脊髓的生物力学特性及测量的研究进展  

Biomechanical properties and measurement advances in spinal cord research

作　　者：马继斌 谷铭勇 苗军[3] Ma Jibin;Gu Mingyong;Miao Jun(Department of Orthopaedics,the Second People's Hospital of Changzhi City,Changzhi 046000,China;Department of Sports Medicine,Jinan Third People's Hospital,Jinan 250132,China)

机构地区：[1]山西省长治市第二人民医院骨科,长治046000 [2]济南市第三人民医院运动医学科,济南250132 [3]天津市天津医院脊柱外科,天津300211

出　　处：《中华骨科杂志》2023年第20期1395-1401,共7页Chinese Journal of Orthopaedics

摘　　要：脊髓是由灰质和白质构成,被硬脊膜、蛛网膜、软脊膜、齿状韧带和脑脊液所环绕。脊髓及其周围不同解剖结构的生物力学特性相关研究已证实脊髓属于非线性黏弹性介质,灰质和白质均具有超弹性材料的特性,在单轴拉伸和机械压缩实验方面的力学性能各异。人体脊髓在全长上呈粗细不均匀的状态,而各节段的硬脊膜表现出明显的异向性,其弹性模量自颈髓至腰髓逐渐减小。尽管对蛛网膜生物力学行为的研究较少,但其对提升脊柱有限元模型的预测准确性具有非常大的潜力。关于人软脊膜生物力学行为的研究尚无文献报道。脊髓浸润在脑脊液中,脑脊液可作为脊髓的震动缓冲器,因此在讨论脊髓的生物力学行为时不应忽视脑脊液的重要作用。当脑脊液压力升高时,脊髓的应力也会升高,反之亦然。齿状韧带的强度自上至下逐渐减弱。脊髓组织柔软,在受损时常发生拉伸、压缩和扭转等混合力学变化。脊髓的测量方法包括磁共振弹性成像(magnetic resonance elastography,MRE)、原子力显微镜、微压痕技术和脊髓造影等。MRE在脊髓形态学研究方面具有一定的优势。脊髓变形损伤时准确测量其力学参数难度大,通过应用影像学技术显示脊髓的动态病理变化,可以为临床治疗与预防提供宝贵的参考信息。有限元分析在研究脊髓损伤方面具有重要的价值,但目前的建模方法存在一定的简化,在脊柱有限元模型中脊髓通常被建模为均质材料,这种建模仍然需要进一步的实验证实其有效性。通过深入研究脊髓的生物力学特性及测量方法的研究进展,能更加深入地理解脊髓损伤机制,并为脊髓损伤的治疗和预防提供重要的理论指导和支持。The spinal cord,encompassed by the dura mater,arachnoid membrane,pia mater,dentate ligament,and cerebrospinal fluid,consists of both gray and white matter.This study delves into the biomechanical properties of the spinal cord and its adjacent structures,revealing its nature as a nonlinear viscoelastic medium.Notably,both gray and white matter exhibit hyperelastic characteristics,displaying distinct mechanical responses during uniaxial tensile and mechanical compression experiments.Furthermore,it is noteworthy that the human spinal cord does not maintain uniform length,while the dura mater exhibits pronounced anisotropy,with its elastic modulus gradually decreasing from the cervical to the lumbar region.While research on the biomechanical behavior of the arachnoid membrane is limited,its potential to enhance predictive accuracy in spinal finite element models is evident.Unfortunately,there is a lack of documented studies exploring the biomechanics of the human pia mater.Crucially,the spinal cord is immersed in cerebrospinal fluid,which acts as a cushion against spinal cord vibrations.Therefore,the significance of cerebrospinal fluid should not be underestimated in examining the biomechanical dynamics of the spinal cord,as changes in cerebrospinal fluid pressure correspondingly affect spinal cord stress levels.Additionally,the strength of the dentate ligament decreases progressively from superior to inferior regions.Due to the inherent softness of spinal cord tissue,it often undergoes complex mechanical alterations such as stretching,compression,and torsion when subjected to injury.Various measurement techniques,including magnetic resonance elastography(MRE),atomic force microscopy,microindentation,and myelography,are employed for spinal cord assessment.MRE,in particular,offers distinct advantages in scrutinizing spinal cord morphology.Accurately quantifying the mechanical parameters of spinal cord deformation injuries remains a challenge.Advanced imaging technologies are employed to monitor the dynamic pathologica

关 键 词：脊髓 生物力学现象 蛛网膜 弹性成像技术 脊髓损伤 有限元分析 

分 类 号：R651.2[医药卫生—外科学]