腰椎椎板減壓術之有限元素分析

Finite element analysis of lumbar laminectomy

許焜翔(Kun-Hsiang Hsu)

指導教授 ： 林鼎勝

義守大學/醫學院/生物醫學工程學系/碩士(2016年)

摘要

隨著年齡增長，脊椎可能會引發椎間盤退化、腰椎滑脫症或椎管狹窄症等情況。椎管狹窄症通常會產生神經性跛行，導致下肢不協調，造成患者長期行走不良等等的情形。然而，在臨床醫師會依照狹窄程度去選擇使用椎板減壓術(laminectomy)或椎弓減壓術(laminotomy)兩種手術解除此症狀，儘管可以暫時性解除神經性症狀，但在術後仍有可能因結構不穩定而造成鄰近椎節滑脫，此時就會置入後固定器，以維持腰椎穩定性，選擇後固定器的搭配方式則有許多種，要依患者症狀而決定。
本研究使用電腦模擬分析，針對椎板減壓術後椎板移除之結構以及植入後固定器後的生物力學特性，與正常腰椎相比較，模擬結果可得知術後在進行動作時的位移、應力分布以及鄰近椎節的應力變化，藉此可讓臨床醫師選擇何種手術對病人較佳，並由模擬的結果希望能幫助臨床醫師了解各椎節可能會受到的影響。

關鍵字

椎板切除術 ； 後固定器 ； 電腦輔助工程

並列摘要

Spine would be degenerated with aging and may suffer from herniation of intervertebral disc, spondylolisthesis, spondylosis or stenosis. Stenosis of spinal canal usually accompanied with neurological problem. Laminectomy or laminotomy would be operated by orthopedic surgeons according to the severity of the stenosis. After that, the posterior fixation would be implanted to maintain the stability of the lumbar spine. This study is to investigate the biomechanical effect of the laminectomy by numerical simulation. The range of motion, stress distribution of the vertebral body and intervertebral disc were observed. The results might help surgeons to select suitable treatments to the patients and understand the possible effect on adjacent vertebral segments.

並列關鍵字

Laminectomy ； Posterior Interbody Fixation ； Computer-aided engineering

參考文獻

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