Yoganandan Narayan, Stemper Brian D, Pintar Frank A, Maiman Dennis J, McEntire B Joseph, Chancey Valeta Carol
Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
Clin Biomech (Bristol). 2013 Jul;28(6):602-9. doi: 10.1016/j.clinbiomech.2013.05.007. Epub 2013 Jun 21.
While cervical spine injury biomechanics reviews in motor vehicle and sports environments are available, there is a paucity of studies in military loadings. This article presents an analysis on the biomechanics and applications of cervical spine injury research with an emphasis on human tolerance for underbody blast loadings in the military.
Following a brief review of published military studies on the occurrence and identification of field trauma, postmortem human subject investigations are described using whole body, intact head-neck complex, osteo-ligamentous cervical spine with head, subaxial cervical column, and isolated segments subjected to differing types of dynamic loadings (electrohydraulic and pendulum impact devices, free-fall drops).
Spine injuries have shown an increasing trend over the years, explosive devices are one of the primary causal agents and trauma is attributed to vertical loads. Injuries, mechanisms and tolerances are discussed under these loads. Probability-based injury risk curves are included based on loading rate, direction and age.
A unique advantage of human cadaver tests is the ability to obtain fundamental data to delineate injury biomechanics and establish human tolerance and injury criteria. Definitions of tolerances of the spine under vertical loads based on injuries have implications in clinical and biomechanical applications. Primary outputs such as forces and moments can be used to derive secondary variables such as the neck injury criterion. Implications are discussed for designing anthropomorphic test devices that may be used to predict injuries in underbody blast environments and improve the safety of military personnel.
虽然已有关于机动车和运动环境中颈椎损伤生物力学的综述，但针对军事载荷情况的研究却很少。本文对颈椎损伤研究的生物力学及应用进行分析，重点关注军事环境中人体对车底爆炸载荷的耐受性。
在简要回顾已发表的关于战场创伤发生与识别的军事研究后，描述了对尸体进行的人体研究，包括使用全身、完整的头颈复合体、带头部的骨韧带颈椎、下颈椎柱以及受不同类型动态载荷（电动液压和摆锤冲击装置、自由落体）作用的孤立节段。
多年来脊柱损伤呈上升趋势，爆炸装置是主要致伤因素之一，创伤归因于垂直载荷。在这些载荷条件下讨论了损伤、机制和耐受性。基于载荷率、方向和年龄纳入了基于概率的损伤风险曲线。
人体尸体试验的一个独特优势是能够获取基础数据，以描绘损伤生物力学并确定人体耐受性和损伤标准。基于损伤确定垂直载荷下脊柱耐受性的定义在临床和生物力学应用中具有重要意义。诸如力和力矩等主要输出可用于推导诸如颈部损伤标准等次要变量。讨论了设计拟人化试验装置的意义，该装置可用于预测车底爆炸环境中的损伤并提高军事人员的安全性。
