Oxland T R, Lin R M, Panjabi M M
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, CT 06510.
J Orthop Res. 1992 Jul;10(4):573-80. doi: 10.1002/jor.1100100412.
The thoracolumbar junction region is a frequent site of spinal trauma. Accurate knowledge of the normal mechanical behavior of the intervertebral joints in this region is of importance to the clinician in treating the spinal injuries. The present study documented the complete three-dimensional motions of levels T11-T12 and T12-L1 in the thoracolumbar region. Pure moments of flexion/extension, bilateral axial torque, and bilateral lateral bending were applied to 11 three-vertebrae human cadaveric specimens (T11-L1) to a maximum of 7.5 Nm. Intervertebral motions were calculated using stereophotogrammetry and presented in the form of load-displacement curves, each containing three rotations and three translations at one intervertebral level. Average +/- SD flexion, extension, axial rotation, and lateral bending ranges of motion to one side were 2.7 +/- 1.3 degrees, 2.4 +/- 1.3 degrees, 1.8 +/- 0.7 degrees, and 3.5 +/- 1.1 degrees, respectively, at level T11-T12. The same ranges of motion at T12-L1 were 2.9 +/- 1.4 degrees, 3.9 +/- 1.4 degrees, 1.2 +/- 0.7 degrees, and 3.7 +/- 1.1 degrees, respectively. The extension and axial rotation ranges of motion at level T11-T12 were found to be significantly different than the same motions at T12-L1. The different geometry in the facet joints explains these observed differences in the mechanical behavior of T11-T12 and T12-L1.
胸腰段交界区是脊柱创伤的常见部位。准确了解该区域椎间关节的正常力学行为对临床医生治疗脊柱损伤具有重要意义。本研究记录了胸腰段T11 - T12和T12 - L1节段的完整三维运动。对11个包含三个椎体的人体尸体标本(T11 - L1)施加最大7.5 Nm的屈伸纯力矩、双侧轴向扭矩和双侧侧方弯曲。使用立体摄影测量法计算椎间运动,并以载荷 - 位移曲线的形式呈现,每条曲线在一个椎间水平包含三个旋转和三个平移。在T11 - T12节段,向一侧的平均±标准差屈伸、轴向旋转和侧方弯曲运动范围分别为2.7±1.3度、2.4±1.3度、1.8±0.7度和3.5±1.1度。在T12 - L1节段相同的运动范围分别为2.9±1.4度、3.9±1.4度、1.2±0.7度和3.7±1.1度。发现T11 - T12节段的伸展和轴向旋转运动范围与T12 - L1节段的相同运动有显著差异。小关节的不同几何形状解释了在T11 - T12和T12 - L1力学行为中观察到的这些差异。