微创医学2026，Vol.21Issue(4)：476-483,8.DOI:10.11864/j.issn.1673.2026.04.10
3种内固定手术治疗上胸椎骨折的有限元分析
Three internal fixation surgeries for upper thoracic spine fractures:a finite element analysis
摘要
Abstract
Objective A finite element analysis was conducted to evaluate the effects of percutaneous pedicle screw fixation(PPSF),anterior spinal plate fixation(ASPF)and anterior thoracic corpectomy and fusion(ATCF)for the treatment of upper thoracic spine fractures.Methods Three-dimensional finite element model of T1-5 was reconstructed using CT scans obtained from a healthy adult male.A V-shaped osteotomy was performed on the T3 vertebra to simulate burst fracture.Based on the V-shaped osteotomy of the T3 vertebra,three internal fixation models including PPSF,ASPF and ATCF were constructed.Six loading conditions including flexion,extension,left lateral bending,right lateral bending,left axial rotation and right axial rotation were simulated.The maximum displacement of motion(DOM)and maximum Von Mises stress in each group were recorded.Results The maximum DOM of the whole vertebra in the fracture group under flexion,extension,bilateral lateral bending and rotation was greater than that in the PPSF,ATCF and ASPF groups.The maximum DOM of the whole vertebra in the ASPF group under flexion,extension,left lateral bending,right lateral bending and left rotation exceeded that in the PPSF and ATCF groups.The maximum DOM of the whole vertebra in the PPSF group under flexion,left lateral bending,right lateral bending,left rotation and right rotation was greater than that in the ATCF group.The maximum DOM of the T3 vertebra in the fracture group under flexion,extension,bilateral lateral bending and rotation was greater than that in the ASPF,PPSF and ATCF groups.The maximum DOM of the T3 vertebra in the ASPF group under flexion,extension,left rotation and right rotation was greater than that in the PPSF and ATCF groups.The maximum DOM of the T3 vertebra in the PPSF group under left lateral bending,right lateral bending,left rotation and right rotation exceeded that in the ATCF group.The maximum Von Mises stress of the PPSF and ASPF internal fixation systems occurred under rotation,while that of the ATCF internal fixation system occurred under lateral bending.The maximum Von Mises stress of the PPSF group under flexion,extension,left lateral bending,right lateral bending,left rotation and right rotation was greater than that of the ASPF and ATCF groups.The maximum Von Mises stress of the ASPF group under extension,left lateral bending,right lateral bending,left rotation and right rotation was greater than that of the ATCF group.The maximum Von Mises stress of the T3 vertebra in the fracture group under left rotation and right rotation exceeded that in the ATCF group.The maximum Von Mises stress of the T3 vertebra in the PPSF group under flexion,extension,left lateral bending,right lateral bending,left rotation and right rotation was greater than that in the ASPF and ATCF groups.The maximum Von Mises stress of the T3 vertebra in the ASPF group under flexion,left lateral bending,right lateral bending,left rotation and right rotation was greater than that in the ATCF group.Conclusion The three surgical techniques including PPSF,ASPF and ATCF could effectively restore spinal stability following T3 upper thoracic burst fracture.The overall biomechanical stability was ranked as ATCF>PPSF>ASPF.关键词
上胸椎爆裂性骨折/有限元分析/经皮椎弓根螺钉内固定术/脊柱前路钢板内固定术/胸椎前路椎体切除术与融合术Key words
Upper thoracic burst fracture/Finite element analysis/Percutaneous pedicle screw fixation/Anterior spinal plate fixation/Anterior thoracic corpectomy and fusion引用本文复制引用
谢佩耕,黄宇,楚野,梁剑敏,熊春翔..3种内固定手术治疗上胸椎骨折的有限元分析[J].微创医学,2026,21(4):476-483,8.基金项目
广西自然科学基金项目(编号:2021GXNSFBA220042,2025GXNSFAA069833) （编号:2021GXNSFBA220042,2025GXNSFAA069833）
