Disc Disease,DDD)。治療退化性椎間盤疾病有許多不同之手術方式,而不同的手術方式,均有其相應的生物力學表現。
傳統的椎間盤手術是在椎間盤切除後植入自體骨或人工骨支架,若有多節椎間盤需治療時並輔以鈦合金固定物,以達到「固定」之目的。但該節被固定後,椎間盤活動度會受限制,需由鄰近節之椎間盤增加活動度加以代償,近來有研究發現此種治療方式會造成鄰近節椎間盤壓力增加、活動量增加進而提高「鄰近節病變」的發生率。本研究即是以有限元素模型模擬人工椎間盤或是椎間融合器輔以鈦合金鋼板治療頸椎退化性椎間盤疾病,以期望能達到減低鄰近節負擔之效果,減低鄰近節病變的發生率。
本研究使用電腦斷層掃瞄與有限元素法套裝軟體,建立完整之頸椎模型,取頸椎第二節至頸椎第七節,並對三節椎間盤(IVD C3-4、IVD C4-5、IVD C5-6)以人工椎間盤配合椎間融合器或者是椎間融合器輔以鋼板治療,觀察脊椎在伸展、前彎、側彎、扭轉等四種動作下,整體頸椎之活動度、應力變化,以及對鄰近節之生物力學影響。
英文摘要 Human’s intervertebral disc will degenerate as time goes by. The nucleus pulposus in disc will be crushed and protrudes through the annulus fibrosus and pressure to the Ligament. This disease which called” Degenerative Disc Disease,DDD”.Traditional intervertebral disc surgery is using cage or anterior plate.But generally considere that spinal fusion surgery will cause the degeneration of adjacent segment. So in recent years,the invention of artificial disc attempt to prevent the degeneration of adjacent segment.This research discuss multisegmental cervical degenerative disease treated by artificial disc,cage,and plate.Trying to find case that can reduce the influence of adjacent segment.This research use finite element method to simulate human,and using finite analysis software ABAQUS. All in all,we found that artificial disc in C56
will reduce the influence of adjacent segment,and plate prefer to place at C34. Detailed description in chapter 4.
論文目次 目錄
摘要 i
ABSTRACT ii
誌謝 v
目錄 vi
表目錄 ix
圖目錄 x
第一章 緒論 1
1.1有限元素法(Finite Element Method, FEM) 1
1.2退化性椎間盤疾病(Degenerative Disc Disease) 2
1.3 頸椎前位減壓手術之介紹 2
1.4椎間融合器介紹 3
1.5人工椎間盤介紹 4
1.6研究動機 5
1.7研究策略與目的 6
第二章 脊椎介紹 7
2.1脊椎結構與組成 7
2.2脊椎骨 9
2.3椎間盤 14
2.4小面關節(Facet Joint) 18
2.5韌帶 18
第三章 研究方法與材料 25
3.1建立模型 25
3.1-1有限元素法建立脊椎模型之介紹 25
3.1-2樣品取得與斷層掃描 28
3.1-3醫學影像處理 30
3.1-4建立有限元素模型 33
3.2手術裝置之模型建立 37
3.2-1人工椎間盤(Artifical Disc) 38
3.2-2椎間融合器(Cage) 40
3.2-3頸椎鋼板(Plate) 41
3.3小面關節之模擬 44
3.4收斂性分析 44
3.5各治療裝置手術之模擬 47
3.6 邊界條件 49
3.6-1單位系統 49
3.6-2預載(Preload)與邊界條件 49
3.6-3運動加載 50
3.7材料與性質 54
第四章 結果分析 57
4.1分析方向 57
4.2相對轉角 63
4.2-1相對轉角定義 63
4.2-2相對轉角: 三椎間融合器搭配鋼板組合比較 64
4.2-3相對轉角:單一人工椎間盤搭配兩椎間融合器比較 67
4.2-4相對轉角:兩人工椎間盤搭配一椎間融合器組合比較 69
4.2-5相對轉角:綜合比較 71
4.3最大von Mises應力 73
4.3-1 von Mises應力簡介[36] 73
4.3-2最大von Mises應力:三椎間融合器搭配鋼板組合比較 73
4.3-3最大von Mises應力:單一人工椎間盤搭配兩椎間融合器比較 75
4.3-4最大von Mises應力:兩人工椎間盤搭配一椎間融合器組合比較 77
4.3-5最大von Mises應力:綜合比較 79
4.4應變能密度 80
4.4-1應變能密度簡介[36] 80
4.4-2應變能密度:三椎間融合器搭配鋼板組合比較 81
4.4-3應變能密度:單一人工椎間盤搭配兩椎間融合器比較 82
4.4-4應變能密度:兩人工椎間盤搭配一椎間融合器組合比較 84
4.4-5應變能密度:綜合比較 85
4.5小面關節接觸力分析 87
4.5-1小面關節接觸壓力最大值比較 87
4.5-2小面關節接觸合力比較 91
第五章 結論與建議 93
5.1結論 93
5.2未來展望 96
參考文獻 97
附錄A Abaqus input檔 101
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