邬超, 高明杰, 王建忠, 张云凤, 于静红, 蔡永强, 王海燕, 和雨洁, 仝玲, 李佳伟, 高尚, 王星, 吴敏, 李志军, and 李筱贺
BACKGROUND: Juvenile idiopathic scoliosis causes changes in spine structure, and the stress of the scoliosis spine changes accordingly. The thoracic and lumbar vertebrae bear most of the stress load throughout the spine. Thus, this study simulates and analyzes the biomechanical characteristics of the thoracolumbar spine under different working conditions, which is very meaningful for the study of the etiology of the disease. OBJECTIVE: To establish a Lenke type 3 three-dimensional digital model of adolescent idiopathic scoliosis, to simulate and analyze the stress and displacement characteristics of scoliosis under six working conditions. METHODS: A case of adolescent patient with idiopathic scoliosis and double main curvature deformity was selected to undergo spine CT scan. The scanned Dicom format CT data were imported into Mimics software. According to the CT gray scale, the corresponding tissues were distinguished and stl or cloud point cloud format was exported. After denoising, paving, smoothing and other processing, the processed image was transferred to Hypermesh software for meshing. Specific material properties were given to the vertebral body and surrounding tissues. A three-dimensional finite element model of adolescent idiopathic scoliosis was established to simulate the role of spinal ligaments. Finally, the mechanical analysis was performed in Abaqus & Ansys software. RESULTS AND CONCLUSION: (1) During flexion and extension, lateral flexion and rotation, the stress of vertebral body in lateral curvature (T6 and T12 vertebral body), thoracolumbar junction and lumbar vertebrae was larger, and the stress of facet joint and pedicle was larger than that of other parts. The stress from the apex to the end decreased gradually. (2) When lateral flexion and rotation motion, the stress at the concave part of the spine (T6-7 at the left margin, T10-11, and L3-4 at the right margin) was greater. (3) Three-dimensional finite element model of chest-waist segment of Lenke 3 adolescent idiopathic scoliosis patients was successfully established. The simulation analysis showed that the stress and displacement of the vertebral body and intervertebral disc of adolescent idiopathic scoliosis at different positions under different loading conditions changed accordingly. The results of the study may provide global and regional quantitative indicators for the three-dimensional scoliosis correction, and provide a digital model for clinical device orthopedics and brace treatment. [ABSTRACT FROM AUTHOR]