人工腰椎之設計與力學分析

Design and mechanical analysis of vertebral body replacement

傅彬豪(Bin-Hau Fu)

指導教授 ： 蘇侃

國立臺灣大學/工學院/機械工程學研究所/碩士(2004年)

https://doi.org/10.6342/NTU.2004.02227

摘要

植入人體內的人工腰椎可以減輕病患疼痛、回復脊椎的弁鄔M幫助復原。通常須要使用人工腰椎的情狀是前方脊柱受到傷害而產生骨折或錯位、後方後凸的病變、胸腰椎的腫瘤或其它脊椎的病變。本研究詳細敘述人工腰椎的設計要點、生物材料選擇、技術上的難題和臨床上需要注意的部份。
新開發的人工脊椎替代物被臨床使用之前，必須先做過一連串的體外試驗以評估其是否適用於人體。因為人體的複雜性與目前眾說紛紜的脊椎負荷條件，因此無法比較各家不同人工腰椎性能的優劣好壞。本篇論文從不同的研究團隊整理歸納出邊界條件，並對在不同負荷模式使用不同材料與不同設計的人工腰椎進行比較。
結果對在本篇論文提出的腰椎替代物進行評估。本篇論文也提出對七種腰椎替代物的設計在使用四種不同的材料（鈦合金、鈷鉻鉬合金、不

關鍵字

人工腰椎 ； 生物材料 ； 胸腰椎

並列摘要

Vertebral body replacements（VBR） have been successfully used to be implanted into the body to relieve patients’ pain, to restore function and to facilitate healing for many years. Possible indications are fractures and dislocations with damage of the anterior column, posttraumatic kyphosis, tumors of the thoracolumbar spine and other spine diseases. The study detailed the design notes, biomaterial selection, technical obstacles and clinical concerns of VBR.
New VBR should be tested in vitro in order to decide whether the implant is accepted for clinical use. Due to the complex and still unknown loading of the spine in vivo, a variety of different test boundary conditions have been used, making comparison of the results of different VBR from different groups almost impossible. This paper using the boundary conditions developed from different working groups analyzes and compares different designs of VBR under different loading modes and biomaterials.
The results show evaluations of designs of VBR mentioned in this paper. The results of seven designs of VBR with four materials（Ti-6Al-4V, CoCrMo alloys, stainless steel 316LV and UHMWPE） under four loading modes（flexion, extension, rotation and lateral bending）are shown.
The conclusion of this study indicated criteria should be noticed in design of VBR. According to such design criteria, this study also indicated that metal VBR can easily satisfies the requirements in stress analysis. After appropriate design and stress analysis, polymer materials can also be used for VBR.

並列關鍵字

vertebral body replacement ； biometrial ； thoracolumbar spine

參考文獻

【1】Schultz A. B. and Anderson G. B. J., “Analysis of loads on the lumbar spine”, Spine, Vol. 6, No. 1, pp. 76-82, 1981.

【2】Berry J. L., Moran J. M., Berg W. S. and Steffee A. D., “A morphometric study of human lumbar and selected thoracic vertebrae”, Spine, Vol. 12, No. 4, pp. 362-367, 1987.

【3】Yamamto I., Panjabi M. M., Crisco T. and Oxland T., “Three-dimensional movement of the whole lumbar spine and lumbosacral joint”, Spine, Vol. 14, No. 11, pp. 1256-60, 1989.

【4】Panjabi M. M., Goel V., Oxland T., Takata K., Duranceau J., Krag M. and Price M., “Human lumbar vertebrae. Quantitative three-dimensional anatomy”, Spine, Vol. 17, No. 3, pp. 299-306, 1992.

【5】Francois Lavaste and Wafa Skalli, “Three-dimensional geometrical and mechanical modeling of the lumbar spine”, Journal of Biomechanics, Vol. 25, No. 10, pp. 1153-1164, 1992.