下颈椎不稳对颈前路手术前后邻近椎间盘变化影响的研究  

The effect of lower cervical instabillity on adjacent intervertebral disc changes before and after anterior cervical surgery

作　　者：乔晓慧 迟峰 孟庆春 喻伟光 邓佳 乔莹莹 QIAO Xiaohui;CHI Feng;MENG Qingchun;YU Weiguang;DENG Jia;QIAO Yingying(不详;People's Hospital of Shijiazhuang,Hebei 050000,China)

机构地区：[1]石家庄市人民医院,河北050000 [2]石家庄市第二医院

出　　处：《医学动物防制》2023年第7期672-675,共4页Journal of Medical Pest Control

基　　金：石家庄市科学技术研究与发展计划项目(201200803)。

摘　　要：目的应用生物力学方法建立下颈椎不稳的动物模型,以研究单节段下颈椎前路手术术前和术后相邻不稳节段椎间盘内的压力变化。方法将12例成年雄性山羊纳入研究对象,采取随机分组方法,分为实验组和对照组,每组6例。实验组建立下颈椎不稳的动物模型,模拟行C5~6单节段颈椎前路手术,完成标本制备。用生物力学机测试加载生理负荷(2N.m)的前屈、后伸及轴向旋转状态下与融合节段相邻节段椎间盘内的压力变化,实验结果用SPSS 20.0软件进行统计分析。结果(1)与术前相比,在前屈、后伸和轴向旋转3种状态下,实验组成年雄性山羊下颈椎固定融合术后,椎间盘内压力比对照组明显增高(P<0.05),差异有统计学意义;(2)前屈和后伸状态下,实验组术前单节段椎间盘内压力大于对照组(P<0.05),轴向旋转状态下,实验组和对照组差异无统计学意义(P>0.05);(3)术后第4个月实验组成年雄性山羊下颈椎屈伸活动度较对照组明显增大,差异有统计学意义(P<0.05);(4)术后前屈、后伸及轴向旋转运动状态下,实验组成年雄性山羊椎间盘内压力高于对照组(P<0.05)。结论下颈椎固定融合术前和术后,颈椎做前屈和后伸运动时,下颈椎相邻节段不稳组的椎间盘内压力均明显高于相邻节段稳定组。Objective An animal model of lower cervical instability was established by biomechanical method to study the pressure changes in the intervertebral disc of the adjacent unstable segments before and after single-segment anterior cervical surgery.Methods Twelve adult male goats were included in the study and were randomly divided into experimental group and control group,with six goats in each group.The animal model of lower cervical instability was established in the experimental group,and C5-6 single-segment anterior cervical surgery was simulated,and the specimen preparation was completed.Biomechanical machines were used to measure the pressure changes in adjacent segments of the fused segment under flexion,extension and axial rotation under physiological load(2N.m).SPSS 20.0 software was used for statistical analysis the experimental results.Results Compared with the pre-operation,the pressure of the intervertebral disc in the experimental group was significantly higher than that in the control group after lower cervical spine fixation and fusion under the three states of flexion,extension and axial rotation(P<0.05).②In flexion and extension,the preoperative single-segment intradiscal pressure in the experimental group was higher than that in the control group(P<0.05).In axial rotation,there was no significant difference between the two groups(P>0.05).③The range of motion of the lower cervical spine in the experimental group was significantly higher than that in the control group at 4th month after surgery(P<0.05),the difference was statistically significant.The adult male goats intervertebral disc pressure in the experimental group was higher than that in the control group in states of motion as flexion,extension,and axial rotation after operation(P<0.05).Conclusion The intervertebral disc pressure of adjacent segment instability group is significantly higher than that of adjacent segment stability group during flexion and extension of lower cervical spine before and after lower cervical spine fusion.

关 键 词：颈椎病 下颈椎不稳 下颈椎邻近节段退变 颈椎前路间盘切除融合术 脊髓信号异常 动物生物力学 手术预后 

分 类 号：R687.3[医药卫生—骨科学]