颈椎三维运动对关节突关节压力的作用  

Role of cervical three-dimensional motion on contact pressures of facet joint

作　　者：赵卫东[1] 徐波[2] 张美超[1] 樊继宏[1] 

机构地区：[1]南方医科大学医用生物力学实验室,广东省广州市510515 [2]南方医科大学附属南方医院脊柱骨病外科,广东省广州市510515

出　　处：《中国组织工程研究与临床康复》2010年第22期3996-3999,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景：颈椎关节突关节压力变化是颈椎生理运动中的一个重要环节,但目前缺少对颈椎生理载荷下关节突间接触压力的直接测量研究。目的：通过测量颈椎三维运动中关节突关节压力的变化,探讨关节突对颈椎应力分布和运动协调的作用。方法：6具成年男性新鲜尸体颈椎标本（C2~C7）作为测试对象,将预制的压敏片置于C3~4、C4~5和C6~7左侧关节突关节内。标本先给予75N跟随载荷,再以持续加载模式加载力偶。屈伸和侧弯最大2.0N？m载荷,轴向旋转最大4.0N？m载荷,测量零力偶和最大力偶时的关节突关节内压力。结果与结论：零载荷时,C3~4、C4~5和C6~7左侧关节突分别承受75N跟随载荷的20.6%,20.0%,21.3%。在运动加载后,完整颈椎在后伸、左侧弯和右旋时均表现为左侧关节突间压力明显增大（P〈0.05）;但前屈、右侧弯和左旋时左侧关节突间压力无明显改变。3个节段在各运动方向关节间压力变化无显著性差异（P〉0.05）。结果提示关节突关节内压力变化主要取决于关节突的角度和加载方向。颈椎关节突在传递分散颈椎应力和协调三维运动中发挥重要作用。BACKGROUND： Contact pressure of facet joint acts an important role in physiological motion. However, there is lack of direct measurement for contact pressures of cervical facet joint. OBJECTIVE： To measure the contact pressure variation of facet joint following cervical multi-level three-dimensional motion and to explore effect of cervical facet joint on stress distribution and segment motion regulation. METHODS： Totally 6 adult fresh cervical spinal specimens （C2-7） were tested. Pressure sensitive film was put into left-side facet joints of C3-4, C4-5 and C5-6 segments. Firstly, 75 N of the follower load was applied, and then a three-dimensional movement was performed with the continuous load model. Contact pressures of facet joint were measured in 0 Nm and 2.0 N？m （flexion/extension, left/right lateral bending） and 4.0 N？m moment （left/right axial rotation）. RESULTS AND CONCLUSION： In the neutral position, contact pressure of left-side facet joint of C3-4, C4-5 and C5-6 received 20.6%, 20.0% and 21.3% load of the 75 N follower loads respectively. Contact pressure of left-side facet joint increased significantly in extension, left lateral bending and right axial rotation in all segments （P 0.05）, but not obviously changed in flexion, right lateral bending and left axial rotation. There was no significance among three segments （P 0.05）. Contact pressure variation of facet joint was affected by facet inclined degrees and load direction. It is indicated that cervical facet joint acts an important role in stress distribution and segment motion regulation.

关 键 词：颈椎 关节突关节 压敏片 关节压力 生物力学 

分 类 号：R318[医药卫生—生物医学工程]