颈椎三维运动状态下颈脊髓所受压力与脊髓腹侧致压深度的关系

Biomechanical study of the pressure sustained by cervical cord-meningeal complex under three-dimensional movement

中文关键词:  颈脊髓  腹侧致压  三维运动  生物力学

英文关键词:Cervical cord  Ventral caused by the pressure  Three-dimensional motion  Biomechanics

中文摘要:

  【摘要】 目的：探讨颈椎三维运动状态下颈脊髓所受压力与脊髓腹侧致压深度的关系。方法：采用10具新鲜成人尸体颈脊柱标本（C1~T1），于C4/5椎间隙水平前后开窗，通过腹侧置入半球形致压杆，模拟颈椎间盘退变时对颈脊髓腹侧致压。致压深度分别为椎管矢状径的10％～60％，逐次递增10％，分别测量三维运动状态下不同致压深度颈脊髓腹背侧所受压力。结果：（1）中立位、后伸30°位、侧弯30°位、旋转15°位时致压深度10%和20%颈脊髓腹侧压力差异无统计学意义（P＞0.05），致压深度30%时颈脊髓腹侧压力明显增加，30%~60%时颈脊髓腹侧压力随致压深度的增加而增大，相邻致压深度两两比较差异有统计学意义（P＜0.05）。前屈30°时，致压深度20%时颈脊髓腹侧压力即明显增加，20%~60%时颈脊髓腹侧压力随致压深度的增加而增大，各相邻致压深度两两比较差异有统计学意义（P＜0.05）。（2）中立位及各运动形式下硬脊膜背侧所受压力随致压深度的增加无明显增加，各相邻致压深度间两两比较差异无统计学意义（P＞0.05）。结论：颈脊髓腹侧所受压力与致压深度密切相关，并随着运动方式不同而改变，提示脊髓腹侧致压时颈椎前屈位脊髓损伤风险增大。

英文摘要:

  【Abstract】 Objectives: To investigate the relationship between the pressure sustained by cervical cord-meningeal complex(CCMC) and the strength under the 3D movement. Methods: 10 intact fresh cervical spines(C1-T1) from adult cadaver were collected, and a hemispherical steel ball was placed in the front of the spine canal through the C4/5 bone window to simulate the pressure of ventral side of CCMC caused by cervical disc herniation. The ventral side of CCMC was compressed with the depth of canal stenosis varying from 10％ to 60％(with an interval of 10％), and the pressure change on the ventral and dorsal side of CCMC following different depths of stress under the 3D movement was measured. Results: (1)In neutral position, 30° of extension, 30° of lateral and 15° of rotation, the pressure on the ventral side of CCMC showed no significance with strength of stress between 10% and 20%(P>0.05); while the pressure on the ventral side of CCMC increased with increasing the depth when the stress depth ranged from 30% to 60％, there was significance between neighboring depths of stress(P＜0.05). In 30° of flexion, the pressure on the ventral side of CCMC increased with increasing the depth from 10% to 60%, there was significance between neighboring depths(P<0.05). (2)The pressure on the dorsal side of CCMC showed no obvious increase with increasing the depth under any movement． There was no statistical significance between neighboring depths of stress(P>0.05). Conclusions: The pressure on the ventral side of CCMC is closely related with the depth of stress． Under the 3D movement, the pressure varies with the movement position. Flexion position may aggravate the injury of spinal cord.