Orthopaedic and Injury Biomechanics Group, Departments of Mechanical Engineering and Orthopaedics, University of British Columbia, 818 W 10th Ave, Vancouver, BC, V5Z 1M9, Canada.
International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, BC, V6T 1Z4, Canada.
Sci Rep. 2020 Apr 28;10(1):7114. doi: 10.1038/s41598-020-63974-w.
There is currently no established injury criterion for the spine in compression with lateral load components despite this load combination commonly contributing to spinal injuries in rollover vehicle crashes, falls and sports. This study aimed to determine an injury criterion and accompanying tolerance values for cervical spine segments in axial compression applied with varying coronal plane eccentricity. Thirty-three human cadaveric functional spinal units were subjected to axial compression at three magnitudes of lateral eccentricity of the applied force. Injury was identified by high-speed video and graded by spine surgeons. Linear regression was used to define neck injury tolerance values based on a criterion incorporating coronal plane loads accounting for specimen sex, age, size and bone density. Larger coronal plane eccentricity at injury was associated with smaller resultant coronal plane force. The level of coronal plane eccentricity at failure appears to distinguish between the types of injuries sustained, with hard tissue structure injuries more common at low levels of eccentricity and soft tissue structure injuries more common at high levels of eccentricity. There was no relationship between axial force and lateral bending moment at injury which has been previously proposed as an injury criterion. These results provide the foundation for designing and evaluating strategies and devices for preventing severe spinal injuries.
尽管这种侧向加载组合在翻车、跌倒和运动中经常导致脊柱损伤，但目前还没有确立用于脊柱压缩伴侧向加载分量的损伤标准。本研究旨在确定颈椎节段在施加不同冠状面偏心距的轴向压缩下的损伤标准和伴随的耐受值。33 个人体尸体功能脊柱单位在施加力的三个侧向偏心距大小下进行轴向压缩。通过高速视频识别损伤，并由脊柱外科医生进行分级。基于包含考虑标本性别、年龄、大小和骨密度的冠状面载荷的标准，使用线性回归来定义颈部损伤耐受值。损伤时的冠状面偏心距越大，相应的冠状面力就越小。失效时的冠状面偏心距水平似乎可以区分所承受的损伤类型，低偏心距时更常见硬组织结构损伤，高偏心距时更常见软组织结构损伤。损伤时的轴向力与横向弯矩之间没有关系，这一点以前曾被提出作为损伤标准。这些结果为设计和评估预防严重脊柱损伤的策略和装置提供了基础。
