人工脊椎椎體支撐器是目前臨床上常用來治療脊椎不同的疾病，例如骨髓炎、破壞的椎體、腫瘤癌細胞轉移脊體、癌症及感染等的治療方法。然而，人工椎體置換術在手術一段時間後，尤其骨質密度差的狀況會有骨融合失敗、滑脫、下陷與植入物破壞的缺點，椎體支撐器的介面與椎體接觸是重要的課題。本研究的目的是防止人工支撐器之下陷與滑脫，使用有限元素法及田口方法來研究變化參數之影響，尋找最佳化的人工脊椎椎骨支撐器之接觸形狀，並以人造假骨實驗驗證最佳化結果，利用牛骨做壓力測試比對不同骨質密度的差異，再驗證防止下陷最佳化結果。
本研究包含三個主題有分析比較市售人工脊椎椎體支撐器之設計，抗拉強度及抗壓強度設計分析與實驗。首先，以電腦斷層掃瞄儀取得台灣健康37歲男子六節脊椎T12∼L5的影像，量測尺寸後繪製三維圖形建構脊椎L2到L4模型，其中L3模擬椎體切除手術（corpectomy），植入市售不同的人工脊椎椎骨支撐器，並植入後方固定器，以有限元素分析非線性壓力接觸運算，比較Stryker牌與TMC型的下陷量。其次，在橫向位移防止滑脫方面：利用田口方法來評估尖釘（the spike）與橫斷接觸面積，選用六種因子設定尖釘與橫斷面尺寸，有尚未骨融合及已經骨融合兩種的情狀，在尚未骨融合條件下，建議最佳化因子的水準為 ，防止滑脫的最佳化的組合是角柱型尖釘、尖釘高度是2mm、尖釘底座尺寸2.2mm、全斜鉤幾何造型、每28mm直徑有11排尖釘，內徑是10mm。有骨融合的條件下，建議最佳化因子的水準為 ，對應的構造是角椎型尖釘、2mm高的尖釘、尖釘底座尺寸2.2mm、全斜鉤幾何、每28mm直徑有11排尖釘，內徑是20mm。比較總反作用力數據，有骨融合的模型比未骨融合的模型平均高26%。在有限元素分析與機械測試驗證方面有不錯的關係，其相關性係數達0.802。再者，在縱向位移防止下陷方面：建議出最佳化因子 ，對應的幾何造型為的最佳化的組合如下：角柱型尖釘、完全倒鉤型的尖釘造型、2 mm的尖釘高度、尖釘底部尺寸 1.4 mm，在外徑28mm下尖釘11 排，用來骨融合的內徑是10mm。在有限元素分析與機械測試驗證方面有不錯的關係，其相關性係數達0.847。
我們一起考慮拉出強度與抗壓強度我們選擇 ，理由是設計人工椎體支撐器不僅要考慮人工椎體支撐器尖釘尺寸與器形狀，也要考慮到抗拉強度。以有限元素為基楚的田口方法能降低設計時間，有效評估植入物的設計因子，可公正地估算每一個設計因子的貢獻度。

The Vertebral Body cages (VBCs) have been used to treat vertebral bodies with different maladies such as osteomyelitis, severe compression fracture, metastases, tumor, or infection. However, a vertebral body replacement commonly experiences graft fracture, loosening, and collapse in a short period after an orthopaedic surgery especially for the osteoporotic bone. The interface between the implant and vertebral body is an important topic. Therefore, the purposes of this study were to analyze the subsidence and loosening by using a FEM-based Taguchi method and mechanical tests and to investigate the effects of various factors to find the robust design of the vertebral body cage interface.
In this study, three kinds of topics would be discussed including the comparative study of the commercially VBC designs, the pullout strength of the VBC, and the subsidence of the VBC. Firstly, the analytical model, which based on a 37-year-old man with no clinical or roentgenological abnormalities, was obtained by computed tomography (CT) scanning. Three-dimensional finite element models of the lumbar spine were created with a vertebral body replacement at L3, and a paired internal fixation device between L2 and L4 was also inserted. The subsidence of both Stryker VBC and Titanium mesh cage (TMC) was performed and compared. The results showed that Stryker VBC was superior to TMC. Secondly, the pullout strength of the VBCs would be evaluated by the Taguchi method and the finite element analysis. Six design variables of the VBCs were considered. Two kinds of fusion situations were discussed including the model with bone fusion and that without bone fusion. The results revealed that the optimum factor level settings in the situation without bone fusion was , which correspond to the pyramidal spike type, a spike height of 2 mm,a spike diameter of 2.2 mm, an oblique geometry, 11 rows per 28 mm, and an inner diameter of 10 mm. In addition, the optimum factor level settings in the situation with bone fusion was , which correspond to the conical spike type, a spike height of 2 mm, a spike diameter of 2.2 mm, an oblique geometry, 11 rows per 28 mm, and an inner diameter of 20 mm. In the correlation study, the results of the finite element models were closely related to that of the mechanical tests with a high correlation coefficient of 0.802. Thirdly, the subsidence of the VBCs was analyzed by using the same method. The results showed that the optimum factor level settings in the situation without bone fusion was , which correspond to the pyramidal spike type, a spike height of 2 mm,a spike diameter of 1.4 mm, an oblique geometry, 11 rows per 28 mm, and an inner diameter of 10 mm. In the correlation study, a high correlation coefficient of 0.847 between the finite element models and the mechanical tests was found. The optimum design of the VBC was , if both the pullout strength and the subsidence were considered simultaneously.
In the conclusions, the FEM-based Taguchi method could decrease the effort and time needed to analyze the spike factors of the VBC, and the mechanical tests might provide useful evidence to prove the applicability of the finite element models.

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