颈椎轴向旋转时各节段间在体三维运动特点  

Study of characteristics of three dimensional motion of cervical spine during maximal axial rotation

作　　者：梁威[1] 李宏达[2] 刘佳男[3] 魏冬[2] 夏群[2] LIANG Wei;LI Hong-da;LIU Jia-nan;WEI Dong;XIA Qun(Graduate School of Tianjin Medical University, Tianjin 300070, China;Department of Orthopedics,the Affiliated Hospital of Logistics University of Chinese People’s Armed Police Forces;Tianjin Hospital)

机构地区：[1]天津医科大学研究生院,300070 [2]武警后勤学院附属医院骨科医院 [3]天津市天津医院

出　　处：《天津医药》2017年第2期139-142,共4页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(81371992);天津市卫生局重点攻关项目(2011KG138)

摘　　要：目的测定生理载荷下颈椎轴向旋转时各运动节段的三维运动数据并分析颈椎的耦合运动特点。方法招募16名健康志愿者,排除颈椎病史、颈部疼痛不适及发育畸形,年龄22~29岁(中位年龄23岁)。采用双X线透视成像系统和CT相结合的技术,将颈椎的CT扫描图像导入计算机三维建模软件,建立颈椎三维模型;然后将模型与双X线透视成像系统捕获的最大左旋、右旋位的颈椎双平面透视的二维影像相匹配,在计算机软件的坐标系中再现颈椎的三维运动,进而算出颈椎最大轴向旋转时各节段的三维运动数据。结果 (1)颈椎轴向旋转时,C1/2旋转范围占颈椎整体旋转角度的绝大部分;下颈椎各节段中以C3/4、C5/6节段轴向旋转范围最大,C2/3最小。(2)颈椎轴向旋转时,C1/2耦合侧屈方向与轴向旋转方向相反;C2/3、C3/4、C4/5、C5/6、C6/7节段的耦合侧屈方向与轴向旋转方向相同,其中C2/3的耦合侧屈角度明显小于C3/4、C4/5、C5/6节段。结论应用二维-三维匹配技术测量颈椎轴向旋转时各节段的三维运动数据,得出颈椎轴向旋转时的耦合运动特点,有助于提高人们对颈椎复杂运动的认知水平,并为颈椎疾病的诊断、治疗及假体设计提供数据支持。Objective To determine the three dimensional motion data of each segment of cervical vertebrae andanalyze the characteristics of the intervertebral coupled motion during cervical axial rotation under physiological weightbearing.Methods A total of16healthy volunteers(ranging from22to29,median age,23years)were recruited to ourstudy.Any cervical spine disorder history,pain or other discomfort and malformations were excluded so as to avoid abnormalneck motion.These subjects underwent CT scans of their cervical segments in a supine position,and3D models of C1-C7were constructed.Next,each subject was asked to sit up straight and was positioned in the following sequence:maximal leftand right twisting,while double oblique images by DFIS were taken simultaneously at each of the positions.Then,the CTmodels were matched to the osseous outlines of the images from the two oblique views to quantify the position of cervicalvertebraes in3D at each position.Through local coordinate systems at the center of vertebral bodies,changes of position andangle of each cephalad vertebrae relative to the cauddal one were calculated before and after the axial rotation.Results(1)In the axial rotation of the cervical spine,the contribution of C1/2accounted for the most of the total cervical rotation range.For the lower levels,axial rotation was found to be maximal at C3/4and C5/6,minimal at C2/3.(2)In cervical axial motion,C1/2demonstrated a coupled lateral bending opposite to the axial rotation direction,while each segment of C2-7demonstrated coupled lateral bending towards the same side of the axial rotation.Among these segments the lateral bendingangle of C2/3was smaller than angles of C3/4,C4/5and C5/6.Conclusion This study investigated the cervical couplingbehavior using the noninvasive2D-3D matching technique and obtained the motion data at each cervical spinal segment.These findings will help to improve the understanding on physiological cervical spine movement and potential biomechanicalmechanism and treatment of cervical spondylosis.A

关 键 词：颈椎 生物力学 二维-三维匹配 耦合运动 脊柱外科 

分 类 号：R681.53[医药卫生—骨科学]