既往有颈椎或腰椎融合术患者在模拟挥鞭样损伤过程中颈椎耦合运动的生物力学：一项有限元研究。
Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion: A Finite Element Study.
作者信息
Huang H, Nightingale R W, Dang A B C
机构信息
Department of Biomedical Engineering, Pratt School of Engineering, Duke University, 305 Teer Engineering Building, BOX 90271, Durham, North Carolina 27708-0271, US.
Department of Orthopaedic Surgery, University of California, 500 Parnassus Avenue, MU-320W, 3rd Floor, San Francisco, California 94143, US
出版信息
Bone Joint Res. 2018 Jan;7(1):28-35. doi: 10.1302/2046-3758.71.BJR-2017-0100.R1.
OBJECTIVES
Loss of motion following spine segment fusion results in increased strain in the adjacent motion segments. However, to date, studies on the biomechanics of the cervical spine have not assessed the role of coupled motions in the lumbar spine. Accordingly, we investigated the biomechanics of the cervical spine following cervical fusion and lumbar fusion during simulated whiplash using a whole-human finite element (FE) model to simulate coupled motions of the spine.
METHODS
A previously validated FE model of the human body in the driver-occupant position was used to investigate cervical hyperextension injury. The cervical spine was subjected to simulated whiplash exposure in accordance with Euro NCAP (the European New Car Assessment Programme) testing using the whole human FE model. The coupled motions between the cervical spine and lumbar spine were assessed by evaluating the biomechanical effects of simulated cervical fusion and lumbar fusion.
RESULTS
Peak anterior longitudinal ligament (ALL) strain ranged from 0.106 to 0.382 in a normal spine, and from 0.116 to 0.399 in a fused cervical spine. Strain increased from cranial to caudal levels. The mean strain increase in the motion segment immediately adjacent to the site of fusion from C2-C3 through C5-C6 was 26.1% and 50.8% following single- and two-level cervical fusion, respectively (p = 0.03, unpaired two-way -test). Peak cervical strains following various lumbar-fusion procedures were 1.0% less than those seen in a healthy spine (p = 0.61, two-way ANOVA).
CONCLUSION
Cervical arthrodesis increases peak ALL strain in the adjacent motion segments. C3-4 experiences greater changes in strain than C6-7. Lumbar fusion did not have a significant effect on cervical spine strain.: H. Huang, R. W. Nightingale, A. B. C. Dang. Biomechanics of coupled motion in the cervical spine during simulated whiplash in patients with pre-existing cervical or lumbar spinal fusion: A Finite Element Study. 2018;7:28-35. DOI: 10.1302/2046-3758.71.BJR-2017-0100.R1.
目的
脊柱节段融合后活动丧失会导致相邻活动节段的应变增加。然而，迄今为止，关于颈椎生物力学的研究尚未评估腰椎耦合运动的作用。因此，我们使用全人有限元（FE）模型模拟脊柱的耦合运动，研究了颈椎融合和腰椎融合后在模拟挥鞭伤过程中的颈椎生物力学。
方法
使用先前验证的处于驾驶员-乘客位置的人体有限元模型来研究颈椎过伸损伤。根据欧洲新车评估计划（Euro NCAP）测试，使用全人有限元模型对颈椎进行模拟挥鞭伤暴露。通过评估模拟颈椎融合和腰椎融合的生物力学效应来评估颈椎和腰椎之间的耦合运动。
结果
正常脊柱中前纵韧带（ALL）的峰值应变范围为0.106至0.382，融合颈椎中为0.116至0.399。应变从颅侧到尾侧水平增加。在C2-C3至C5-C6融合部位紧邻的运动节段中，单节段和双节段颈椎融合后的平均应变增加分别为26.1%和50.8%（p = 0.03，非配对双因素检验）。各种腰椎融合手术后的颈椎峰值应变比健康脊柱中的应变小1.0%（p = 0.61，双向方差分析）。
结论
颈椎关节固定术会增加相邻运动节段的ALL峰值应变。C3-4节段的应变变化比C6-7节段更大。腰椎融合对颈椎应变没有显著影响。：H. Huang、R. W. Nightingale、A. B. C. Dang。颈椎或腰椎脊柱融合患者在模拟挥鞭伤过程中颈椎耦合运动的生物力学：有限元研究。2018；7：28-35。DOI：10.1302/2046-3758.71.BJR-2017-0100.R1。
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