颈椎前路手术后邻近节段运动变化的生物力学研究  

A biomechanical study on pressure changes of zygapophysial joints after cervical spine anterior operations

作　　者：樊仕才[1] 刘成恩[1] 王宏波[1] 赵卫东[2] 

机构地区：[1]广东省深圳市沙井人民医院骨科,518104 [2]南方医科大学生物力学实验室,广州市510515

出　　处：《中华创伤骨科杂志》2005年第10期924-927,共4页Chinese Journal of Orthopaedic Trauma

基　　金：国家自然科学基金(30371449);广东省科委基金资助(99B06703G);深圳市宝安区科技基金(2003120)

摘　　要：目的利用压敏片(PSF)技术,测量颈椎前路手术后关节突关节内压力的变化,探讨颈前路手术后远期邻近节段退变的生物力学发病机制。方法10具新鲜成人颈椎尸体标本(C2～T1),行前路C4,5椎间盘切除、C4,5椎间植骨钢板内固定术。将压敏片置于关节突关节内,在脊柱三维运动试验机上测量0载荷和2N·m载荷下,后伸、左右侧弯、左右旋转过程中关节突关节内压力的变化。结果颈椎前路手术后,邻近节段关节突关节内的压力增加,以后伸和左右旋转时最为明显,差异有显著性意义(P<0.05)。结论颈椎前路短节段植骨融合术后,邻近节段关节突关节内压力明显增加,可诱发邻近节段关节突关节的退变,从而引起相应的病症。Objective To explore the biomechanical mechanism of long-term complication of cervical spinal operations by measuring pressure changes of zygapophysial joints using pressure sensitive film （PSF） after cervical spine anterior operations. Methods C4,5 anterior discectomy and C4,5 anterior plate fixation were done on 10 fresh adult cervical spine specimens （C2-T1 ） . PSF was put into zygapophysial joints and pressure changes were measured in positions of extension, left/right lateral bending and axial rotation on a universal testing machine. Results After cervical spine anterior operations, pressure of the adjacent facet joints increased. The differences were significant in extension and axial rotation （P〈0.05）. Conclusion Since cervical spine operations can increase the pressure of adjacent facet joints, they may induce acceleration of degenerative changes of adjacent facet joints and may bring about complications.

关 键 词：颈椎前路手术 颈椎运动 生物力学 植骨融合术 颈椎内固定术 

分 类 号：R687.3[医药卫生—骨科学] R318.01[医药卫生—外科学]