Yoganandan Narayan, Pintar Frank A, Stemper Brian D, Wolfla Christopher E, Shender Barry S, Paskoff Glenn
Department of Neurosurgery, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA.
J Bone Joint Surg Am. 2007 May;89(5):1066-74. doi: 10.2106/JBJS.F.00200.
Aging, trauma, or degeneration can affect intervertebral kinematics. While in vivo studies can determine motions, moments are not easily quantified. Previous in vitro studies on the cervical spine have largely used specimens from older individuals with varying levels of degeneration and have shown that moment-rotation responses under lateral bending do not vary significantly by spinal level. The objective of the present in vitro biomechanical study was, therefore, to determine the coronal and axial moment-rotation responses of degeneration-free, normal, intact human cadaveric cervicothoracic spinal columns under the lateral bending mode.
Nine human cadaveric cervical columns from C2 to T1 were fixed at both ends. The donors had ranged from twenty-three to forty-four years old (mean, thirty-four years) at the time of death. Retroreflective targets were inserted into each vertebra to obtain rotational kinematics in the coronal and axial planes. The specimens were subjected to pure lateral bending moment with use of established techniques. The range-of-motion and neutral zone metrics for the coronal and axial rotation components were determined at each level of the spinal column and were evaluated statistically.
Statistical analysis indicated that the two metrics were level-dependent (p < 0.05). Coronal motions were significantly greater (p < 0.05) than axial motions. Moment-rotation responses were nonlinear for both coronal and axial rotation components under lateral bending moments. Each segmental curve for both rotation components was well represented by a logarithmic function (R(2) > 0.95).
Range-of-motion metrics compared favorably with those of in vivo investigations. Coronal and axial motions of degeneration-free cervical spinal columns under lateral bending showed substantially different level-dependent responses. The presentation of moment-rotation corridors for both metrics forms a normative dataset for the degeneration-free cervical spines.
衰老、创伤或退变会影响椎间运动学。虽然体内研究可以确定运动情况,但力矩不易量化。以往关于颈椎的体外研究大多使用来自退变程度不同的老年个体的标本,并且已经表明,侧弯时的力矩-旋转反应在不同脊柱节段之间没有显著差异。因此,本体外生物力学研究的目的是确定无退变、正常、完整的人体尸体颈胸段脊柱在侧弯模式下的冠状面和轴面力矩-旋转反应。
将9个从C2到T1的人体尸体颈椎柱两端固定。供体死亡时年龄在23岁至44岁之间(平均34岁)。在每个椎体中插入反光标记物以获取冠状面和轴面的旋转运动学数据。使用既定技术对标本施加纯侧弯力矩。在脊柱的每个节段确定冠状面和轴面旋转分量的运动范围和中性区指标,并进行统计学评估。
统计分析表明,这两个指标与脊柱节段有关(p < 0.05)。冠状面运动明显大于轴面运动(p < 0.05)。在侧弯力矩作用下,冠状面和轴面旋转分量的力矩-旋转反应均为非线性。两个旋转分量的每个节段曲线都可以用对数函数很好地表示(R² > 0.95)。
运动范围指标与体内研究结果相比具有优势。无退变颈椎柱在侧弯时的冠状面和轴面运动表现出明显不同的节段依赖性反应。这两个指标的力矩-旋转通道呈现为无退变颈椎提供了一个标准数据集。