Three-dimensional simulation of Harrington distraction instrumentation for surgical correction of scoliosis.
Three-dimensional simulation of Harrington distraction instrumentation for surgical correction of scoliosis.
复制标题
用于矫正脊柱侧凸手术的 Harrington 牵引仪器的三维模拟。
DOI：
10.1097/00007632-199312000-00015
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发表时间：
1993
期刊：
影响因子：
3
通讯作者：
Gardner-Morse,M
中科院分区：
文献类型：
--
作者：
Stokes,IA;Gardner-Morse,M
对6例女性特发性脊柱侧弯患者行Harrington牵张棒手术，采用三维骨膜有限元模型模拟脊柱和胸腔的三维几何结构，并与测量结果进行比较。旋转末端的边界条件用于保持骨盆和头部对齐。使用了已出版的材料和灵活性属性。通过测量钩位之间的距离变化(范围为13-27 mm)，计算出钩位移动量。最初的模拟平均低估了6%的柯布角修正。他们低估了36%的脊柱伸长，并预测后凸角度平均增加12美元，而实际平均减少10美元。5例中，当代表运动节段的横梁向后移位时，矢状面变化的一致性得到改善，在第六例(将棒应用于脊柱前凸区域)中，与运动节段横梁向前移位的一致性得到改善。给出最佳一致性的梁位移量是可变的，我们不能对每个个体进行预测。测量和模拟的椎体横向平面旋转和肋骨角度的变化都很小，这些模拟中最大的误差来源似乎是不能通过体外测量的僵硬特性来表示体内运动节段的行为。
Harrington distraction rod surgery on six female patients with idiopathic scoliosis was simulated in three-dimensional osseoligamentous finite element models with individual geometry taken from preoperative stereo roentgenographic reconstructions of the spine and ribcage and compared with the measured outcome. Boundary conditions at the ends of the spins were used to maintain pelvis and head alignment. Published material and flexibility properties were used. This amount of hook distraction was calculated from measured changes in the distance between the hook sites (range, 13–27 mm). Initial simulations underestimated the Cobb angle correction by an average 6%. They underestimated the spinal elongation by 36% and predicted an average 12$$ increase in kyphosis angle compared with en actual 10$$ average decrease, Agreement for sagittal plane changes improved in five cases when the beams representing the motion segments were displaced posteriorly, In the sixth case (with the rod applied over a lordotic spinal region), agreement was improved with the motion segment beams displaced anteriorly. The amount of the beam displacement that gave the best agreement was variable, and we were not able to predict it for each individual. Both measured and simulated changes in vertebral transverse plane rotations and in rib angulations were small, The greatest source of errors in these simulations appeared to be inadequate representation of in vivo motion segment behavior by in vitro measured stiffness properties.