電腦模擬技術與醫療執行－以腰椎融合術為例

本研究以電腦模擬技術討論腰椎第二節到第四節 ( L2-L4 ) 接受三種不同類型之腰椎融合術，包刮前位融合、後側位融合以及後位融合，在不同座姿傾角時，融合部位上下方椎間盤內最大應力變化，以瞭解融合術對脊椎動力學之影響。本文以多孔媒體有限元素理論為分析基礎，輔以醫學影像處理及數值方法計算椎間盤應力。研究顯示，三種常用融合術中，腰椎施以後位融合術最符合生物力學原則；而此種模擬技術更有助於醫療品質之提昇。
Using the finite element (FE) methods, this study sough to understand the kinetic behaviors in the human spine. Three kinds of fusions, the anterior, the posterolateral and the posterior, which practiced in the lumbar spinal segments L2 to L4 were investigated. FE models were built with the medical images, and the numerical simulation techniques were based on porous medium theory. Inclination of the spine in various seating angles was also taken into consideration. In this study, variations on the highest failure criterion on von Mises stresses in intervertebral discs adjacent to the fused segments were inspected and compared. Results revealed that among the three fusions posterior fusion treatment of the lumbar spine is most correlated with the biomechanical rules. Moreover, the techniques used here were found to be very helpful in evaluating the preoperative condition and will no doubt improve future medical doing.