颈椎牵引治疗有无颈部支撑:有限元分析。

PubMed ID
G H
发表日期 2017年04月

原始出处 肌肉骨骼科学与实践
Musculoskeletal science & practice
作者 Wang  Kuan  Wang  Huihao  Deng  Zhen  Li  Zhengyan  Zhan  Hongsheng  Niu  Wenxin 

文献标题 颈椎牵引治疗有无颈部支撑:有限元分析。
Cervical traction therapy with and without neck support: A finite element analysis.
Cervical traction therapy with and without neck support: A finite element analysis.

文献摘要 BACKGROUND

颈部牵引是治疗颈部疼痛的常用方法。然而,很少有研究探讨这种牵引对软组织的生物力学影响。

OBJECTIVES

分析仰卧位有无颈部支撑(NS和non-NS)颈椎牵引治疗的生物力学。

METHODS

建立颈椎有限元模型,探讨颈椎牵引治疗的机理。在C0的上表面施加100-N的轴向牵引力来模拟牵引重量。颈托牵引通过附加约束C4椎板表面的前后运动来模拟。计算并比较了两种情况下的平均vonmises应力、张力和相关组织的运动。同时记录屈曲时后环纤维的应力,以作比较。

RESULTS

在C4-C5和C5-C6水平,NS牵引导致前凸角减少较少。在这些水平上,最大的平均应力分布在无NS牵引的后环纤维上,两种牵引疗法对后环纤维产生的应力大于物理屈曲。在两种牵引治疗期间,C4-T1间的所有椎间盘的椎间盘内压力均降低。

CONCLUSION

颈部支撑牵引治疗在C4-C5和C5-C6水平对后环纤维和韧带产生的张力较小。为了在临床实践中尽量减少对软组织的潜在伤害,根据目标水平使用颈部支撑可能是有益的。


BACKGROUND

Cervical traction is commonly used for treating neck pain. However, few studies have investigated the biomechanical impact such traction has on soft tissues.

OBJECTIVES

To analyze the biomechanics of cervical traction therapy in a supine position with and without neck support (NS and non-NS).

METHODS

A finite element model of the cervical spine was constructed to investigate the mechanism behind cervical traction therapy. An axial traction force of 100-N was loaded on the upper surface of C0 to simulate traction weight. Neck support traction was simulated by additionally constraining anterior-posterior motion of the surface of the C4 vertebral lamina. The average von Mises stress, tensile force and motions of related tissues were calculated and compared between the two conditions. Stress in the posterior annulus fibers under flexion was also recorded for comparison.

RESULTS

At the C4-C5 and C5-C6 levels, NS traction resulted in less of a decrease in the lordotic angle. At these levels, the highest average stress was distributed in the posterior annulus fibers with non-NS traction and both traction therapies produced greater stress on the posterior annulus fibers than physical flexion. The intradiscal pressure in all intervertebral discs between C4-T1 decreased during both traction therapies.

CONCLUSION

Neck support traction therapy produced less tension on the posterior annulus fibers and ligaments posterior to it at the C4-C5 and C5-C6 levels. In order to minimize the potential harm to soft tissue in clinical practice, it may be beneficial to use a neck support according to the targeted level.

BACKGROUND

Cervical traction is commonly used for treating neck pain. However, few studies have investigated the biomechanical impact such traction has on soft tissues.

OBJECTIVES

To analyze the biomechanics of cervical traction therapy in a supine position with and without neck support (NS and non-NS).

METHODS

A finite element model of the cervical spine was constructed to investigate the mechanism behind cervical traction therapy. An axial traction force of 100-N was loaded on the upper surface of C0 to simulate traction weight. Neck support traction was simulated by additionally constraining anterior-posterior motion of the surface of the C4 vertebral lamina. The average von Mises stress, tensile force and motions of related tissues were calculated and compared between the two conditions. Stress in the posterior annulus fibers under flexion was also recorded for comparison.

RESULTS

At the C4-C5 and C5-C6 levels, NS traction resulted in less of a decrease in the lordotic angle. At these levels, the highest average stress was distributed in the posterior annulus fibers with non-NS traction and both traction therapies produced greater stress on the posterior annulus fibers than physical flexion. The intradiscal pressure in all intervertebral discs between C4-T1 decreased during both traction therapies.

CONCLUSION

Neck support traction therapy produced less tension on the posterior annulus fibers and ligaments posterior to it at the C4-C5 and C5-C6 levels. In order to minimize the potential harm to soft tissue in clinical practice, it may be beneficial to use a neck support according to the targeted level.


获取全文 10.1016/j.msksp.2017.01.005