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在完整以及部分和完全不稳定的尸体脊柱模型中,采用动力床疗法或传统滚动法对颈椎和胸腰椎脊柱运动进行生物力学分析。

Biomechanical analysis of cervical and thoracolumbar spine motion in intact and partially and completely unstable cadaver spine models with kinetic bed therapy or traditional log roll.

作者信息

Rechtine Glenn R, Conrad Bryan P, Bearden Brook G, Horodyski MaryBeth

机构信息

Department of Orthopaedics, University of Rochester, Rochester, NY 14642, USA.

出版信息

J Trauma. 2007 Feb;62(2):383-8; discussion 388. doi: 10.1097/01.ta.0000225924.12465.e6.

Abstract

BACKGROUND

The main comorbidities associated with spinal cord injury patients are secondary to immobilization. Kinetic bed therapy is used currently to reduce the complications associated with immobilization, but the effect on the unstable spine has not been quantified. The purpose of this study was to compare the motion in the cervical and thoracolumbar spine when cadavers with spinal instabilities are log rolled (LR) on a standard hospital bed or rotated on a RotoRest kinetic treatment table (KTT).

METHODS

Cervical and lumbar instabilities were created surgically in three embalmed cadavers. An electromagnetic tracking device was used to measure the three-dimensional segmental motion generated at C5 to C6 and T12 to L2 during LR and KTT treatments.

RESULTS

In both the cervical and lumbar spine, significantly more motion was observed during LR than KTT treatment.

CONCLUSIONS

We found that in cadavers with severely unstable cervical spine, rotation using a KTT produced less flexion and lateral bending than the LR. Also, in cadavers with severely unstable lumbar spine, treatment with the KTT produced less axial rotation than the LR. Currently, we think that the best way to immobilize the spine while still allowing therapeutic motion is through the use of a KTT.

摘要

背景

与脊髓损伤患者相关的主要合并症继发于制动。目前采用动力床疗法来减少与制动相关的并发症,但对不稳定脊柱的影响尚未量化。本研究的目的是比较脊柱不稳定的尸体在标准医院床上进行滚木式翻身(LR)或在RotoRest动力治疗床(KTT)上旋转时,颈椎和胸腰椎的运动情况。

方法

通过手术在三具防腐尸体上造成颈椎和腰椎不稳定。使用电磁跟踪装置测量在LR和KTT治疗期间C5至C6以及T12至L2处产生的三维节段运动。

结果

在颈椎和腰椎,LR治疗期间观察到的运动均明显多于KTT治疗期间。

结论

我们发现,在颈椎严重不稳定的尸体中,使用KTT进行旋转产生的屈曲和侧方弯曲比LR少。此外,在腰椎严重不稳定的尸体中,KTT治疗产生的轴向旋转比LR少。目前,我们认为在仍允许治疗性运动的同时固定脊柱的最佳方法是使用KTT。

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