生理载荷下健康成人寰枢椎三维瞬时运动的特点  

Three-dimensional transient motion characteristics of atlanto-axial joint in healthy adults under physiological load

作　　者：魏冬[1,2] 夏群[2] 苗军[2] 白剑强[2] 刘佳男[2] 李宏达[2] 

机构地区：[1]天津中医药大学研究生院,天津市300193 [2]天津医院脊柱外科二病区,天津市300162

出　　处：《中国组织工程研究》2016年第17期2526-2532,共7页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金资助项目(81472140;8157090604)~~

摘　　要：背景:人体的颈椎是承载头颅和连接脊柱的重要结构,虽然是脊柱中体积最小,但是灵活性最大,活动频率最高的节段,同时也是人体几何形体和运动特性最为复杂的的骨性结构之一,承受了头部的生理负荷,还肩负着屈伸、侧弯、旋转等运动功能。因此,颈椎成为了人体脊柱最容易受到伤害和出现退行性病变的结构之一。而对颈椎特别是上颈椎生物力学的分析,认识和理解其正常的功能和力学机制,也将为更好的治疗上颈椎疾患提供理论基础。目的:通过双荧光透视影像系统联合螺旋CT观察测定健康成年人生理载荷下寰枢椎在体三维瞬时运动特点。方法:招募17名健康志愿者,采用双X射线透视影像系统和螺旋CT检查相结合技术,利用相关处理软件建模,并与双荧光透视影像系统捕获的X射线透视图像匹配,重现上颈椎三维瞬时运动状态,通过建立椎体几何中心坐标并进行测量,从而获得健康成人生理载荷下上颈椎在体三维瞬时运动学数据。结果与结论:1前屈后伸时,C1-2节段与C2-3节段在冠状轴位移、矢状轴位移和旋转角度差异有显著性意义;2左右侧屈时,C1-2节段旋转角度明显大于C2-3节段。左右旋转时,C1-2节段与C2-3节段在冠状轴位移、垂直轴位移,侧屈角度和旋转角度均有明显差异且有显著性意义;3说明双荧光透视影像系统联合螺旋CT测量能够获得健康成人寰枢椎在体三维瞬时运动六自由度数据,并发现寰枢椎活动以旋转运动为主,以及上颈椎在体生理活动范围及特点,为上颈椎疾病非固定手术方案提供了量化参考。BACKGROUND：The cervical spine of the human body is an important structure carrying the head and connecting the spine.Its volume is small,but its flexibility was great.Activity frequency was highest.Simultaneously,cervical spine is the most complicated bony structure of geometric and kinematic characteristics of human body,bears the physiological load of the head,has functions of flexion and extension,lateral bending and rotation.Therefore,the cervical spine has become one of the most vulnerable structures with degenerative diseases of the spine.Analysis of upper cervical spine biomechanics,recognition and understanding of its normal function and mechanical mechanism will provide a theoretical basis for better treatment of upper cervical spine disorders.OBJECTIVE：To observe the in vivo three-dimensional kinematics of the upper cervical spine in healthy human beings under physiological load with dual fluorescence X-ray imaging system and spiral CT.METHODS：Seventeen healthy volunteers were recruited for this study.The vertebral segment motion of each subject was reconstructed with three-dimensional computed tomography and solid modeling software.In vivo cervical vertebral motion during functional postures was observed with dual fluoroscopic imaging.Coordinate systems were established at the vertebral center to obtain the intervertebral range of motion.RESULTS AND CONCLUSION：（1） During the flexion-extension motion,significant differences in the distance in coronal axis,sagittal axis and angle of rotation were detected in C1-2 and C2-3 segments.（2） During the left-right bending motion,the angle of rotation was obviously greater at C1-2 segment than that at C2-3 segment.During the left-right twisting motion,significant differences in distance of the vertical axis and the coronal axis,lateral flexion angle and rotation angle were detectable between C1-2 and C2-3 segments.（3） These findings confirmed that dual fluorescence X-ray imaging system combined with CT scan can obtain atlanto-axial three-dimen

关 键 词：寰枢关节 解剖 组织工程 骨科植入物 数字化骨科 生理载荷 寰枢椎 运动学 透视 三维模型 瞬时运动 在体试验 健康成人 国家自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]