Yang King H, King Albert I
Wayne State University, Detroit, United States.
Pain Res Manag. 2003 Summer;8(2):79-85. doi: 10.1155/2003/839740.
The purpose of this study was to document the kinematics of the neck during low-speed rear-end impacts. In a series of experiments reported by Deng et al (2000), a pneumatically driven mini-sled was used to study cervical spine motion using six cadavers instrumented with metallic markers at each cervical level, a 9-accelerometer mount on the head, and a tri-axial accelerometers on the thorax. A 250-Hz x-ray system was used to record marker motion while acceleration data were digitized at 10,000 Hz. Results show that, in the global coordinate system, the head and all cervical vertebrae were primarily in extension during the entire period of x-ray data collection. In local coordinate systems, upper cervical segments were initially in relative flexion while lower segments were in extension. Facet joint capsular stretch ranged from 17 to 97%. In the vertical direction, the head and T1 accelerated upward almost instantaneously after impact initiation while there was delay for the head in the horizontal direction. This combination was the result of a force vector which was pointed in the forward and upward direction to generate an extension moment. Upward ramping of the torso was larger in tests with a 20-deg seatback angle. The study concluded that the kinematics of the neck is rather complicated and greatly influenced by the large rotations of the thoracic spine. Significant posterior shear deformation was found, as evidenced by the large facet capsular stretch. Although the neck forms a "mild" S-shaped curve during whiplash, using its shape as an injury mechanism can be misleading because the source of pain is likely to be located in the facet capsules.
本研究的目的是记录低速追尾碰撞时颈部的运动学特征。在邓等人(2000年)报道的一系列实验中,使用气动微型雪橇对六具尸体的颈椎运动进行研究,这些尸体在每个颈椎水平都装有金属标记物,头部安装了9轴加速度计,胸部安装了三轴加速度计。使用250赫兹的X射线系统记录标记物的运动,同时以10000赫兹对加速度数据进行数字化处理。结果表明,在全局坐标系中,在X射线数据收集的整个期间,头部和所有颈椎主要处于伸展状态。在局部坐标系中,上颈椎节段最初处于相对屈曲状态,而下颈椎节段处于伸展状态。小关节囊的拉伸范围为17%至97%。在垂直方向上,撞击开始后头部和T1几乎立即向上加速,而头部在水平方向上存在延迟。这种组合是由一个向前和向上指向的力矢量产生伸展力矩的结果。在座椅靠背角度为20度的测试中,躯干向上倾斜更大。该研究得出结论,颈部的运动学相当复杂,并且受到胸椎大旋转的极大影响。发现了明显的后向剪切变形,小关节囊的大拉伸证明了这一点。尽管在挥鞭伤期间颈部形成了“轻度”的S形曲线,但将其形状用作损伤机制可能会产生误导,因为疼痛的来源可能位于小关节囊中。