Panjabi M M
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut 06510.
J Spinal Disord. 1992 Dec;5(4):390-6; discussion 397. doi: 10.1097/00002517-199212000-00002.
The neutral zone is a region of intervertebral motion around the neutral posture where little resistance is offered by the passive spinal column. Several studies--in vitro cadaveric, in vivo animal, and mathematical simulations--have shown that the neutral zone is a parameter that correlates well with other parameters indicative of instability of the spinal system. It has been found to increase with injury, and possibly with degeneration, to decrease with muscle force increase across the spanned level, and also to decrease with instrumented spinal fixation. In most of these studies, the change in the neutral zone was found to be more sensitive than the change in the corresponding range of motion. The neutral zone appears to be a clinically important measure of spinal stability function. It may increase with injury to the spinal column or with weakness of the muscles, which in turn may result in spinal instability or a low-back problem. It may decrease, and may be brought within the physiological limits, by osteophyte formation, surgical fixation/fusion, and muscle strengthening. The spinal stabilizing system adjusts so that the neutral zone remains within certain physiological thresholds to avoid clinical instability.
中立区是围绕中立姿势的椎间运动区域，在此区域被动脊柱提供的阻力很小。多项研究——体外尸体研究、体内动物研究和数学模拟——表明，中立区是一个与其他表明脊柱系统不稳定的参数密切相关的参数。已发现其会随着损伤增加，可能还会随着退变增加；会随着跨越节段的肌肉力量增加而减小，也会随着脊柱内固定而减小。在大多数这些研究中，发现中立区的变化比相应活动范围的变化更敏感。中立区似乎是脊柱稳定功能的一项重要临床指标。它可能会随着脊柱损伤或肌肉无力而增加，进而可能导致脊柱不稳定或下背部问题。它可能会因骨赘形成、手术固定/融合以及肌肉强化而减小，并可能被控制在生理限度内。脊柱稳定系统会进行调整，以使中立区保持在一定的生理阈值内，以避免临床不稳定。
