Borkowski Sean L, Tamrazian Eric, Bowen Richard E, Scaduto Anthony A, Ebramzadeh Edward, Sangiorgio Sophia N
The J. Vernon Luck, Sr., M.D. Orthopaedic Research Center, Orthopaedic Institute for Children, University of California, Los Angeles, Los Angeles, California.
Lucideon, Schenectady, New York.
JBJS Rev. 2016 Apr 5;4(4):e51-e511. doi: 10.2106/JBJS.RVW.O.00048.
Segmental motion is a fundamental characteristic of the thoracic spine; however, studies of segmental ranges of motion have not been summarized or analyzed. The purpose of the present study was to present a summary of the literature on intact cadaveric thoracic spine segmental range of motion in each anatomical plane.
A systematic MEDLINE search was performed with use of the terms "thoracic spine," "motion," and "cadaver." Reports that included data on the range of motion of intact thoracic human cadaveric spines were included. Independent variables included experimental details (e.g., specimen age), type of loading (e.g., pure moments), and applied moment. Dependent variables included the ranges of motion in flexion-extension, lateral bending, and axial rotation.
Thirty-three unique articles were identified and included. Twenty-three applied pure moments to thoracic spine specimens, with applied moments ranging from 1.5 to 8 Nm. Estimated segmental range of motion pooled means ranged from 1.9° to 3.8° in flexion-extension, from 2.1° to 4.4° in lateral bending, and from 2.4° to 5.2° in axial rotation. The sums of the range of motion pooled means (T1 to T12) were 28° in flexion-extension, 36° in lateral bending, and 45° in axial rotation.
The pooled ranges of motion were similar to reported in vivo motions but were considerably smaller in magnitude than the frequently referenced values reported prior to the widespread use of biomechanical testing standards. Improved reporting of biomechanical testing methods, as well as specimen health, may be beneficial for improving on these estimations of segmental cadaveric thoracic spine range of motion.
节段性运动是胸椎的一个基本特征；然而，尚未对节段性运动范围的研究进行总结或分析。本研究的目的是对完整尸体胸椎在各解剖平面内的节段性运动范围的文献进行总结。
使用“胸椎”“运动”和“尸体”等术语在MEDLINE上进行系统检索。纳入包含完整人体尸体胸椎运动范围数据的报告。自变量包括实验细节（如标本年龄）、加载类型（如纯力矩）和施加的力矩。因变量包括屈伸、侧弯和轴向旋转的运动范围。
共识别并纳入33篇独特的文章。23篇文章对胸椎标本施加了纯力矩，施加的力矩范围为1.5至8牛米。估计的节段性运动范围合并均值在屈伸时为1.9°至3.8°，侧弯时为2.1°至4.4°，轴向旋转时为2.4°至5.2°。运动范围合并均值之和（T1至T12）在屈伸时为28°，侧弯时为36°，轴向旋转时为45°。
合并的运动范围与报道的体内运动相似，但在幅度上比生物力学测试标准广泛应用之前经常引用的值要小得多。改进生物力学测试方法以及标本健康状况的报告可能有助于改善对尸体胸椎节段性运动范围的这些估计。
