完整后设资料纪录
DC 栏位 | 值 | 语言 |
---|---|---|
dc.contributor.author | 江铭杰 | en_US |
dc.contributor.author | Chiang, Ming-Chieh | en_US |
dc.contributor.author | 洪景华 | en_US |
dc.contributor.author | Hung, Ching-Hua | en_US |
dc.date.accessioned | 2014-12-12T02:38:21Z | - |
dc.date.available | 2014-12-12T02:38:21Z | - |
dc.date.issued | 2013 | en_US |
dc.identifier.uri | http://140.113.39.130/cdrfb3/record/nctu/#GT079514805 | en_US |
dc.identifier.uri | http://hdl.handle.net/11536/73619 | - |
dc.description.abstract | 腰椎间盘退化和其所引发的各种并发症是目前世界常遭遇的脊椎病变之一,其治疗方式分为保守与手术治疗,其中,腰椎间融合术是手术治疗方式之一,其方法是清除发生病变的腰椎间盘,再将自体或异体骨植入,且合并使用椎间融合器,以达到去除病源、提供稳定脊椎、避免神经压迫等治疗效果。研究指出,在前腰椎融合术(Anterior lumbar interbody fusion, ALIF)单独使用融合器,无法提供脊椎在后弯动作下足够的稳定性,必须搭配后位内固定器才能有良好稳性效果,达成椎间融合的目的。但植入后位内固定器需增开后方伤口,会损坏肌肉血管组织甚至伤及脊神经。因此,一种具备自我稳定能力的独立椎间融合器(Self-stabilizing stand-alone fusion cage)设计发展出来,期望透过特殊的几何设计,在融合手术时无需搭配后位内固定器就能达成椎间融合的融合效果。 本研究利用一个经过验证的五节腰椎有限元素模型,在施加伴随负荷(Follower load)的情形进行分析,共分为两个部分,第一部分进行三款Self-stabilizing stand-alone cage:新型 Latero 融合器,与两种旧有的ALIF融合器(SynFix,Stabilis),对比传统ALIF融合器搭配后位内固定器的稳定效果比较,并藉由多种生物评估参数包括:稳定性、环带应力、小面关节受力以及植入物应力,来探讨三款Stand-alone 融合器的椎间稳定度与此三种融合器对于腰椎界面造成的影响。第二部分则对Latero融合器提出后续设计建议并加以分析。 本研究第一部分结果发现,新型Stand-alone 融合器Latero的稳定效果相似于和传统ALIF融合器搭配后位内固定器,若在考量避免增开后方伤口对病患造成影响的情形下,建议使用Latero融合器,就可提供腰椎间足够的稳定性与适合融合的环境。第二部分结果则提出针对Latero融合器的后续设计建议。 | zh_TW |
dc.description.abstract | For anterior lumbar interbody fusion (ALIF), stand-alone cages can be supplemented with vertebral plate, locking screws, or threaded cylinder to avoid the use of posterior fixation. Intuitively, the plate, screw, and cylinder aim to be embedded into the vertebral bodies to effectively immobilize the cage itself. The kinematic and mechanical effects of these integrated components on the lumbar construct have not been extensively studied. In the part-1 of this study, a nonlinearly lumbar finite-element model was developed and validated to investigate the biomechanical differences between three stand-alone (Latero, SynFix, and Stabilis) and SynCage-Open plus transpedicular fixation. All four cages were instrumented at the L3-4 level. In the part-2 of this study, the Latero was analyzed for different design parameters. The lumbar models were subject to the follower load along the lumbar column and the moment at the lumbar top to produce flexion (FL), extension (EX), left/right lateral bending (LLB, RLB), and left/right axial rotation (LAR, RAR). A 10 Nm moment was applied to obtain the six physiological motions in all models. The comparison indices included disc ROM, facet contact force, and stresses of the annulus and implants. At the surgical level, the SynCage-open model supplemented with transpedicular fixation decreased ROM (>76%) greatly; while the SynFix model decreased ROM 56-72%, the Latero model decreased ROM 36-91%, in all motions as compared with the INT model. However, the iii Stabilis model decreased ROM slightly in extension (11%), lateral bending (21%), and axial rotation (34%). At the adjacent levels, there were no obvious differences in ROM and annulus stress among all instrumented models. ALIF instrumentation with the Latero or SynFix cage provides an acceptable stability for clinical use without the requirement of additional posterior fixation. However, the Stabilis cage is not favored in extension and lateral bending because of insufficient stabilization. | en_US |
dc.language.iso | en_US | en_US |
dc.subject | 前位融合 | zh_TW |
dc.subject | 独立式融合器 | zh_TW |
dc.subject | 有限元素分析 | zh_TW |
dc.subject | ALIF | en_US |
dc.subject | stand-alone cage | en_US |
dc.subject | finite element analysis | en_US |
dc.title | 新型腰椎独立式融合器的生物力学分析 | zh_TW |
dc.title | Biomechanical Analysis of A New Stand-alone Lumbar Cage | en_US |
dc.type | Thesis | en_US |
dc.contributor.department | 机械工程系所 | zh_TW |
显示于类别: | Thesis |
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