Von Forell Gregory A, Bowden Anton E
a Department of Mechanical Engineering , Brigham Young University , Provo , UT 84602 , USA.
Comput Methods Biomech Biomed Engin. 2014 Nov;17(15):1685-95. doi: 10.1080/10255842.2013.763936. Epub 2013 Mar 12.
Many lumbar spine surgeries either intentionally or inadvertently damage or transect spinal ligaments. The purpose of this work was to quantify the previously unknown biomechanical consequences of isolated spinal ligament transection on the remaining spinal ligaments (stress transfer), vertebrae (bone remodelling stimulus) and intervertebral discs (disc pressure) of the lumbar spine. A finite element model of the full lumbar spine was developed and validated against experimental data and tested in the primary modes of spinal motion in the intact condition. Once a ligament was removed, stress increased in the remaining spinal ligaments and changes occurred in vertebral strain energy, but disc pressure remained similar. All major biomechanical changes occurred at the same spinal level as the transected ligament, with minor changes at adjacent levels. This work demonstrates that iatrogenic damage to spinal ligaments disturbs the load sharing within the spinal ligament network and may induce significant clinically relevant changes in the spinal motion segment.
许多腰椎手术有意或无意地损伤或横断脊柱韧带。本研究的目的是量化孤立性脊柱韧带横断对腰椎其余脊柱韧带（应力传递）、椎体（骨重塑刺激）和椎间盘（椎间盘压力）此前未知的生物力学影响。建立了全腰椎的有限元模型，并根据实验数据进行验证，然后在完整状态下对脊柱运动的主要模式进行测试。一旦移除一条韧带，其余脊柱韧带中的应力就会增加，椎体应变能也会发生变化，但椎间盘压力保持相似。所有主要的生物力学变化都发生在与横断韧带相同的脊柱节段，相邻节段有轻微变化。这项研究表明，医源性脊柱韧带损伤会扰乱脊柱韧带网络内的负荷分担，并可能在脊柱运动节段引起显著的临床相关变化。
