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系統識別號 U0026-2108201500010100
論文名稱(中文) 以有限元素法分析腰薦椎退化經軸向椎間融合手術後之生物力學影響
論文名稱(英文) Finite Element Analysis of Biomechanics of Degenerative Lumbosacral Spine after Axial Lumbar Interbody Fusion
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 103
學期 2
出版年 104
研究生(中文) 許家瀚
研究生(英文) Chia-Han Hsu
學號 N66014085
學位類別 碩士
語文別 中文
論文頁數 143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-吳致平
口試委員-王永明
口試委員-方中
中文關鍵字 生物力學  有限元素法  軸向椎間融合手術  融合手術 
英文關鍵字 Biomechanics  Finite element analysis  AxiaLIF  Interbody fusion 
學科別分類
中文摘要 脊椎為人體主要的支撐結構,腰薦椎是承受負載最大的位置,隨著年紀的增長,脊椎的退化是必然的趨勢,而腰薦椎則是最容易發生退化病變的地方。治療腰薦椎退化性疾病的手術發展已經有很長的一段時間,一般的融合手術不可避免的會傷害到脊椎附近組織,容易有併發症的發生,近年來則是發展出微創軸向椎間融合手術來避免上述情形發生。
本研究以電腦斷層掃描建立腰椎第二節至薦椎第一節模型,利用HyperMesh前處理軟體建立弱化後模型,弱化方式為椎間盤楊氏模數降至原來的20%。另外建立軸向椎間融合手術、前路式椎間融合手術、後路式椎間融合手術、椎弓根固定手術等手術後模型,利用ABAQUS軟體做有限元素求解分析。分析方法分為兩階段,第一階段分析軸向椎間融合手術不同植入角度於伸展、前彎、側彎、扭轉四種不同動作下相對轉角、最大von Mises應力值與最大應變能密度的分析比較,第二階段則是分析軸向椎間融合手術與各種融合手術如後路式椎間融合手術、前路式椎間融合手術做一完整的生物力學分析比較,目的是了解軸向椎間融合手術於生物力學上的優缺點,期望能做為日後臨床治療的參考與提升未來技術的發展。
研究得出軸向椎間融合手術在未施作固定手術時,手術效果比起傳統融合手術略為差,但在施作固定手術後,則是有最佳的表現。結果說明軸向椎間融合手術對於穩定脊椎方面有不錯的效果。
英文摘要 Spine is the main structure supports the body, while the lumbosacral position is subjected to the greatest load. Spine’s degeneration is an inevitable trend with age, and lumbosacral spine is the most prone to degenerative diseases. Surgical treatment of lumbosacral spine of development of degenerative diseases has been a long period of time. Traditional interbody fusion will inevitably hurt the spine and adjacent soft tissue, likely to have complications. In recent years, a minimally invasive surgery which called axial lumbar interbody fusion (AxiaLIF) which avoid these situations occur was developed. The thesis analyzes the biomechanical effect of the L5-S1, which received the axial lumbar interbody fusion by using HyperMesh and ABAQUS as the pre-pocessing and finite element analysis software, respectively.
The research shows that the performance of the surgical results was improved comparing with the traditional interbody fusion after applying the posterior instrumentation. The results illustrate that the axial lumbar interbody fusion is beneficial for the stability of the spines.
論文目次 摘要 I
誌謝 VI
目錄 VII
圖目錄 IX
表目錄 XI
第一章 1
緒論 1
1.1 前言 1
1.2 腰椎疾病 2
1.3 治療方法 6
1.4 有限元素法的發展與在醫學工程的應用 14
1.5 研究動機 15
1.6 研究目的 15
1.7 研究方法 16
第二章 17
脊椎介紹 17
2.1 脊椎結構概述 17
2.2 脊椎骨 19
2.3 椎間盤 26
2.4 小面關節 30
2.5 韌帶 32
第三章 40
研究方法 40
3.1 前言 40
3.2 脊椎模型建立 40
3.3 手術裝置模型建立 50
3.4 融合手術模型建立 55
3.5 材料性質設定 64
3.6 邊界條件與運動負載方式 68
第四章 72
結果分析 72
4.1 分析方法介紹 72
4.2 相對轉角介紹 75
4.3 最大von Mises應力介紹 77
4.4 應變能密度介紹 79
4.5 第一階段分析 80
4.6 第二階段分析 90
第五章 103
結論 103
5.1 總結 103
5.2 未來展望 104
參考文獻 106
附錄一:ABAQUS Input檔【ALIF(LR)】 111
附錄二:ABAQUS Input檔【ALIF(AR)】 119
附錄三:ABAQUS Input檔【PLIF&PI】 127
附錄四:ABAQUS Input檔【AxIALIF&PI】 135
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