Wilder D G, Pope M H, Frymoyer J W
Department of Orthopaedics and Rehabilitation, University of Vermont, Burlington 05405.
J Spinal Disord. 1988;1(1):16-32.
A multipart study has been performed to provide a mechanical explanation for the epidemiologic association between sitting in static (e.g., factory or office) or vibration (e.g., car or truck driving) environments and acute herniated lumbar discs. It was shown that a 1 h exposure to sitting environments caused significant changes in the mechanical properties of the lumbar intervertebral disc. During many of the latter tests, specimens were unstable (exhibited by a sudden, large flexion and/or lateral bend rotation response to an axially applied load). This showed that a motion segment in the lumbar spine could suddenly buckle and apply a tensile impact loading to the posterolateral region of the disc. We also demonstrated that a combined lateral bend, flexion, and axial rotation vibration loading could cause tracking tears proceeding from the nucleus through the posterolateral region of the anulus. It suggests that a mechanism for disc herniation is mechanical changes leading to instability of the motion segment. These experiments complete the argument that lumbar disc herniations can be a direct mechanical consequence of prolonged sitting in static or vibration environments.
已开展一项多部分研究，旨在为长时间处于静态环境（如工厂或办公室）或振动环境（如汽车或卡车驾驶）与急性腰椎间盘突出症之间的流行病学关联提供力学解释。研究表明，暴露于坐姿环境1小时会导致腰椎间盘力学性能发生显著变化。在许多后续测试中，标本不稳定（表现为对轴向施加的载荷突然产生大幅度的屈曲和/或侧弯旋转反应）。这表明腰椎运动节段可能会突然弯曲，并对椎间盘后外侧区域施加拉伸冲击载荷。我们还证明，侧弯、屈曲和轴向旋转的联合振动载荷可导致从髓核穿过纤维环后外侧区域的追踪性撕裂。这表明椎间盘突出的一种机制是导致运动节段不稳定的力学变化。这些实验完善了这样一个观点，即腰椎间盘突出可能是长时间处于静态或振动环境的直接力学后果。
