Yu Yan, Mao Haiqing, Li Jing-Sheng, Tsai Tsung-Yuan, Cheng Liming, Wood Kirkham B, Li Guoan, Cha Thomas D
Department of Spine Surgery, Tongji Hospital, Tongji University School of Medicine, Shanghai 2000065, China;Department of Orthopedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114.
Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu, China.
J Biomech Eng. 2017 Jun 1;139(6):0645011-7. doi: 10.1115/1.4036311.
While abnormal loading is widely believed to cause cervical spine disc diseases, in vivo cervical disc deformation during dynamic neck motion has not been well delineated. This study investigated the range of cervical disc deformation during an in vivo functional flexion-extension of the neck. Ten asymptomatic human subjects were tested using a combined dual fluoroscopic imaging system (DFIS) and magnetic resonance imaging (MRI)-based three-dimensional (3D) modeling technique. Overall disc deformation was determined using the changes of the space geometry between upper and lower endplates of each intervertebral segment (C3/4, C4/5, C5/6, and C6/7). Five points (anterior, center, posterior, left, and right) of each disc were analyzed to examine the disc deformation distributions. The data indicated that between the functional maximum flexion and extension of the neck, the anterior points of the discs experienced large changes of distraction/compression deformation and shear deformation. The higher level discs experienced higher ranges of disc deformation. No significant difference was found in deformation ranges at posterior points of all the discs. The data indicated that the range of disc deformation is disc level dependent and the anterior region experienced larger changes of deformation than the center and posterior regions, except for the C6/7 disc. The data obtained from this study could serve as baseline knowledge for the understanding of the cervical spine disc biomechanics and for investigation of the biomechanical etiology of disc diseases. These data could also provide insights for development of motion preservation surgeries for cervical spine.
虽然人们普遍认为异常负荷会导致颈椎间盘疾病,但动态颈部运动过程中颈椎间盘的体内变形情况尚未得到很好的描述。本研究调查了颈部体内功能性屈伸过程中颈椎间盘的变形范围。使用组合双荧光透视成像系统(DFIS)和基于磁共振成像(MRI)的三维(3D)建模技术对10名无症状人体受试者进行了测试。通过每个椎间节段(C3/4、C4/5、C5/6和C6/7)上下终板之间空间几何形状的变化来确定椎间盘的整体变形。分析每个椎间盘的五个点(前、中、后、左和右)以检查椎间盘变形分布。数据表明,在颈部功能性最大屈伸之间,椎间盘的前点经历了较大的牵张/压缩变形和剪切变形变化。较高节段的椎间盘经历了更高的变形范围。所有椎间盘后点的变形范围未发现显著差异。数据表明,椎间盘变形范围取决于椎间盘节段水平,除C6/7椎间盘外,前部区域的变形变化比中部和后部区域更大。本研究获得的数据可作为了解颈椎间盘生物力学以及研究椎间盘疾病生物力学病因的基线知识。这些数据还可为颈椎运动保留手术的发展提供见解。