Fukushima Makoto, Kaneoka Koji, Ono Koshiro, Sakane Masataka, Ujihashi Sadayuki, Ochiai Naoyuki
Department of Orthopaedic Surgery, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.
Spine (Phila Pa 1976). 2006 Apr 15;31(8):903-8. doi: 10.1097/01.brs.0000209257.47140.fc.
Digitized measurements of the intervertebral motions using cervical cineradiographs of 10 volunteers during direct impacts applied to their faces.
To clarify the cervical spine motion during direct face impact and postulate some mechanisms of neck injuries.
Neck injury occurs mostly in traffic or falling accidents. Hyperextension of the neck is considered the most common mechanism of the injury because most victims have lacerations or contusions on their faces.
A low-level backward impact load was applied to 10 healthy male volunteers' faces at the forehead and maxilla via a strap using a free-falling small mass. Cervical vertebral motion was recorded by radiograph cineradiography during the impact.
The upper cervical spine showed a flexion motion for both conditions. Consequently, the cervical spine had an S-shaped curvature similar to that in cervical retraction. Intervertebral motions of the cervical spine were evaluated using an radiograph frame taken at the maximum cervical retraction. For the forehead load, intervertebral motion at C1-C2 was flexion, and motions of the lower cervical spine were extension. For the maxilla load, intervertebral motions from occiput-C1 through C4-C5 were flexion. The inflection point of the curvature was influenced by the impact location.
We detected a flexion motion of the upper or middle cervical spine during direct face impact. In an actual accident, if the cervical spine is forced into similar motion, we speculate that neck injury would occur in this retraction-like curvature of the cervical spine.
利用10名志愿者面部受到直接撞击时的颈椎动态X线片对椎间运动进行数字化测量。
阐明面部直接撞击时颈椎的运动情况，并推测颈部损伤的一些机制。
颈部损伤大多发生在交通或坠落事故中。颈部过伸被认为是最常见的损伤机制，因为大多数受害者面部有裂伤或挫伤。
通过使用自由落体小质量物体的绑带，在前额和上颌对10名健康男性志愿者的面部施加低水平向后撞击负荷。在撞击过程中通过动态X线摄影记录颈椎运动。
两种情况下上颈椎均显示屈曲运动。因此，颈椎呈现出与颈椎后缩时相似的S形弯曲。使用在颈椎最大后缩时拍摄的X线片帧评估颈椎的椎间运动。对于前额负荷，C1-C2处的椎间运动为屈曲，下颈椎的运动为伸展。对于上颌负荷，从枕骨-C1到C4-C5的椎间运动为屈曲。弯曲的拐点受撞击位置的影响。
我们在面部直接撞击过程中检测到上颈椎或中颈椎的屈曲运动。在实际事故中，如果颈椎被迫进行类似运动，我们推测在这种类似后缩的颈椎弯曲中会发生颈部损伤。
