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退变对人腰椎节段六自由度力学性能的影响。

Effect of degeneration on the six degree of freedom mechanical properties of human lumbar spine segments.

作者信息

Amin Dhara B, Sommerfeld Dana, Lawless Isaac M, Stanley Richard M, Ding Boyin, Costi John J

机构信息

Biomechanics and Implants Research Group, The Medical Device Research Institute, School of Computer Science, Engineering and Mathematics, Flinders University, Bedford Park 5042, South Australia, Australia.

Institute of Biomechanics, Hamburg University of Technology, Hamburg, Germany.

出版信息

J Orthop Res. 2016 Aug;34(8):1399-409. doi: 10.1002/jor.23334. Epub 2016 Jun 28.

Abstract

While the effects of disc degeneration on compression and rotation motions have been studied, there is no data for shear loading. Clinical research has shown that those with low back pain (a potential consequence of degeneration) experience a 75% greater lateral shear force than those without it. Therefore, the aim was to compare the effect of degeneration on spine segment stiffness and phase angle in each of six degree of freedom (6DOF) loading directions. Fourteen intact functional spinal units (FSU) were dissected from human lumbar spines (mean (SD) age 76.2 (11) years, Thompson grades 3 (N = 5, mild), 4 (N = 6, moderate), 5 (N = 3, severe)). Each FSU was tested in ±6DOFs while subjected to a physiological preload, hydration, and temperature (37°C) conditions in a hexapod robot. A one-way ANOVA between degenerated groups was performed on stiffness and phase angle for each DOF. Significant differences in stiffness were found between mild and moderate degenerative groups in lateral shear (p = 0.001), and axial rotation (p = 0.001), where moderate degeneration had decreased stiffness. For phase angle, significant differences were seen in anterior shear (p = 0.017), and axial rotation (p = 0.026), where phase angle for mild degeneration was less than moderate. Trends of stiffness and phase angle changes between degenerative groups were similar within each DOF. Clinically, the identification of the DOFs that are most affected by degeneration could be used in rehabilitation to improve supplemental stabilization of core muscle groups. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1399-1409, 2016.

摘要

虽然已经研究了椎间盘退变对压缩和旋转运动的影响,但尚无关于剪切负荷的数据。临床研究表明,患有腰痛(退变的潜在后果)的人所承受的横向剪切力比没有腰痛的人高75%。因此,本研究的目的是比较退变对脊柱节段在六个自由度(6DOF)加载方向上的刚度和相角的影响。从人腰椎中解剖出14个完整的功能脊柱单元(FSU)(平均(标准差)年龄76.2(11)岁,汤普森分级3级(N = 5,轻度)、4级(N = 6,中度)、5级(N = 3,重度))。每个FSU在六足机器人中,在生理预负荷、水合作用和温度(37°C)条件下进行±6DOF测试。对每个自由度的退变组之间进行单向方差分析,比较刚度和相角。在横向剪切(p = 0.001)和轴向旋转(p = 0.001)方面,轻度和中度退变组之间的刚度存在显著差异,其中中度退变的刚度降低。对于相角,在前向剪切(p = 0.017)和轴向旋转(p = 0.026)方面存在显著差异,其中轻度退变的相角小于中度退变。在每个自由度内,退变组之间刚度和相角变化的趋势相似。临床上,确定受退变影响最大的自由度可用于康复治疗,以改善核心肌群的补充稳定性。©2016骨科研究协会。由威利期刊公司出版。《矫形外科学研究》34:1399 - 1409,2016年。

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