后韧带复合体胸腰段韧带的生物力学作用：一项有限元研究
Biomechanical Role of the Thoracolumbar Ligaments of the Posterior Ligamentous Complex: A Finite Element Study.
作者信息
Wu Cong-Cong, Jin Hai-Ming, Yan Ying-Zhao, Chen Jian, Wang Ke, Wang Jian-Le, Zhang Zeng-Jie, Wu Ai-Min, Wang Xiang-Yang
机构信息
Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Second Medical School of Wenzhou Medical University, Zhejiang Spine Surgery Centre, Wenzhou, Zhejiang, China.
Department of Spine Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Second Medical School of Wenzhou Medical University, Zhejiang Spine Surgery Centre, Wenzhou, Zhejiang, China.
出版信息
World Neurosurg. 2018 Apr;112:e125-e133. doi: 10.1016/j.wneu.2017.12.171. Epub 2018 Jan 6.
OBJECTIVES
To investigate the effect of sequential ligament failure on the range of motion (ROM) and location of the instantaneous axes of rotation (IAR) of the thoracolumbar spine (T12-L1) finite element (FE) model, and to verify the role of the supraspinous ligament (SSL) in maintaining the stability of the injured thoracolumbar spine.
METHODS
An FE model of the fractured thoracolumbar spine was developed and validated against published data. The posterior ligamentous complex (PLC) in the fractured T12-L1 segment was then reduced in a sequential manner from the facet capsular ligament (FCL), part of the interspinous ligament (ISL), SSL, and entire ISL, to the ligamentum flavum (LF). The ROM and IAR of the T12-L1 segment were measured at the fracture and at each reduced ligament step under 4 directions of flexion, extension, lateral bending, and rotation, and 4 bending motions of 1.5, 3.0, 4.5, 6.0 Nm.
RESULTS
The FE model showed a consistent increase in the ROM and location of the IAR as the ligaments were removed sequentially. Furthermore, failure of the SSL had the most significant influence on the change in the ROM and IAR in flexion. In extension, removal of the FCL caused the largest shift.
CONCLUSIONS
The SSL is a significant ligament that allows the PLC to maintain the stability of the thoracolumbar spine during injury.
目的
研究连续韧带损伤对胸腰椎（T12-L1）有限元（FE）模型活动范围（ROM）和瞬时旋转轴（IAR）位置的影响，并验证棘上韧带（SSL）在维持损伤胸腰椎稳定性中的作用。
方法
建立骨折胸腰椎的有限元模型，并根据已发表的数据进行验证。然后，将骨折的T12-L1节段的后韧带复合体（PLC）从关节囊韧带（FCL）、部分棘间韧带（ISL）、SSL和整个ISL依次减少至黄韧带（LF）。在4个方向的前屈、后伸、侧屈和旋转以及1.5、3.0、4.5、6.0 Nm的4种弯曲运动下，测量骨折时以及每个韧带减少步骤下T12-L1节段的ROM和IAR。
结果
有限元模型显示，随着韧带依次被移除，ROM和IAR的位置持续增加。此外，SSL损伤对前屈时ROM和IAR的变化影响最为显著。在后伸时，移除FCL导致最大的移位。
结论
SSL是一种重要的韧带，可使PLC在损伤期间维持胸腰椎的稳定性。
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