- 學位論文
創新型椎間盤PEEK骨融合支架之穩定性增強於脊椎之應用
Innovative intervertebral disc PEEK bone fusion enhanced the stability of scaffold for spinal applications
摘要
現有脊椎椎間盤骨融合器在植入後不易調整，若在手術植入時位置有所偏差，植體亦不易回拉或取出，容易造成病患傷害及醫療資源的浪費，故本研究擬以研發並製造腰椎椎間盤PEEK骨融合器，在腰椎椎間盤PEEK骨融合器加入凸齒狀構造，提升支架在脊椎椎體間的穩定性，使應力的負載平均，減少支架滑動及下陷到脊椎海綿骨中的機率，以免壓迫到神經組織。此外，本研究所設計的腰椎椎間盤PEEK骨融合器於工具端特別設計專屬工具孔，搭配專屬工具則可容易將植體回拉或取出。本研究擬以電腦輔助設計軟體(Computer Aided Design, CAD)來實現三維模型，經由專業醫師諮議後，修改植體前端的子彈頭設計，採用更為流線的外型，將使得手術時能更容易且快速地將腰椎椎間盤PEEK骨融合器植入適當的位置。修改側窗孔設計改為兩孔，將使得植體結構更為穩固，另外在工具端加入定位卡筍，本設計將使得專屬植入容易與植體對位，同時也將更穩固植入手術時的整體穩定性。研究結果顯示，本研究創新之脊椎支架因在側邊的開口處有加上粗網格之設計，可大幅提升此產品之支撐力，在脊椎做任何運動時（包括前後、左右以及軸旋轉）大部分的Von Mises 應力值都小於國際品牌，可供臨床參考。
並列摘要
The spinal intervertebral bone fusion after implantation is not easy to adjust in the recent clinical treatment. When biased position occurred during surgically implantation, the implant would not be easy to pull back or remove easily lead to patient harm and waste of medical resources. Thus, the present study is attempt to investigate, design and produce a novel the intervertebral disc PEEK bone fusion for enhanced the stability of scaffold in spinal, average the stress loading distribution and reduce subsidence to the probability of vertebral cancellous bone, in order to avoid compression of the nerve tissue reduce the scaffold sliding and subsidence to the probability of vertebral cancellous bone, in order to avoid compression of the nerve tissue. Moreover, PEEK bone fusion of the institute of design lumbar intervertebral disc was specially designed tool end exclusive tool hole, with a dedicated tool can easily explants pull back or remove. A three-dimensional computer-aided design software (Computer Aided Design, CAD) model was used in the present study. The analysis results indicated that due to the opening in the side of the plus coarse mesh design can significantly enhance the support for the innovated spinal scaffold product, when do any movement in the spine (including front and rear, left and right, and the axis of rotation). Most of the Von Mises stress values are less than the international brands which can be available for clinical applications.
參考文獻
延伸閱讀
- 江珮如（2008）。重拾活動力－非融合固定脊椎新術式。人醫心傳－慈濟醫療人文月刊，(54)，76-77。https://doi.org/10.30151/MH.200806.0018
- 蘇振興（2018）。使用PMMA人工骨泥增強椎弓根螺釘內固定手術治療骨質疏鬆性脊柱疾病之成效〔碩士論文，中山醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0003-0608201816152200
- 黃爾怡（2020）。椎弓螺釘與皮質螺釘聯合治療之椎間融合後部固定系統生物力學探討〔碩士論文，義守大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0074-2407202114065700
- Yen, C. Y., Chen, W. J., Chen, L. H., Niu, C. C., & Shih, C. H. (1996). Operation for Recurrent Herniated Intervertebral Disc of Lumbar Spine Twenty-Five Cases Followed 2 Years~ 9 Years. Journal of Orthopaedic Surgery Taiwan, 13(2), 175-179. https://www.airitilibrary.com/Article/Detail?DocID=10116923-199606-13-2-175-179-a
- 蔡凱駖（2020）。Biomechanical Investigation of Sacrovertebral Fracture in Osteoporosis〔碩士論文，義守大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0074-2608202002352400