Kubo Shinichiro, Goel Vijay K, Yang Seok-Jo, Tajima Naoya
Department of Orthopedic Surgery, Miyazaki Medical College, Japan.
J Spinal Disord Tech. 2002 Dec;15(6):477-85. doi: 10.1097/00024720-200212000-00008.
The aim of this study is to evaluate the biomechanical effects of multilevel foraminotomy and foraminotomy with double-door laminoplasty compared with foraminotomy with laminectomy. Using fresh human cadaveric specimens (C2-T1), sequential injuries were created in the following order: intact, bilateral foraminotomies (C3-C4, C4-C5, C5-C6), laminoplasty (C3-C6) using hydroxyapatite spacer, removal of the spacers, and laminectomy. Changes in the rotations of each vertebra in each injury status were measured in six loading modes: flexion, extension, right and left lateral bending, and right and left axial rotation. Foraminotomy alone and following laminoplasty showed no significant differences in motion compared with intact except in axial rotation. After removal of the spacers and following laminectomy, the motion increased significantly in flexion and axial rotation. The ranges of initial slack showed similar trends when compared with the results at maximum load. Clinical implications of these observations are presented.
本研究的目的是评估多级椎间孔切开术以及双开门椎板成形术式椎间孔切开术与椎板切除术式椎间孔切开术相比的生物力学效应。使用新鲜的人体尸体标本（C2-T1），按以下顺序依次造成损伤：完整状态、双侧椎间孔切开术（C3-C4、C4-C5、C5-C6）、使用羟基磷灰石间隔物的椎板成形术（C3-C6）、取出间隔物以及椎板切除术。在六种加载模式下测量每种损伤状态下每个椎体的旋转变化：前屈、后伸、右侧和左侧侧屈以及右侧和左侧轴向旋转。单独的椎间孔切开术以及椎板成形术后与完整状态相比，除了轴向旋转外，在运动方面没有显著差异。取出间隔物后以及椎板切除术后，前屈和轴向旋转时的运动显著增加。与最大负荷时的结果相比，初始松弛范围呈现出相似的趋势。本文还阐述了这些观察结果的临床意义。
