腰椎人工椎間盤之運動軌跡分析

Analysis of the Motion Locus of Lumbar Artificial Disc

錢威廷(Wei-Ting Chien)

指導教授 ： 林上智 ； 鄔蜀威

國立中央大學/工學院/機械工程學系/碩士(2007年)

摘要

目前治療椎間盤退化性疾病(DDD: Degenerative Disc Disease)之主要治療方式為在受治療之椎間盤處植入椎籠，希望能造成椎骨間的骨融合(Intervertebral Fusion)，進而恢復塌陷椎間盤之原有高度，但在臨床上已發現術後常會有脫出(Back-out)及位移(Displacement)等併發症的產生，而且由於接受治療之區域發生椎骨間的融合，造成治療區域之椎間盤活動度(ROM: Range of Motion)喪失，其活動度將由鄰近之椎間盤分擔，因而增加了鄰近椎間盤之運動量，造成這些椎間盤發生加速老化的問題(Junctional Problem)，因而發產出活動是人工椎間盤。目前市面上之磨耗型人工椎間盤可分為限制型及非限制型兩種，而各自有其優缺點。
本研究希望設計一種新型磨耗型人工椎間盤，在植入人體後，將可重建塌陷椎間盤的原有高度，同時能提供手術區域之椎間盤自然的運動型式與活動範圍，並能有效限制人工椎間盤活動之範圍，避免於屈曲與伸展及左右側彎時過大的動作所造成之不良影響。

關鍵字

椎間盤退化性疾病 ； 人工椎間盤 ； 椎間盤活動度 ； 椎骨間的骨融合 ； 椎籠

並列摘要

Nowadays, we know the main treatment of Degenerative Disc Disease that implants cage into the cured intervertebral idsc. We also hope that makes Intervertebral Fusion, and then restores the high of dent one, but it is easy to see that will being back-out and displacement or complications after operations.
According to this situation, those cages are merged in the accepted curing region; it also makes lose ROM(Range of Motion), in the area and the movement is not only shared by both side of intervertebral idsc, but also increasing it’s motion. Due to those points, making intervertebral idsc develops some junctional problems speedy. The last development is Artificial Disc. Wearing type of artificial intervertebral disc on the market can divide into two kinds that are constrained and unconstrained, and have its pluses and minuses each.
We hope to design a new style of Artificial Disc through this research that puts it into internal. It also rebuilds the original height of intervertebral disc and provides the range of intervertebral disc’s movement and exercise in nature way. To limit the move range of Artificial Disc effectively and avoid the counterproductive effect of movement in flexing, stretch and turn right or left.

並列關鍵字

Intervertebral Fusion ； cage ； Artificial Disc ； Degenerative Disc Disease ； Range of Motion

參考文獻

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[3] Martini Bartholomew, Essentials of anatomy & physiology,ch6.

[4] James Watkins, structure and function of the musculoskeletal system.ch3，ch6.

[5] Lindh,M.1989.biomechanics of the lumbar spine. In Basic biomechanics of the musculoskeletal system,eds.M.Nordin and V.H. Frankel.Philadelphia:Lea & Febiger.