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通过生物力学方法探索椎间盘和小关节在退行性脊柱侧凸发展中的病理作用。

Exploring the pathological role of intervertebral disc and facet joint in the development of degenerative scoliosis by biomechanical methods.

作者信息

Zheng Jie, Yang Yonghong, Cheng Boyle, Cook Daniel

机构信息

First Department of Orthopaedics, The Spine Surgery Therapeutic Center, The 903th Hospital of PLA, Hangzhou 310004, China.

First Department of Orthopaedics, The Spine Surgery Therapeutic Center, The 903th Hospital of PLA, Hangzhou 310004, China.

出版信息

Clin Biomech (Bristol). 2019 Dec;70:83-88. doi: 10.1016/j.clinbiomech.2019.08.006. Epub 2019 Aug 16.

DOI:10.1016/j.clinbiomech.2019.08.006
PMID:31445401
Abstract

BACKGROUND

To investigate the biomechanical changes in the development of scoliosis due to intervertebral disc and facet joint degeneration.

METHODS

We enrolled 39 cases of fresh-frozen lumbar spine specimens and underwent CT scanning and 3D reconstruction. An Osirix Dicom imaging system was to assess the degeneration of the intervertebral disc and facet joints, and mechanical loading was conducted using a spine mechanical instrument with the frequency set at plus/minus 7.5 NM, 0.005 Hz. Range of motion (ROM) and neutral zone (NZ) of 39 cadaveric lumbar spines were tested.

FINDINGS

Degeneration existed in all 39 cases of the lumbar specimens: the Cobb angle >10° in 5 cases (degenerative scoliosis (DS) group), between 3° and 10° in 9 cases (pre-degenerative scoliosis (PS) group) and <3° in 25 cases (no scoliosis (NS) group). The axial torsion (AT) range of motion (ROM) and the NZ of the DS and PS groups was greater than in the NS group and increased with increasing Cobb angle. A significant correlation was found between the degeneration of the intervertebral disc and the AT and the AT correlated with the Cobb angle and facet joint degeneration.

INTERPRETATION

The AT correlated with intervertebral disc and facet joint degeneration, which might be a mechanic factor in the occurrence and development of degenerative scoliosis.

摘要

背景

探讨椎间盘和小关节退变导致脊柱侧弯发展过程中的生物力学变化。

方法

我们纳入了39例新鲜冷冻的腰椎标本，进行CT扫描和三维重建。使用Osirix Dicom成像系统评估椎间盘和小关节的退变情况，并使用脊柱力学仪器进行力学加载，频率设定为正负7.5牛米，0.005赫兹。测试了39个尸体腰椎的活动范围（ROM）和中性区（NZ）。

结果

39例腰椎标本均存在退变：Cobb角>10°的有5例（退行性脊柱侧弯（DS）组），3°至10°的有9例（退变前脊柱侧弯（PS）组），<3°的有25例（无脊柱侧弯（NS）组）。DS组和PS组的轴向扭转（AT）活动范围（ROM）和中性区大于NS组，且随Cobb角增大而增加。发现椎间盘退变与AT之间存在显著相关性，且AT与Cobb角和小关节退变相关。

解读

AT与椎间盘和小关节退变相关，这可能是退行性脊柱侧弯发生和发展的一个力学因素。

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