下颈椎单侧小关节脱位对颈椎稳定性影响的生物力学研究  

Effect of unilateral cervical facet dislocation on stability of lower cervical spine

作　　者：江晨 崔华[1] 徐辉[1] Jiang Chen;Cui Hua;Xu Hui(Department of Orthopaedics,Haimen People's Hospital,Haimen 226100,China)

机构地区：[1]海门市人民医院骨科,226100

出　　处：《国际医药卫生导报》2019年第3期365-368,共4页International Medicine and Health Guidance News

基　　金：海门市科技计划项目(2017SF12).

摘　　要：目的 通过测量山羊下颈椎单侧小关节脱位前后的颈椎活动度,探讨下颈椎单侧小关节脱位对颈椎稳定性的影响。方法 将6具新鲜海门山羊颈椎C3~7标本先后制成正常颈椎、单侧小关节脱位伴交锁及复位后的颈椎模型,分别测量各组在前后屈伸、左右侧弯、轴向旋转时6个方向的颈椎活动度(Range of motion,ROM),比较3组之间ROM的差异。结果 与正常组相比,单侧小关节脱位伴交锁时下颈椎的前后屈伸、左侧弯、轴向旋转明显减小([9.28±2.26)°比(11.93±4.31)°、(7.52±1.97)°比(10.65±3.73)°、(8.17±2.15)°比(10.46±2.84)°、(12.93±3.64)°比(15.21±2.83)°、(11.76±4.09)°比(15.47±3.19)°],差异均有统计学意义(均P<0.05)。当复位以后,其ROM与正常组相比显著增大[(15.68±3.35)°比(11.93±4.31)°、(14.97±3.07)°比(10.65±3.73)°、(14.86±3.24)°比(10.46±2.84)°、(13.65±2.96)°比(10.32±3.04)°、(23.53±5.81)°比(15.21±2.83)°、(21.94±4.52)°比(15.47±3.19)°],差异均有统计学意义(均P<0.05)。结论 单侧小关节脱位伴交锁时,下颈椎处于假性稳定状态;复位以后,其稳定性显著降低,手术治疗予以固定融合是较好的选择。Objective To assess the effect of unilateral cervical facet dislocation on stability of lower cervical spine measuring the range of motion(ROM)of the goat in the normal condition and after unilateral facet dislocation.Methods Six fresh specimens of goat cervical spine C3-7 were modeled as a normal group,a unilateral facet locked group,and a reduced group.The range of motion(ROM)in each group was measured under six directions of motion:flexion and extension,lateral bending,and axial rotation.Results After locking,the ROM were significantly lower than those in the normal group[(9.28±2.26)°vs.(11.93±4.31)°,(7.52±1.97)°vs.(10.65±3.73)°,(8.17±2.15)°vs.(10.46±2.84)°,(12.93±3.64)°vs.(15.21±2.83)°,and(11.76±4.09)°vs.(15.47±3.19)°],with statistical differences(all P<0.05).After unlocking,rang of motion were significantly higher than those in the normal group[(15.68±3.35)°vs.(11.93±4.31)°,(14.97±3.07)°vs.(10.65±3.73)°,(14.86±3.24)°vs.(10.46±2.84)°,(13.65±2.96)°vs.(10.32±3.04)°,(23.53±5.81)°vs.(15.21±2.83)°,and(21.94±4.52)°vs.(15.47±3.19)°],with statistical differences(all P<0.05).Conclusions Lower cervical spine appears to be stable while the facet is locked unilaterally;however,the motion segment becomes overtly unstable after the facet dislocation is reduced;and surgery for fixation and fusion is the optimal treatment.

关 键 词：颈椎 单侧小关节 脱位 稳定性 生物力学 

分 类 号：R687.3[医药卫生—骨科学]