颈椎棘突骨折累及后方韧带复合体损伤对羊颈椎生物力学稳定性的影响  

The effects of cervical spinous process fracture with posterior ligamentous complex injury on stability of the goat cervical spine

作　　者：吴荣 闵继康[1] 黄曙峰[1] 朱建祥[1] 李强[2] 王朝阳[2] 沈彦[2] 张文[3] 杨惠林[3] 

机构地区：[1]湖州市第一人民医院骨科,湖州313000 [2]中国人民解放军第九八医院骨科,湖州313000 [3]苏州大学骨科研究所,苏州215006

出　　处：《医用生物力学》2017年第5期422-426,共5页Journal of Medical Biomechanics

基　　金：南京军区医学科技创新项目(MS009)

摘　　要：目的通过体外羊标本模拟颈椎棘突骨折累及后方韧带复合体(posterior ligamentous complex,PLC)损伤对颈椎生物力学稳定性的影响,探讨颈椎后方结构在维持颈椎稳定性中的作用。方法将新鲜羊颈椎C3~6标本24具随机平均分为3组:正常对照组(A组);单纯颈椎棘突骨折组(B组);颈椎棘突骨折合并PLC损伤组(C组)。在1.5 N·m力矩加载下,分别测量各组在前屈、后伸、左右侧弯和左右旋转6种工况下颈椎活动度(range of motion,ROM),使用单因素方差分析比较3组之间的ROM差异。结果单纯颈椎棘突骨折对羊颈椎稳定性影响不大,各工况下ROM同正常对照组比较差异无统计学意义(P>0.05);颈椎棘突骨折合并PLC损伤组在前屈、后伸及左右旋转工况下ROM显著增加,同正常对照组相比,差异具有统计学意义(P<0.05),颈椎棘突骨折合并PLC损伤组在左右侧弯工况下同正常对照组比较ROM变化不显著,差异无统计学意义(P>0.05)。结论单纯颈椎棘突骨折本身并不影响颈椎整体稳定性,但颈椎棘突骨折伴有PLC损伤时可造成颈椎不稳,需要手术干预。Objective To investigate the effect of cervical spinous process fracture with posterior ligamentous complex （PLC） injury on biomechanical stability of the goat cervical spine specimen in vitro, and evaluate the role of posterior structure in maintaining the stability of cervical spine. Methods Twenty-four fresh goat cervical spine C3-6 specimens were randomly and evenly divided into 3 groups： control group （group A）, simple cervical spinous process fracture group （group B） and cervical spinous process fracture with PLC injury group （group C）. Under loading of 1..5 N ~ m torque, the range of motion （ROM） in each group was respectively measured under 6 working conditions： flexion, extension, lateral bending and axial rotation, and the ROM differences among 3 groups were compared by using one-way ANOVA analysis. Results Simple cervical spinous process fracture had little effect on the stability of cervical spine and there was no significant difference in ROM between group B and control group （ P 〉 0.0.5） under all working conditions. Compared with control group, the ROM in flexion, ex-tension and axial rotation significantly increased in group C （ P 〈 0. 05 ）, and no significant ROM difference was found in lateral bending between control group and group C （ P 〉 0.05 ）. Conclusions Simple cervical spinous process fracture does not affect the overall stability of cervical spine. Cervical spinous process fracture with PLC injury is more likely to cause cervical instability than simple cervical spinous process fracture, and surgical inter- vention is required in cervical spinous process fracture with PLC injury.

关 键 词：颈椎棘突骨折 后方韧带复合体 颈椎不稳 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]