后纵韧带对椎体爆裂骨折椎骨内骨块复位作用的生物力学行为特性及其临床意义探讨  

MECHANICAL BEHAVIOR OF POSTERIOR LONGITUDINAL LIGAMENT ON THE INDIRECT REDUCTION OF RETROPULSED FRAGMENT IN SPINAL CANAL OF THORACOLUMBER FRACTURE

作　　者：蔡福金[1] 阮狄克[2] 沈根标[3] 刘富华[1] 

机构地区：[1]解放军第101医院骨科,无锡214044 [2]海军总医院骨科,北京100037 [3]第四军医大学唐都医院骨科,西安710038

出　　处：《医用生物力学》2001年第3期150-154,共5页Journal of Medical Biomechanics

摘　　要：目的：观测脊柱后纵韧带（ＰＬＬ）对椎体爆裂骨折突入椎管骨块前推复位力的生物力学行为特点。方法：取人体脊柱标本制作爆裂骨折损伤模型，以测力探头测试不同脊柱状态下ＰＬＬ对突入椎管骨块的前推复位力。结果：在撑开力（１４０Ｎ）作用下ＰＬＬ前推复位力明显增加，无撑开力作用时后伸状态ＰＬＬ前推复位力大于前屈状态，撑开后伸时ＰＬＬ前推力与撑开前屈无显著差异，ＰＬＬ前推力与骨块占位程度成正相关。结论：撑开力是ＰＬＬ对骨块间接复位作用的决定性因素，脊柱前屈后伸状态及骨块占位程度也是影响因素。在治疗胸腰椎爆裂骨折中要获得椎管内骨块的间接复位减压，使用具有较强撑开能力的内固定装置进行纵向撑开是最重要的。Objectives To study the mechanical behavior of the posterior longitudinal ligament (PLL) to retropulsed fragment in spinal canal in different conditions of thoracolumber burst fracture. Methods 5 fresh human thoracolumber spine were tested in following conditions intact specimen injury specimen with lordosis injury specimen with lordosis and axial distraction injury specimen with kyphosis injury specimen with kyphosis and axial distraction. A probe containing a strain gauge tip was mimicked as a retropulsed fragment by passing through L1 body tunnel which was created previously to press PLL in different deepness. Results The indirect reduction strength of PLL without axial distraction was less than with axial distraction (p<0.05). There was not a significant difference statistically between lordosis and kyphosis after axial distraction.There was a good correlation between the degree of canal encroachment and indirect reduction strength of PLL. conclusions Regardless of the sagital plane angulation of the injuried spine the indirect reduction strength of retropulsed fragment in spinal canal by tension of PLL is mainly affected by axial distraction force It is importment to use the distraction device in management thoracolumber burst fracture in order to achieve indirect reduction of retropulsed fragment in spinal canal.

关 键 词：脊柱骨折 脊柱内固定 后纵韧带 生物力学 PLL 

分 类 号：R683.2[医药卫生—骨科学] R318.01[医药卫生—外科学]