单侧小关节分级切除对同节段腰椎间孔形态影响的实验研究  

Experimental study of morphologic changes in the same segment intervertebral foramina associated with unilateral graded facetectomy on lumbar spine

作　　者：刘成[1] 刘守应[1] 马骁[1] 王永成[1] 高燕[1] 

机构地区：[1]解放军第253医院骨科,内蒙古呼和浩特010050

出　　处：《中国矫形外科杂志》2012年第1期75-77,共3页Orthopedic Journal of China

摘　　要：[目的]了解单侧腰椎小关节分级切除对不同运动状态下同节段腰椎间孔形态变化的影响机制。[方法]取8例新鲜尸体脊柱腰段完整标本,依次进行分级切除L4、5的后部结构,造成5种减压情况,依次测量加载前后各组L4、5椎间孔高度及最大、最小宽度值并比较分析。[结果]①完整组标本负载荷状态下,L4、5椎间孔各孔径均减小而且变化存在显著性差异;以扭力矩加载时,L4、5椎间孔高度及最大、最小宽度分别在中立位、后伸、同侧弯状态下三者均显著减小,在前屈、对侧弯状态下明显增大;②在中立位、后伸位和同侧弯体位负载时,当腰椎单侧小关节切除大于1/2后,L4、5椎间孔孔径均有显著性差异。[结论]在外科操作进行后部结构切除手术时,尤其是小关节切除手术应严格掌握指征。[Objectivel To reveal the mechanisms of morphologic changes in the L4.5 intervertebral foramina associated with unilateral graded facetectomy on lumbar spine during the different motion condition. [ Methods ] A total of eight human fresh cadaveric osacral spines were utilized in this investigation and biomechanical evaluation. Then graded faeetectomy of the samples were operated. [Results] 1. In axial position, change of height, maximum width and minimum width of L4.5 under2 000 N loading is very signficantly. By 10 Nm bending moment loading, the L4.5 intervertebral foramina height, maximum and minimum width of the intact group increased significantly during flexion and contralateral bendinlg, while decreased significantly during axial, extension and isolateral bending position. 2. In axial, extension, isolateral bending position loading 2000N, when the unilateral articular capsule if the range of graded faceteetomy exceeding 1/2, the L4.5 foraminal height, maximum width and mininluln width compared with the intact group there were significant difference. [ Conclusion] We should handle indication strictly when perform posterior structure excision especially facetectomy.

关 键 词：小关节切除 腰椎 椎间孔 形态学 

分 类 号：R687.3[医药卫生—骨科学]