Haher T R, Tozzi J M, Lospinuso M F, Devlin V, O'Brien M, Tenant R, Ahmad J, Valenza J, Parrish S
SUNY-HSC, Brooklyn, New York.
Paraplegia. 1989 Dec;27(6):432-9. doi: 10.1038/sc.1989.69.
The load carrying capacity (LCC) of the human spine was evaluated in 10 human cadaver spines. The specimens consisted of segments from T11 to S1 with markers placed on the specimens at each vertebral level in both Ap and lateral planes. The specimens were loaded to 1250 N and spinal deflections were recorded and photographed at 125 N intervals during the loading cycle. In 5 specimens, axial and flexion loads were applied to the intact spine. The anterior and middle columns were destroyed in sequence at L2 and the loading process repeated. In the remaining 5 specimens, axial and extension loads were applied with the spine intact and after the posterior and middle columns were destroyed in sequence at L2. Load deflection curves were generated for each test and comparisons were made between intact spines and spines with single and double column destruction.
When the axis of loading was anterior to the posterior longitudinal ligament (PLL), destruction of the anterior and middle columns reduced the LCC by 46% and 68% respectively and destruction of the posterior and middle columns reduced the LCC by 30% and 63% respectively. There was minimal change in the LCC when the axis of loading was posterior to the PLL and the anterior and middle columns were destroyed. Two column destruction of the spine reduced its load carrying capacity for flexion loads by 70%. In thoracolumbar spinal fractures where flexion loads are predominant and anticipated, the authors conclude that surgical stabilisation is indicated with double column failure.
对10具人类尸体脊柱的承载能力（LCC）进行了评估。标本包括T11至S1节段，在矢状面和冠状面的每个椎体水平均在标本上放置标记物。将标本加载至1250 N，并在加载周期中每隔125 N记录并拍摄脊柱的挠度。在5个标本中，对完整脊柱施加轴向和屈曲载荷。依次破坏L2节段的前柱和中柱，然后重复加载过程。在其余5个标本中，先对完整脊柱施加轴向和伸展载荷，然后依次破坏L2节段的后柱和中柱，再施加同样的载荷。为每个测试生成载荷-挠度曲线，并对完整脊柱与单柱和双柱破坏的脊柱进行比较。
当载荷轴位于后纵韧带（PLL）前方时，前柱和中柱破坏分别使LCC降低46%和68%，后柱和中柱破坏分别使LCC降低30%和63%。当载荷轴位于PLL后方且前柱和中柱被破坏时，LCC变化极小。脊柱的双柱破坏使其屈曲载荷的承载能力降低70%。在以屈曲载荷为主且预期存在的胸腰椎骨折中，作者得出结论，双柱失效时应进行手术稳定。
