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研究生: 劉哲瑋
Che-Wei Liu
論文名稱: 動態與靜態腰椎後方傳統及皮質骨釘固定器之有限元素分析
Spinal Posterior Fixation by Static and Dynamic Traditional and Cortical Bone Trajectory Screws: A Finite-element Study
指導教授: 林上智
Shang-Chih Lin
口試委員: 林上智
Shang-Chih Lin
潘如瑜
Ju-Yu Pan
葉祖德
Tsu-Te Yeh
王誌謙
Chih-Chien Wang
汪志雄
Chih-Hsiung Wang
學位類別: 博士
Doctor
系所名稱: 應用科技學院 - 應用科技研究所
Graduate Institute of Applied Science and Technology
論文出版年: 2021
畢業學年度: 109
語文別: 中文
論文頁數: 113
中文關鍵詞: 腰椎有限元素分析皮質骨軌跡傳統軌跡
外文關鍵詞: Lumbar spine, Finite element analysis, Cortical Bone Trajectory, Traditional Trajectory
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  • 摘要 I Abstract V 致謝 VIII 目錄 IX 圖目錄 XIII 表目錄 XVI 第一章 緒論 1 1-1 研究背景與動機 1 1-3 腰椎骨融合手術植入物介紹 2 1-4 腰椎椎弓根固定器之手術植入軌跡介紹 5 1-5 腰椎動態椎弓根固定器介紹 5 1-5-1 靜態高強度固定器 6 1-5-2 連接桿具橈性式動態固定器 7 1-5-3 連接桿具關節式動態固定器 8 1-5-4 骨釘頭具關節式動態固定器 9 1-6 論文架構 10 第二章 文獻回顧 11 2-1 術後椎間盤手術鄰近節衍生問題 11 2-2 椎弓根固定器之骨釘抗拔出能力 13 2-3 不同手術軌跡對於腰椎活動之影響 14 2-4 動態椎弓根固定器之生物力學效益 15 2-4-1 Dynesys動態椎弓根固定器之臨床結果 16 2-4-2 Dynesys動態椎弓根固定器之體外測試 18 2-4-3 Dynesys動態椎弓根固定器之有限元素分析 20 第三章 研究材料與方法 23 3-1 五節腰椎有限元素模型系統建立 23 3-1-1 幾何外型建立 24 3-1-2 模型材料性質設定 26 3-1-3 模型邊界設定 26 3-1-4 模型介面設定 27 3-1-5 網格優化設定 28 3-1-6 肌肉及韌帶組模型 29 3-1-7 模擬運動之控制法說明 31 3-1-8 模型分析可行性驗證方法 32 3-2 靜態椎弓根固定器不同骨釘植入參數有限元素模型建立 32 3-2-1 骨釘植入參數定義 33 3-2-2 骨釘尺寸規格定義 34 3-2-3 骨釘材料性質設定 34 3-2-4 骨釘與骨頭介面條件設定 35 3-3 腰椎椎弓跟固定器之皮質骨骨釘應力分散策略研究 35 3-3-1 皮質骨釘外徑與螺牙型式分界概念 35 3-3-2 皮質骨釘優化設計分析 35 3-3-3 有限元素模型參數設定 36 3-4 腰椎後方傳統及皮質骨釘動態椎弓根固定器有限元素模型建立 36 3-4-1 傳統與皮質骨骨釘動態固定器模擬 36 3-4-2 傳統與皮質骨骨釘動態固定器模擬 37 3-4-3 動態固定器零件之間及與骨頭介面條件設定 37 3-5 椎籠植入與小面關節切除對傳統及皮質骨釘的影響 38 3-5-1 小面關節切除及椎籠植入模擬 38 3-5-2 椎籠與骨釘材料性質設定 39 3-5-3 植入物與骨頭之介面條件設定 39 3-6 脊椎生物力學結果參數選定 40 3-6-1 椎間盤活動角度 40 3-6-2 椎間盤或椎籠應力 40 3-6-3 小面關節接觸力 41 3-6-4 骨釘應力 41 第四章 結果 42 4-1 腰椎有限元素模型可行性驗證 42 4-2 靜態椎弓根固定器不同骨釘植入參數有限元素模型建立 43 4-2-1 椎間盤活動角度 43 4-2-2 椎間盤應力 45 4-2-3 小面關節接觸力 49 4-2-4 骨釘應力 52 4-3 腰椎椎弓跟固定器之皮質骨骨釘應力分散策略研究 54 4-3-1 椎間盤活動角度 55 4-3-2 椎間盤應力 55 4-3-3 小面關節接觸力 56 4-3-4 骨釘應力 57 4-4 傳統及皮質骨釘靜態與動態固定器探討 58 4-4-1 椎間盤活動角度 58 4-4-2 椎間盤應力 60 4-4-3 小面關節接觸力 63 4-4-4 骨釘應力 65 4-5 小面關節切除與椎籠植入效益探討 68 4-5-1 椎間盤活動角度 68 4-5-2 椎籠應力 71 4-5-3 骨釘應力 72 第五章 討論 75 5-1骨釘手術參數系統性研究 75 5-1-1 骨釘直徑與椎間盤活動效果之關聯性 75 5-1-2 骨釘長度與椎間盤活動效果之關聯性 77 5-1-3 植入軌跡與椎間盤活動效果之關聯性 78 5-2 改良式皮質骨釘之優勢 80 5-3 傳統及皮質骨釘靜態與動態椎弓根固定器效益探討 82 5-4 小面關節切除與椎籠植入效益探討 84 第六章 結論與未來展望 88 6-1 結論 88 6-2 未來展望 90 第七章 參考文獻 91

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