颈脊柱姿势及预负荷对颈椎间盘扭转强度的影响  

An experimental study of cervical spinal posture and prior loading history affecting intervertebral discs intortion strength

作　　者：孙麟[1] 马迅[1] 赵斌[1] 李满[1] 牛建鹏[1] 

机构地区：[1]山西医科大学第二医院骨科,太原市030001

出　　处：《实用医学杂志》2010年第11期1900-1903,共4页The Journal of Practical Medicine

摘　　要：目的:研究颈脊柱姿势及预负荷对颈椎间盘扭转强度的影响。方法:选用10具新鲜成人尸体颈脊柱标本,解剖出C3～4、C5～6共20个运动单位(包括上下两个椎骨和椎间盘),仅保留完整前、后纵韧带及椎间盘。模拟颈脊柱两种姿势(中立位和屈曲位)和两种预负荷状态(晨起高度水化和劳作后脱水状态),施以扭转载荷,测量颈椎间盘的极限扭转强度。分离颈椎间盘并制备组织学切片,观察颈椎间盘的损伤情况。结果:水化状态下,颈脊柱中立位时颈椎间盘极限扭转强度比屈曲位时低(P<0.01);而脱水状态下,颈脊柱中立位时颈椎间盘极限扭转强度高于屈曲位时(P<0.01)。中立位和屈曲位时,水化状态下颈椎间盘极限扭转强度均比脱水状态下低(P<0.01)。可明显观察到软骨终板和纤维环处损伤。结论:水化状态下颈脊柱中立位时较屈曲位时颈椎间盘易受扭转暴力损伤,而脱水状态下相反;不同姿势下晨起颈椎间盘高度水化状态下受到扭转暴力时颈椎间盘均更易损伤。扭转暴力作用后损伤以软骨终板和纤维环处最显著。Objective To investigate the effect of cervical spinal posture and prior loading history on intervertebral discs intortion strength.Method Ten human cadaver cervical spine were dissected into 20 motion segments containing 2 vertebrae and intervertebral discs（C3 ） ～ 4and C5 ～ 6 and integrative anterior longitudinal ligament, the posterior longitudinal ligament and the intervertebral discs.Intortion loads were executed for assessments of the effects of 2 postures（neutral trunk, flexed） and 2 loading conditions（dehydrated after crafts, hydrated in early morning）.The tissue injury was determined by histopathological methods.Result Under the hydrated conditions, specimens had a lower ultimate intortion strength in neutral trunk posture than that in flexed posture（P 0.01）.However, under the dehydrated conditions, specimens had a higher ultimate intortion strength in neutral trunk posture than that in flexed posture（P 0.01）.In both postures, hydrated specimens had a lower ultimate intortion strength than that of dehydrated specimens（P 0.01）.The end plate and the annual fibrous of the discs are injuried seriously.Conclusion In the hydrated state, the cervical intervertebral discs may be more prone to be injuried in the position of neutral trunk, while in the dehydrated state the consequence will not happen.In both positions, the discs are more prone to be injuried when they are at highest level of hydration in early morning.After the loading of the ultimate intortion strength, the end plate and the annual fibrous of the discs will be injuried seriously.

关 键 词：脊柱 颈椎间盘 扭转载荷 极限强度 生物力学 

分 类 号：R687.3[医药卫生—骨科学]