活体数字人脊柱脊髓与脑脊液系统生物力学平台构建关键技术及其在数字外科的应用

On the base of multi-mode images dataset of living digital human and analysis system of symplectic finite element methods, a 3D fluid-structure interaction biomechanical platform of the spine, spinal cord and cerebrospinal fluid will be developed in this project. The key technologies of the biomechanical platform include: 3D motion analysis, modal analysis, and transient dynamic analysis of spine and spinal cord complex, fluid-solid coupling dynamics analysis of the system of spine, spinal cord and cerebrospinal fluid, digitized test in vivo of cerebrospinal fluid dynamics. Therefore, we will focus on the secondary development function of finite element program. Using Hamiltonian symplectic system, we will establish the governing differential equations of fluid-solid coupling dynamics for the spine, spinal cord and cerebrospinal fluid. Then, we will construct the finite element method of symplectic mechanics to perform the numerical computation. The corresponding computation results will be validated by the experimental testing. This biomechanical platform would support the mechanism studies for injury or degenerative disease of the spine and spinal cord (cerebrospinal fluid) complex. Simultaneously, considering the relationship of spine, spinal cord and cerebrospinal fluid, comprehensive design and controlled study between traditional spinal fusion and innovative spinal non-fusion will be performed when above-mentioned injury or degenerative disease is treated. According to the strategy of prospective clinical randomized controlled trial (RCT), model controlled trial (MCT) of digital surgery will be put into practice. Through evidence-based investigation of MCT and RCT, the effects of different surgical operations on the spine and spinal cord (cerebrospinal fluid) complex will be analyzed, and surgery optimization and innovation of digital surgery in spine and spinal cord will be finally realized.

本项目在活体数字人多模影像数据集和辛有限元分析体系中，构建脊柱脊髓与脑脊液系统三维流固耦合生物力学平台，需要研发的关键技术有：脊柱脊髓三维运动分析技术、模态分析技术、瞬态动力学分析技术，脊柱脊髓与脑脊液系统的流固耦合动力分析技术，脑脊液动力学在体测试技术。为此，本项目将深度研究有限元软件的二次开发功能，通过哈密顿辛体系推导脊柱脊髓与脑脊液系统的流固耦合动力学控制微分方程，构建辛力学有限元方法求解并结合实验检验，为探索脊柱脊髓(脑脊液)复合体的损伤或退变性疾病机制提供生物力学技术支持。同时，考虑脊柱、脊髓与脑脊液的关系，治疗此类损伤或退变性疾病时，开展脊柱传统融合术和动态非融合新手术的深度设计和对照研究，按照前瞻性临床随机对照试验(RCT)策略，实施数字外科模型对照试验(MCT)。通过MCT和RCT的循证研究分析不同手术对脊柱脊髓(脑脊液)复合体的影响，实现脊柱脊髓数字外科的手术优化和创新。

本项研究遵循实验室与临床双向转化理念，在活体数字人脊柱脊髓和脑脊液系统生物力学平台构建关键技术及其在数字外科的应用研究中，取得了3项创新成果：.(1) 中国活体数字人脊柱脊髓多模影像数据集和脊柱脊髓数字影像模型数据库的构建。在遴选中国人男性与女性健康志愿者，实施全身CT与MRI扫描基础上，完成了多模影像扫描(fMRI、脑脊液动力学影像扫描等)，构建中国活体数字人的脊柱脊髓完整影像数据库系统；完成了脊柱脊髓复合体(脑室、颈段脊髓、胸段脊髓、腰段脊髓)三维重建模型数据库。.(2) 中国活体数字人脊柱脊髓和脑脊液系统生物力学关键技术系列深度研究。系统性地研究中国活体数字人的脊柱(包括骨盆骶部、下腰椎、胸腰椎、胸椎与胸肋关节、下颈椎、上颈椎等)生物力学有限元分析技术，有限元模态分析技术，有限元瞬态动力学分析技术，在体三维运动测试分析技术。与合作单位一起，开展了健康志愿者颈椎管内脑脊液动力学研究；颈椎间盘突出患者颈椎管内脑脊液动力学研究；健康志愿者胸椎管内脑脊液动力学研究；颈椎病患者胸椎管内脑脊液动力学研究；健康志愿者腰椎MRI和DTI研究；腰椎间盘退变患者腰椎MRI和DTI研究。.(3) 基于中国活体数字人和临床试验转化技术平台的脊柱脊髓数字外科手术优化技术体系构建。在脊柱脊髓相关的6个临床亚专科实施应用(①腰骶骨盆外科，②下腰椎外科，③胸腰椎外科，④胸椎与胸肋外科，⑤颈椎外科，⑥颅脑颌面与神经外科)。并在胸腰椎骨折疾病手术优化中开展了有限元模型对照试验(MCT)和临床随机对照试验(RCT)研究。.本项目依托活体数字人生物力学平台和临床RCT数字病案数据库的多重技术支持，实施数字外科的模型对照试验(MCT)与临床随机对照试验(RCT)的并行分析和互动规划。根据循证医学研究理念与技术要求，实现脊柱脊髓数字外科的手术优化和创新。