腰椎间盘髓核与软骨终板切除术后生物力学变化的实验研究  

The Biomechanics Change of the Lumbar Intervertebral Disc following Resection of Nucleus Pulposus and Cartilage Endplates

作　　者：刘亚[1] 田云虎[2] 刘文华[1] 姜小坤[2] 王韶峰[2] 

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261042 [2]潍坊医学院附属医院骨科

出　　处：《潍坊医学院学报》2007年第3期216-218,Ⅲ,共4页Acta Academiae Medicinae Weifang

摘　　要：目的 通过研究腰椎间盘髓核与软骨终板同时切除以及单纯髓核摘除术后生物力学变化,明确其对腰椎稳定性的影响.方法 选择1岁健康犬9只,作为动物模型,手术部位为L5～6,L6～7,L7～S1,根据手术方式将27个椎间隙分为3组:分别为A组(对照组)、B组(单纯髓核摘除术)、C组(髓核及软骨终板切除术).术后24周取出L5～S1椎体,固定于生物力学实验机上测量相应节段在前屈、后伸、侧弯和轴向旋转载荷下的生物力学稳定性.结果 B组脊柱节段稳定性与对照组比较差异有显著性,表现为在屈/伸方向上施加载荷时,运动范围(ROM)和中性区(NZ)均明显增大,在侧弯和轴向旋转方向上施加载荷时,NZ明显增大;C组脊柱节段在各方向上的ROM和NZ与对照组比较差异无显著性,稳定性较好.结论 髓核及软骨终板同时切除能够较好地保持脊柱节段的生物力学稳定性,可防止术后腰椎不稳的发生.Objective To evaluate the biomechanics effects on the lumbar interverbral discs following resection of nucleus pulposus and cartilage endplates,and identify the effects on stabiliy of spine segment,and explore the new operation way for protrusion of irtervertebral disc.Methods Set up the animal models of lumbar discectomy in nine canines as proceeding.Twenty-seven lumbar discs including L5～6,L6～7,L7～S1 were randomly assigned to three groups,A group:control group;B group:removal the nucleus pulposus of disc;C group:remove the nucleus pulposus and cartilage endplates at the same time.The animals were killed and the spinal segments were removed at the time 24 week.Each of the nine canine spine specimens,L5～S1,were tested on biomechincs tester to evaluate the segmental stability of flexion/extension,lateral bending and axial rotation.Results In the range of motion(ROM) and neutral zone(NZ) of B group were larger than contral group at the flexion/extension load.While the lateral bending and axial rotation moments were applied,the NZ were larger than contral group;No significant difference was observed between C group and contral group.Conclusion The remove the nucleus pulposus and cartilage endplates at the same time can perserved the spine segmental stabiliy postoperatively,so can prevent the happen of lumbar spine unsteadiness.

关 键 词：腰椎间盘 生物力学 髓核 软骨终板 

分 类 号：R681.5+3[医药卫生—骨科学]