挥鞭样损伤后颈部韧带强度会降低。

Neck ligament strength is decreased following whiplash trauma.

作者信息

Tominaga Yasuhiro, Ndu Anthony B, Coe Marcus P, Valenson Arnold J, Ivancic Paul C, Ito Shigeki, Rubin Wolfgang, Panjabi Manohar M

机构信息

Department of Orthopaedic Surgery, St. Marianna University School of Medicine, Kanagawa, Japan.

出版信息

BMC Musculoskelet Disord. 2006 Dec 21;7:103. doi: 10.1186/1471-2474-7-103.

DOI:10.1186/1471-2474-7-103

PMID:17184536

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC1764743/

Abstract

BACKGROUND

Previous clinical studies have documented successful neck pain relief in whiplash patients using nerve block and radiofrequency ablation of facet joint afferents, including capsular ligament nerves. No previous study has documented injuries to the neck ligaments as determined by altered dynamic mechanical properties due to whiplash. The goal of the present study was to determine the dynamic mechanical properties of whiplash-exposed human cervical spine ligaments. Additionally, the present data were compared to previously reported control data. The ligaments included the anterior and posterior longitudinal, capsular, and interspinous and supraspinous ligaments, middle-third disc, and ligamentum flavum.

METHODS

A total of 98 bone-ligament-bone specimens (C2-C3 to C7-T1) were prepared from six cervical spines following 3.5, 5, 6.5, and 8 g rear impacts and pre- and post-impact flexibility testing. The specimens were elongated to failure at a peak rate of 725 (SD 95) mm/s. Failure force, elongation, and energy absorbed, as well as stiffness were determined. The mechanical properties were statistically compared among ligaments, and to the control data (significance level: P < 0.05; trend: P < 0.1). The average physiological ligament elongation was determined using a mathematical model.

RESULTS

For all whiplash-exposed ligaments, the average failure elongation exceeded the average physiological elongation. The highest average failure force of 204.6 N was observed in the ligamentum flavum, significantly greater than in middle-third disc and interspinous and supraspinous ligaments. The highest average failure elongation of 4.9 mm was observed in the interspinous and supraspinous ligaments, significantly greater than in the anterior longitudinal ligament, middle-third disc, and ligamentum flavum. The average energy absorbed ranged from 0.04 J by the middle-third disc to 0.44 J by the capsular ligament. The ligamentum flavum was the stiffest ligament, while the interspinous and supraspinous ligaments were most flexible. The whiplash-exposed ligaments had significantly lower (P = 0.036) failure force, 149.4 vs. 186.0 N, and a trend (P = 0.078) towards less energy absorption capacity, 308.6 vs. 397.0 J, as compared to the control data.

CONCLUSION

The present decreases in neck ligament strength due to whiplash provide support for the ligament-injury hypothesis of whiplash syndrome.

摘要

背景

先前的临床研究记录了通过对包括关节囊韧带神经在内的小关节传入神经进行神经阻滞和射频消融，挥鞭样损伤患者颈部疼痛得到缓解。以前没有研究记录过因挥鞭样损伤导致动态力学性能改变而引起的颈部韧带损伤。本研究的目的是确定遭受挥鞭样损伤的人颈椎韧带的动态力学性能。此外，将当前数据与先前报告的对照数据进行比较。所研究的韧带包括前纵韧带、后纵韧带、关节囊韧带、棘间韧带、棘上韧带、中三分之一椎间盘和黄韧带。

方法

从六个颈椎制备了总共98个骨 - 韧带 - 骨标本（C2 - C3至C7 - T1），分别在3.5、5、6.5和8g的后向撞击以及撞击前后进行柔韧性测试。以725（标准差95）mm/s的峰值速率将标本拉伸至破坏。测定破坏力、伸长量、吸收的能量以及刚度。对韧带之间的力学性能进行统计学比较，并与对照数据进行比较（显著性水平：P < 0.05；趋势：P < 0.1）。使用数学模型确定韧带的平均生理伸长量。

结果

对于所有遭受挥鞭样损伤的韧带，平均破坏伸长量超过平均生理伸长量。黄韧带的平均破坏力最高，为204.6N，显著高于中三分之一椎间盘以及棘间韧带和棘上韧带。棘间韧带和棘上韧带的平均破坏伸长量最高，为4.9mm，显著高于前纵韧带、中三分之一椎间盘和黄韧带。吸收的平均能量范围从中三分之一椎间盘的0.04J到关节囊韧带的0.44J。黄韧带是最硬的韧带，而棘间韧带和棘上韧带最柔韧。与对照数据相比，遭受挥鞭样损伤的韧带破坏力显著降低（P = 0.036），为149.4N对186.0N，并且在能量吸收能力方面有降低趋势（P = 0.078），为308.6J对397.0J。