Oxland T R, Panjabi M M, Southern E P, Duranceau J S
Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, New Haven, Connecticut 06510.
J Orthop Res. 1991 May;9(3):452-62. doi: 10.1002/jor.1100090318.
To determine the anatomic basis for spinal instabilities, 16 porcine cervical spine specimens were subjected to a well-defined sagittal plane trauma. The multidirectional instability of each specimen was measured before and after trauma. Detailed anatomic dissections were performed on each traumatized specimen to quantitate the extent of injury to several distinct anatomic structures and columns. Multiple regression models were constructed to determine which anatomic structures and columns correlated best with each multidirectional instability. Flexion instability correlated best with injury to the interspinous/supraspinous ligaments and the ligamentum flavum. Extension instability correlated best with anterior longitudinal ligament and pedicle injury. Axial rotation instability correlated best with anterior disc-end-plate and capsular ligament injuries, while lateral bending instability correlated best with posterior disc-end-plate injuries. Anterior column injuries correlated best with extension, axial rotation, and lateral bending instabilities, while posterior column injuries correlated best with flexion instability. Finally, individual anatomic structural injuries had higher correlations with multidirectional instabilities than did the injuries defined by the anatomic columns.
为确定脊柱不稳定的解剖学基础，对16个猪颈椎标本施加明确的矢状面创伤。在创伤前后测量每个标本的多方向不稳定情况。对每个创伤标本进行详细的解剖剖析，以量化对几个不同解剖结构和柱的损伤程度。构建多元回归模型以确定哪些解剖结构和柱与每种多方向不稳定的相关性最佳。屈曲不稳定与棘间/棘上韧带和黄韧带损伤的相关性最佳。伸展不稳定与前纵韧带和椎弓根损伤的相关性最佳。轴向旋转不稳定与前椎间盘终板和关节囊韧带损伤的相关性最佳，而侧方弯曲不稳定与后椎间盘终板损伤的相关性最佳。前柱损伤与伸展、轴向旋转和侧方弯曲不稳定的相关性最佳，而后柱损伤与屈曲不稳定的相关性最佳。最后，个体解剖结构损伤与多方向不稳定的相关性高于解剖柱所定义的损伤。
