Quinn Kyle P, Winkelstein Beth A
Department of Bioengineering, University of Pennsylvania, 240 Skirkanich Hall, 210 S. 33rd Street, Philadelphia, PA 19104-6321, USA.
J Biomech. 2007;40(10):2299-306. doi: 10.1016/j.jbiomech.2006.10.015. Epub 2006 Dec 1.
The cervical facet joint has been identified as a source of neck pain, and its capsular ligament is a likely candidate for injury during whiplash. Many studies have shown that the mechanical properties of ligaments can be altered by subfailure injury. However, the subfailure mechanical response of the facet capsular ligament has not been well defined, particularly in the context of physiology and pain. Therefore, the goal of this study was to quantify the structural mechanics of the cervical facet capsule and define the threshold for altered structural responses in this ligament during distraction. Tensile failure tests were preformed using isolated C6/C7 rat facet capsular ligaments (n=8); gross ligament failure, the occurrence of minor ruptures and ligament yield were measured. Gross failure occurred at 2.45+/-0.60 N and 0.92+/-0.17 mm. However, the yield point occurred at 1.68+/-0.56 N and 0.57+/-0.08 mm, which was significantly less than gross failure (p<0.001 for both measurements). Maximum principal strain in the capsule at yield was 80+/-24%. Energy to yield was 14.3+/-3.4% of the total energy for a complete tear of the ligament. Ligament yield point occurred at a distraction magnitude in which pain symptoms begin to appear in vivo in the rat. These mechanical findings provide insight into the relationship between gross structural failure and painful loading for the facet capsular ligament, which has not been previously defined for such neck injuries. Findings also present a framework for more in-depth methods to define the threshold for persistent pain and could enable extrapolation to the human response.
颈椎小关节已被确定为颈部疼痛的一个来源,其关节囊韧带很可能是挥鞭伤时的损伤部位。许多研究表明,韧带的力学性能可因亚失效损伤而改变。然而,小关节囊韧带的亚失效力学响应尚未得到很好的界定,尤其是在生理学和疼痛方面。因此,本研究的目的是量化颈椎小关节囊的结构力学,并确定该韧带在牵张过程中结构响应改变的阈值。使用分离的大鼠C6/C7小关节囊韧带(n = 8)进行拉伸破坏试验;测量韧带的整体破坏、微小破裂的发生情况和韧带屈服。整体破坏发生在2.45±0.60 N和0.92±0.17 mm处。然而,屈服点出现在1.68±0.56 N和0.57±0.08 mm处,显著低于整体破坏(两项测量的p均<0.001)。屈服时囊内的最大主应变是80±24%。屈服能量是韧带完全撕裂总能量的14.3±3.4%。韧带屈服点出现在一个牵张幅度,此时大鼠体内开始出现疼痛症状。这些力学研究结果为小关节囊韧带的整体结构破坏与疼痛负荷之间的关系提供了见解,而此前此类颈部损伤尚未有过相关界定。研究结果还为更深入地确定持续性疼痛阈值的方法提供了一个框架,并能够外推至人类反应。