面向个性化青少年重度僵硬性Lenke 3型脊柱侧凸建模模拟截骨矫形的几何形态与生物力学研究

Adolescent severe rigid Lenke 3 type spinal scoliosis is double major scoliotic deformity of the spine. A safe and effective method of correct this type of deformity is a challenge that is in urgent need to overcome. However, there is no consensus on the appropriate simulation system to study methods of osteotomy for the treatment of this type of spinal deformity. In our previous research, we have studied the simulation system for ankylosing spondylitis kyphosis, and we assume that its methodology can be applied for Lenke type 3 spinal scoliosis. The current study will use the data from computed tomography exams of patients with severe Lenke 3 type spinal scoliosis to build finite element simulation system, simulate osteotomy on the vertex and junction of the double major curve on the system, and study the geometrical and biomechanical characteristics of screws and rods during the surgical procedures such as derotation, segmental opening and closing. The current study will design an optimized combination of surgical techniques for the correction of spinal deformity and achieve coronal and sagittal balance. Results of this can provide important data on the biomechanical characteristics of severe Lenke 3 type spinal scoliosis, and provide experimental basis for designing optimized osteotomy approaches for the disease in the future.

青少年重度僵硬性Lenke 3型脊柱侧凸是一种双主弯型脊柱侧凸畸形，它严重影响人类的生活质量。如何安全、有效的矫正该类畸形是目前脊柱外科领域亟待解决的难题。目前尚无公认合理的模型对该类脊柱畸形的矫正进行模拟的系统研究。该课题组前期进行了强直性脊柱后凸建模模拟截骨的研究和分析，此项研究与僵硬性Lenke 3型脊柱侧凸模拟截骨具有一定的关联性。通过采集Lenke 3型脊柱侧凸患者CT扫描数据进行建模，分别选择双主弯顶点和双弯交界处模拟截骨，研究椎体间应力、截骨断端位移、中间过渡矫形棒及矫形过渡曲线的几何形态、钉棒系统生物力学的变化，从而设计出矫正该类畸形重建脊柱冠状位、矢状位平衡的优化组合方案。该研究结果将为我国脊柱侧凸生物力学数据库提供数据，为临床矫正Lenke 3型脊柱侧凸提供可靠的理论依据。

青少年重度僵硬性Lenke 3型脊柱侧凸是一种双主弯型脊柱侧凸畸形，它严重影响人类的生活质量。如何安全、有效的矫正该类畸形是目前脊柱外科领域亟待解决的难题。目前尚无公认合理的模型对该类脊柱畸形的矫正进行模拟的系统研究。课题组通过采集典型Lenke 3型脊柱侧凸患者数例进行CT扫描获得侧凸数据进行三维建模，并个性化选择双主弯顶椎区、双主弯交界处及多部位、多种方式模拟截骨并建立有限元模型，导入ANSYS软件研究椎体间应力、截骨断端位移、中间过渡矫形棒及矫形过渡曲线的几何形态、钉棒系统生物力学的变化，结果提示：双主弯顶椎区不同截骨方式对内置物等效应力具有显著影响；不同截骨节段的选择对于截骨后位移场的影响较大，从而对整体截骨矫形该类脊柱畸形具有重要意义，从而为截骨矫正该类畸形重建脊柱三维平衡提供一定参考依据。该研究结果将为我国脊柱侧凸生物力学数据库提供数据，为临床矫正Lenke 3型脊柱侧凸提供可靠的理论依据。