Musculoskeletal Biomechanics Research Laboratory, Department of Physical Medicine and Rehabilitation, University of Minnesota, Minneapolis, MN 55455, USA.
J Biomech. 2013 Apr 5;46(6):1147-54. doi: 10.1016/j.jbiomech.2013.01.005. Epub 2013 Feb 14.
Head and neck injuries, the leading cause of death for children in the U.S., are difficult to diagnose, treat, and prevent because of a critical void in our understanding of the biomechanical response of the immature cervical spine. The objective of this study was to investigate the functional and failure biomechanics of the cervical spine across multiple axes of loading throughout maturation. A correlational study design was used to examine the relationships governing spinal maturation and biomechanical flexibility curves and tolerance data using a cadaver human in vitro model. Eleven human cadaver cervical spines from across the developmental spectrum (2-28 years) were dissected into segments (C1-C2, C3-C5, and C6-C7) for biomechanical testing. Non-destructive flexibility tests were performed in tension, compression, flexion, extension, lateral bending, and axial rotation. After measuring their intact biomechanical responses, each segment group was failed in different modes to measure the tissue tolerance in tension (C1-C2), compression (C3-C5), and extension (C5-C6). Classical injury patterns were observed in all of the specimens tested. Both the functional (p<0.014) and failure (p<0.0001) mechanics exhibited significant relationships with age. Nonlinear flexibility curves described the functional response of the cervical spine throughout maturation and elucidated age, spinal level, and mode of loading specificity. These data support our understanding of the child cervical spine from a developmental perspective and facilitate the generation of injury prevention or management schema for the mitigation of child spine injuries and their deleterious effects.
头部和颈部损伤是美国儿童死亡的主要原因，由于我们对未成熟颈椎生物力学反应的理解存在重大空白，因此这些损伤难以诊断、治疗和预防。本研究的目的是研究颈椎在多个加载轴上的功能和失效生物力学，以了解脊柱成熟和生物力学灵活性曲线以及使用尸体体外模型的容限数据之间的关系。采用相关性研究设计，使用尸体体外模型研究了指导脊柱成熟和生物力学灵活性曲线以及容限数据的关系。对 11 个人类尸体颈椎进行了解剖，这些颈椎来自不同的发育阶段（2-28 岁），分为 C1-C2、C3-C5 和 C6-C7 节段进行生物力学测试。进行了非破坏性的灵活性测试，包括拉伸、压缩、弯曲、伸展、侧屈和轴向旋转。在测量其完整的生物力学反应后，每个节段组以不同的方式失效，以测量拉伸（C1-C2）、压缩（C3-C5）和伸展（C5-C6）中的组织容限。所有测试的标本均观察到典型的损伤模式。功能（p<0.014）和失效（p<0.0001）力学均与年龄有显著关系。非线性灵活性曲线描述了整个成熟过程中颈椎的功能反应，并阐明了年龄、脊柱水平和加载方式的特异性。这些数据支持了我们从发育角度理解儿童颈椎的认识，并为儿童脊柱损伤及其有害影响的预防或管理方案的制定提供了依据。
