对后纵韧带骨化症中脊髓静态压迫程度影响的生物力学研究。
Biomechanical study of the effect of degree of static compression of the spinal cord in ossification of the posterior longitudinal ligament.
机构信息
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi, Japan.
出版信息
J Neurosurg Spine. 2010 Mar;12(3):301-5. doi: 10.3171/2009.9.SPINE09314.
OBJECT
The authors evaluated the biomechanical effect of 3 different degrees of static compression in a model of the spinal cord in order to investigate the effect of cord compression in patients with ossification of the posterior longitudinal ligament (OPLL).
METHODS
A 3D finite element spinal cord model consisting of gray matter, white matter, and pia mater was established. As a simulation of OPLL-induced compression, a rigid plate compressed the anterior surface of the cord. The degrees of compression were 10, 20, and 40% of the anteroposterior (AP) diameter of the cord. The cord was supported from behind by the rigid body along its the posterior border, simulating the lamina. Stress distributions inside of the cord were evaluated.
RESULTS
The stresses on the cord were very low under 10% compression. At 20% compression, the stresses on the cord increased very slightly. At 40% compression, the stresses on the cord became much higher than with 20% compression, and high stress distributions were observed in gray matter and the lateral and posterior funiculus. The stresses on the compressed layers were much higher than those on the uncompressed layer.
CONCLUSIONS
The stress distributions at 10 and 20% compression of the AP diameter of the spinal cord were very low. The stress distribution at 40% compression was much higher. The authors conclude that a critical point may exist between 20 and 40% compression of the AP diameter of the cord such that when the degree of the compression exceeds this point, the stress distribution becomes much higher, and that this may contribute to myelopathy.
目的
作者评估了脊髓模型中 3 种不同程度静态压迫的生物力学效应,以研究后纵韧带骨化(OPLL)患者脊髓受压的影响。
方法
建立了一个由灰质、白质和软脑膜组成的三维有限元脊髓模型。作为 OPLL 引起的压迫模拟,刚性板压迫脊髓的前表面。压迫程度为脊髓前后径的 10%、20%和 40%。刚性体沿脊髓后缘支撑脊髓的后部,模拟椎板。评估了脊髓内的应力分布。
结果
在 10%的压缩下,脊髓上的应力非常低。在 20%的压缩下,脊髓上的应力略有增加。在 40%的压缩下,脊髓上的应力比 20%的压缩高得多,并且在灰质和侧索及后索中观察到高应力分布。受压层上的应力远高于未受压层上的应力。
结论
脊髓前后径 10%和 20%压缩时的应力分布非常低。40%压缩时的应力分布要高得多。作者得出结论,在脊髓前后径的 20%和 40%压缩之间可能存在一个临界点,当压缩程度超过这个临界点时,应力分布会变得更高,这可能导致脊髓病。