颈椎棘突骨折累及后方韧带复合体损伤对羊颈椎生物力学稳定性的影响

发布时间：2018-03-24 00:19

本文选题：颈椎棘突骨折　切入点：后方韧带复合体　出处：《医用生物力学》2017年05期

【摘要】：目的通过体外羊标本模拟颈椎棘突骨折累及后方韧带复合体(posterior ligamentous complex,PLC)损伤对颈椎生物力学稳定性的影响,探讨颈椎后方结构在维持颈椎稳定性中的作用。方法将新鲜羊颈椎C3~6标本24具随机平均分为3组:正常对照组(A组);单纯颈椎棘突骨折组(B组);颈椎棘突骨折合并PLC损伤组(C组)。在1.5 N·m力矩加载下,分别测量各组在前屈、后伸、左右侧弯和左右旋转6种工况下颈椎活动度(range of motion,ROM),使用单因素方差分析比较3组之间的ROM差异。结果单纯颈椎棘突骨折对羊颈椎稳定性影响不大,各工况下ROM同正常对照组比较差异无统计学意义(P0.05);颈椎棘突骨折合并PLC损伤组在前屈、后伸及左右旋转工况下ROM显著增加,同正常对照组相比,差异具有统计学意义(P0.05),颈椎棘突骨折合并PLC损伤组在左右侧弯工况下同正常对照组比较ROM变化不显著,差异无统计学意义(P0.05)。结论单纯颈椎棘突骨折本身并不影响颈椎整体稳定性,但颈椎棘突骨折伴有PLC损伤时可造成颈椎不稳,需要手术干预。
[Abstract]:Objective through in vitro simulation sheep specimens spinous process of cervical vertebra fracture involved posterior ligament complex (posterior ligamentous, complex, PLC) damage effect on the biomechanical stability of cervical vertebra, posterior cervical structures in maintaining the stability of cervical spine in vitro. Methods the fresh sheep cervical spine C3~ 6 specimens from 24 cadavers were randomly divided into 3 groups: normal control group (A group); simple cervical spine fracture group (B group); combined injury group PLC fracture of spinous process of cervical vertebra (group C). In 1.5 N - M torque loading, were respectively measured in flexion, extension, lateral bending and rotation around the 6 condition of cervical activity (range of motion, ROM the use of single factor variance analysis), the difference of ROM between the 3 groups were compared. Results the cervical spinous process fracture has little effect on the sheep cervical spine stability under the condition of ROM with the normal control group was not statistically significant (P0.05); injury group with PLC cervical spinous process fracture In flexion, extension and rotation under the condition of ROM increased significantly compared with the normal control group, the difference was statistically significant (P0.05), normal control group and ROM no significant change in lateral bending condition below PLC with cervical spine fracture injury group, the difference was not statistically significant (P0.05). Conclusion: simple cervical spine the fracture itself does not affect the overall stability of the cervical spine, but with the PLC spinous process of cervical vertebra fracture injury can cause cervical instability, the need for surgical intervention.

【作者单位】：湖州市第一人民医院骨科;中国人民解放军第九八医院骨科;苏州大学骨科研究所;
【基金】：南京军区医学科技创新项目(MS009)
【分类号】：R318.01;R687

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