人工颈椎间盘置换术后邻近下位关节突关节压力变化的生物力学研究  

Biomechanics of pressure changes in adjacent inferior zygapophyseal joint after artificial disc replacement

作　　者：胡孔和[1] 吴强[1] 李康华[2] 席新华[1] 卢海波[1] 李雄[2] 陈立科[2] 王斌[2] 

机构地区：[1]汕头大学医学院附属粤北人民医院骨科,广东韶关512026 [2]中南大学湘雅医院骨科,长沙410008

出　　处：《中国临床解剖学杂志》2009年第4期474-476,共3页Chinese Journal of Clinical Anatomy

基　　金：韶关市科技计划项目(韶科(卫)2007-06)

摘　　要：目的:探讨人工颈椎间盘置换术后邻近下位关节突关节内压力的变化,为其在临床应用提供生物力学依据。方法:在11具保留C3至T1的新鲜成人颈椎标本上,采用自行设计的圆片状微阻电式传感器测量C5/6椎间盘完整、椎间盘摘除、人工椎间盘置换和椎间融合4个模型组C6/7关节突关节内的压力负荷。结果:人工椎间盘置换组C6/7关节突关节内的压力在轴向(16.98±3.74)N、左侧弯(26.87±5.78)N、右侧弯(12.91±3.50)N、前屈(20.88±5.77)N、后伸(20.63±5.30)N,与完整组接近,差异无统计学意义(P>0.05),高于椎间盘摘除组(P<0.05),低于椎间融合组(P<0.05)。结论:人工颈椎间盘置换后邻近下位关节突关节内的压力接近正常,提示人工椎间盘置换符合颈椎正常生物力学要求。Objective：To explore the changes of pressure in adjacent inferior zygapophyseal joint after artificial disc replacement and provide biomechanical basis for the clinical practice. Methods： 11 fresh cervical spinal specimens （C3-T1） were obtained from young adult cadavers. The specimens were divided into the integrity group, the discectomy group, the artificial disc replacement group and the intervertebral fusion group. The changes of pressure in left C6/7 zygapophyseal joint were measured in 4 groups by using self-designing round resistance type transducer. Results：There were no statistic difference in pressures of C6/7 zygapophyseal joint between replacement group and integrity group, with the axial load of （ 16.98±3.74 ）N, left lateral bending of （26.87±5.78）N, right lateral bending of （12.91±3.50）N, flexion of （20.88±5.77）N and the extension of （20.63±5.30）N. Significant greater zygapophyseal joint pressures appeared in replacement group comparing to diseectomy group （P〈0.05）,and lower pressures appeared in replacement group comparing to fusion group （P〈0.05）. Conclusions：The result indicates that there was no obvious pressure change of adjacent inferior zygapophyseal joint after artificial disc replacement, while artificial disc replacement can meet the requirements of the normal cervical biomechanics.

关 键 词：颈椎 人工椎间盘 生物力学 关节突关节 

分 类 号：R681.5[医药卫生—骨科学]