摘要：
[目的]探讨改良解剖型颈椎钛网在颈椎前路椎体次全切除融合术(anterior cervical corpectomy and fusion,ACCF)中的生物力学分布特点.[方法]建立正常人C3～C7的三维有限元模型,模拟ACCF过程,分别装配传统颈椎钛网及改良解剖型钛网,并对模型施加40 N的预载荷及1.5 Nm的运动附加力,使模型产生前屈、后伸、侧倾及旋转运动,比较两种钛网植骨方式对钛网、椎体及钛网对终板-钛网界面应力分布的差异.[结果]在前屈、后伸、左倾、右倾、左转、右转等6种不同的工况下,传统颈椎钛网最大的等效应力值分别为73.782、177.36、124.42、100.85、191.64及221.91 MPa,新型改良钛网的最大等效应力值分别为31.028、62.236、46.053、44.337、41.549及39.255 MPa,新型改良钛网的椎体应力分布远小于传统钛网,改良钛网C4及C6终板-钛网接触面的应力小于传统钛网相应接触点的应力. [结论]在ACCF中应用改良解剖型颈椎钛网可有效避免终板应力过度集中,理论上可以降低钛网下沉的发生率.%[Objective]To evaluate biomechanical property of improved anatomical titanium mesh cage (IMTMC) in anterior cervical corpectomy and fusion (ACCF).[Methods]A finite element model of intact cervical spine (C3～7) was developed to simulate the ACCF operation process, establishing both traditional titanium mesh cage and improved anatomical titanium cage.Tests were made with pre-load of 40N and 1.5Nm torque to the model, which caused motion of flexion, extension, left, right bending and left, right rotation of the model.The maximum stress, stress distribution of both two kinds of cages, cervical vertebra and TMC-endplate contact were recorded.[Results]Under 6 different conditions of flexion, extension, left, right, left turn, right turn , the maximum equivalent stress values of the traditional cervical titanium mesh were 73.782, 177.36, 124.42, 100.85, 191.64 and 221.91 MPa, respectively;the maximum equivalent stress values of the new modified titanium mesh were 31.028, 62.236, 46.053, 44.337, 41.549 and 39.255 MPa, respectively;The stress distribution of the vertebral body of the new modified titanium mesh was much smaller than that of the traditional titanium mesh;The stress of C4 and C6 endplate contact surface of the modified titanium mesh was less than that of traditional titanium mesh contact point.[Conclusion]The application of modified anatomic cervical titanium mesh in ACCF can effectively avoid the stress concentration of endplate, and can reduce the incidence of titanium mesh depression theoretically.
