基于筋束骨理论建立慢性劳损型上颈椎失稳尸体模型及评价  

Establishment and evaluation of a cadaveric model of chronic strain-induced upper cervical spine instability based on fascia-bone theory

作　　者：梁龙 于杰[1,2] 魏戌 周帅琪[1,3] 尹逊路 刘广伟 谢瑞 谢榕 庄明辉 朱立国 冯敏山 Liang Long;Yu Jie;Wei Xu;Zhou Shuaiqi;Yin Xunlu;Liu Guangwei;Xie Rui;Xie Rong;Zhuang Minghui;Zhu Liguo;Feng Minshan(Second Department of Spine,Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Beijing Key Laboratory of TCM Bone Setting,Beijing 100102,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院望京医院脊柱二科,北京市100102 [2]中医正骨技术北京市重点实验室,北京市100102 [3]北京中医药大学,北京市100029

出　　处：《中国组织工程研究》2020年第20期3152-3156,共5页Chinese Journal of Tissue Engineering Research

基　　金：国家自然科学基金(81173279)，项目负责人：朱立国;国家自然科学基金(81774330)，项目负责人：冯敏山;国家科技支撑计划(2014BAI08B06)，项目负责人：朱立国;中医药行业科研专项(201107004)，项目负责人：朱立国;横向课题(HZL2017001)，项目负责人：冯敏山;中国中医科学院“十三五”重点领域科研专项(ZZ10-022)，项目负责人：朱立国;中国中医科学院科技创新优势团队(YS1304)，项目负责人：朱立国;国家留学基金委基金(201908110307)，项目负责人：梁龙~~

摘　　要：背景:对于上颈椎失稳机制的尸体标本研究多集中于急性暴力模型,尚缺乏慢性劳损型上颈椎失稳模型。目的:根据“筋束骨”理论构建慢性劳损致上颈椎失稳尸体模型并进行模型评价。方法:将9具新鲜尸体颈椎标本准备完毕后,先用Motion Analysis运动捕捉系统进行正常椎体活动度的检测,再使用BOSE动态疲劳试验机进行最大幅度的屈伸和旋转疲劳加载构建上颈椎失稳尸体模型,再次进行活动度的检测,比较造模前和造模后的上颈椎模型的枕寰关节、寰枢关节和整个上颈椎结构的前屈、后伸、左侧屈、右侧屈、左旋、右旋活动度。研究方案的实施符合南方医科大学的相关伦理要求,标本供者自愿捐赠。结果与结论:①在前屈运动时,造模后标本的寰枢关节(C1-2)、整个上颈椎(C0-2)活动范围明显大于造模前的标本(P<0.05);后伸时,造模后标本的寰枕关节(C0-1)、整个上颈椎(C0-2)活动范围明显大于造模前(P<0.05);在屈伸复合运动时,造模后标本的寰枢关节(C1-2)、整个上颈椎(C0-2)活动范围显著大于造模前标本(P<0.05);②在侧屈活动中,造模后标本寰枕关节(C0-1)、寰枢关节(C1-2)、整个上颈椎(C0-2)的活动度均较造模前有所增大,但差异无显著性意义(P>0.05);③在右旋活动时,造模后标本的整个上颈椎(C0-2)的活动度较造模前明显增加(P<0.05);④在左右旋复合运动时,造模后标本的寰枢关节(C1-2)、整个上颈椎(C0-2)活动范围明显大于造模前的标本(P<0.05);⑤结果说明,采取该造模方法可以很好地反映慢性劳损型上颈椎失稳的状态。BACKGROUND:Studies regarding the instability of upper cervical spine in cadaveric specimens are mostly based on an acute violence model,and there is still no chronic strain-induced upper cervical instability model.OBJECTIVE:To construct and evaluate the cadaveric model of the upper cervical spine instability caused by chronic strain according to the theory of“fascia and bone.”METHODS:Nine fresh cadaveric cervical spine specimens were prepared and the normal vertebral range of motion was detected by Motion Analysis Motion Capture System.The upper cervical spine instability model was constructed by using BOSE dynamic fatigue testing machine with maximum flexion,extension and rotation fatigue loading.Then,the vertebral range of motion was tested again.The anterior flexion,posterior extension,left flexion,right flexion,left and right rotation of the occipitoatlantoaxial joint,the atlantoaxial joint and the whole upper cervical spine were compared before and after modeling.The implementation of the study protocol complied with the relevant ethical requirements of Southern Medical University,and the specimens were voluntarily donated.RESULTS AND CONCLUSION:(1)During anterior flexion,the range of motion of the atlantoaxial joint(C1-2)and the entire upper cervical vertebra(C0-2)of the specimens after modeling was significantly larger than that before modeling(P<0.05).During posterior extension,the range of motion of the atlantooccipital joint(C0-1)and the entire upper cervical vertebra(C0-2)of the specimens after modeling was significantly larger than that before modeling(P<0.05).During both flexion and extension,the range of motion of the atlantoaxial joint(C1-2)and the entire upper cervical vertebra(C0-2)of the specimens after modeling was significantly larger than that of the pre-modeling specimen(P<0.05).(2)During lateral flexion,the range of motion of the atlantooccipital joint(C0-1),the atlantoaxial joint(C1-2),and the entire upper cervical vertebra(C0-2)of the specimens after modeling was increased compared wi

关 键 词：上颈椎失稳 慢性劳损 造模 活动度 筋束骨 

分 类 号：R446[医药卫生—诊断学] R496[医药卫生—临床医学]