腰椎间盘切除与人工椎间盘对关节突关节内压力的影响  

The stress changes of zygapophysial joints after discectomy and artificial disc replacement

作　　者：李康华[1] 王华[1] 雷光华[1] 宋先村[2] 

机构地区：[1]中南大学湘雅医院骨科,湖南省长沙市410008 [2]国防科技大学宇航科学与工程系,湖南省长沙市410003

出　　处：《中国临床康复》2003年第4期558-559,共2页Chinese Journal of Clinical Rehabilitation

基　　金：湖南省医药卫生科技基金项目资助(2001-Y06)

摘　　要：目的:测量腰椎间盘切除及人工椎间盘置换后关节突关节内的压力变化,探讨椎间盘切除及人工椎间盘置换对关节突关节的影响。方法:分别测量L4～5椎间盘切除前、后及SB-ChaiteⅢ型人工椎间盘置换后轴向、后伸、侧弯载荷下关节突关节内的压力变化,采用自身对照法进行比较。结果:相同的轴向、后伸、侧弯载荷下,椎间盘切除后关节突关节内的压力变化率明显大于椎间盘切除前与人工椎间盘置换后,差异均有显著性意义(P<0.01),人工椎间盘置换后较椎间盘切除前差异无显著性意义(P>0.05)。结论:椎间盘切除后关节突关节内压力变化率的增高提示椎间盘切除后腰椎生物力学的改变可能是关节突关节退行性变的重要原因;人工椎间盘置换可以消除椎间盘切除对关节突关节内压力改变的负面影响,恢复关节突关节内近似正常的压力改变,提示人工椎间盘可以起到正常椎间盘的作用。AIM:To investigate the stress change in zygapophysial joints after discectomy and artificial disc replacement(ADR),to provide evidences for the choose of the therapy of intervertebral disc disorder and clinic application of intervertebra l disc plerosis or ADR. METHODS:Using self-control study, the stress changes in the L4～5 zygapophysial joints were tested by special miniature pressure sensor after discectomy and ADR under axial load, lateral bending moment or posterior extension moment.RESULTS:Under axial load, lateral bending moment or posterior e xtension moment,the stress changes in the zygapophysial joints rose after discec tomy(P< 0.01).After SB-Chaite Ⅲ ADR, the stress changes returned the pre-dis cectomy level(P< 0.01).CONCLUSION:The stress change in the zygapophysial joints after discectomy cued that discectomy could cause the biomechanics' change and d egeneration in zygapophysial joints.The ADR can prevent the stress change after discectomy.

关 键 词：腰椎间盘切除 人工椎间盘 关节突关节内压力 影响 

分 类 号：R681.5[医药卫生—骨科学]