Deng Zhen, Wang Kuan, Wang Huihao, Lan Tianying, Zhan Hongsheng, Niu Wenxin
Baoshan Branch, Shuguang Hospital Affiliated to Shanghai University of TCM, Shanghai, 201900, China.
Institute of Traumatology & Orthopedics, Shanghai Academy of TCM, Shanghai, 201203, China.
Eur Spine J. 2017 Sep;26(9):2308-2317. doi: 10.1007/s00586-017-5193-5. Epub 2017 Jun 28.
Traditional Chinese cervical manipulation (TCCM) has been claimed as an effective treatment for diseases of the cervical spine, but its biomechanical effects on the vertebral body and intervertebral discs remain unclear. The aim of this study was to develop and validate a detailed finite element model of cervical spine, which was then used to investigate the biomechanical response of the cervical spine to TCCM.
The model of a C2-T1 cervical spine was constructed based on CT images of a healthy male volunteer and validated against published in vitro studies under different loading conditions. The detailed force-time data of TCCM were measured on the same volunteer through dynamometric diaphragms. The data were applied on the validated finite element model to simulate TCCM.
The current model could offer potentials to effectively reflect the behavior of human cervical spine suitable for biomechanics studies of TCCM. Under simulated TCCM condition, the stress distributions in cervical spine and intervertebral discs could not be completely explained through the traditional theory.
Spinal manipulation, or TCCM, might play no role in reducing intradiscal pressure for treating cervical spondylosis. It could cause less stress concentration in intervertebral discs while operating spinal manipulation or TCCM when the adjustment points was chosen near the root of spinous process than the top of spinous process.
传统中医颈椎手法（TCCM）已被宣称是治疗颈椎病的有效方法，但其对椎体和椎间盘的生物力学影响仍不清楚。本研究的目的是建立并验证一个详细的颈椎有限元模型，然后用其研究颈椎对TCCM的生物力学反应。
基于一名健康男性志愿者的CT图像构建C2-T1颈椎模型，并根据已发表的不同加载条件下的体外研究进行验证。通过测力膜片在同一名志愿者身上测量TCCM的详细力-时间数据。将这些数据应用于经过验证的有限元模型以模拟TCCM。
当前模型有潜力有效反映适合TCCM生物力学研究的人体颈椎行为。在模拟TCCM条件下，颈椎和椎间盘内的应力分布无法通过传统理论完全解释。
脊柱手法，即TCCM，在治疗颈椎病时可能对降低椎间盘内压力不起作用。当选择在棘突根部附近而非棘突顶部进行脊柱手法或TCCM操作时，椎间盘内产生的应力集中可能较小。
