Baranto Adad, Ekström Lars, Holm Sten, Hellström Mikael, Hansson Hans-Arne, Swärd Leif
Department of Orthopaedics, The Sahlgrenska Academy at Göteborg University and Sahlgrenska University Hospital, SE-416 45 Göteborg, Sweden.
Clin Biomech (Bristol). 2005 Dec;20(10):1046-54. doi: 10.1016/j.clinbiomech.2005.06.014. Epub 2005 Aug 15.
Abnormalities of the intervertebral discs have been found in a high frequency among young elite athletes. Several studies have also reported that the adolescent spine, especially the vertebral growth zones, is vulnerable to trauma. However, there is incomplete knowledge regarding the injury mechanism of the growing spine. In this study, the injury patterns of the adolescent porcine spine with disc degeneration were examined.
Twenty-four male pigs were used. A degenerative disc was created by drilling a hole through the cranial endplate of a lumbar vertebra into the disc. Two months later the animals were sacrificed and the degenerative functional spinal units (segments) were harvested. The segments were divided into three groups and exposed to axial compression, flexion compression or extension compression to failure. The load and angle at failure were measured for each group. The segments were examined with magnetic resonance imaging and plain radiography before and after the loading and finally examined macroscopically and histologically.
The degenerated segments required considerably more compressive load to failure than non-degenerated segments. Creating a flexion injury required significantly more load than an extension injury. Fractures and/or separations of the endplates from the vertebral bodies were seen at the margins of the endplates and in the growth zone. Only severe separations and fractures could be seen on plain radiography and magnetic resonance imaging.
The weakest part of the adolescent porcine lumbar spine with experimentally-induced degeneration, when loaded in axial compression, flexion compression or extension compression, was the growth zone, and, to a lesser extent, the endplate. Degenerated discs seem to withstand higher mechanical loads than non-degenerated discs, probably due to altered stress distribution.
在年轻的精英运动员中,椎间盘异常的发生率很高。多项研究还报告称,青少年脊柱,尤其是椎体生长区,容易受到创伤。然而,关于生长中脊柱的损伤机制,我们的了解并不完整。在本研究中,我们检查了患有椎间盘退变的青少年猪脊柱的损伤模式。
使用24只雄性猪。通过在腰椎的颅侧终板钻孔进入椎间盘来制造退变椎间盘。两个月后处死动物,收获退变的功能性脊柱单元(节段)。将节段分为三组,分别施加轴向压缩、屈曲压缩或伸展压缩直至破坏。测量每组破坏时的载荷和角度。在加载前后对节段进行磁共振成像和X线平片检查,最后进行大体和组织学检查。
退变节段破坏所需的压缩载荷比未退变节段多得多。造成屈曲损伤所需的载荷明显多于伸展损伤。在终板边缘和生长区可见终板与椎体的骨折和/或分离。在X线平片和磁共振成像上只能看到严重的分离和骨折。
在轴向压缩、屈曲压缩或伸展压缩加载时,实验诱导退变的青少年猪腰椎脊柱最薄弱的部位是生长区,其次是终板。退变椎间盘似乎比未退变椎间盘能承受更高的机械载荷,这可能是由于应力分布改变所致。