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不同负荷下下腰椎小关节的运动学特征及生物力学变化

Kinematic Characteristics and Biomechanical Changes of Lower Lumbar Facet Joints Under Different Loads.

作者信息

Song Yang, Wen Wang-Qiang, Xu Jin, Zhang Ze-Pei, Han Ye, Li Ke-Peng, Wang Xiao-Dong, Xu Hao-Xiang, Liu Jianan, Miao Jun

机构信息

Department of Graduate Institute, Tianjin Medical University, Tianjin, China.

Department of orthopaedics, Chifeng City Hospital, Inter Mongolia, China.

出版信息

Orthop Surg. 2021 May;13(3):1047-1054. doi: 10.1111/os.12894. Epub 2021 Mar 11.

Abstract

OBJECTIVE

To explore the kinematic biomechanical changes and symmetry in the left and right sides of the facet joints of lumbar spine segments under different functional loads.

METHODS

Participants (n = 10) performing standing flexion and extension movements were scanned using computed tomography (CT) and dual fluoroscopy imagine system. Instantaneous images of the L -S vertebrae were captured, and by matching a three-dimensional CT model with contours from dual fluoroscopy images, in vivo facet joint movements were reproduced and analyzed. Translations and rotations of lumbar vertebral (L and L ) facet joints of data were compared for different loads (0, 5, 10 kg). The participants performed flexion and extension movements in different weight-bearing states, the translations and angles changes were calculated respectively.

RESULTS

From standing to extension, there were no statistical differences in rotation angles for the facet joint processes of different vertebral segment levels under different weight loads (P > 0.05). Mediolateral axis and cranio-caudal translations under different weight loads were not statistically different for vertebral segment levels (P > 0.05). Anteroposterior translations for L (1.4 ± 0.1 mm) were greater than those for L (1.0 ± 0.1 mm) under the different load conditions (P = 0.04). Bilaterally, mediolateral, anteroposterior, and cranio-caudal translations of the facet joints under different weights (0, 10 kg) for each segment level (L and L ) were symmetric (P > 0.05). From flexion to standing, there were no statistical differences in rotation angles for different weights (0, 5, 10 kg) for each level (L and L ) (P > 0.05). There were no statistical differences between mediolateral, anteroposterior, and cranio-caudal translations at each segment level (L and L ) under different loads (P > 0.05). Under the condition of no weight (0 kg), L mediolateral translations on the left side (1.7 ± 1.6 mm) were significantly greater (P = 0.03) than those on the right side (1.6 ± 1.6 mm). Left side (1.0 ± 0.7 mm) L mediolateral translations were significantly smaller (P = 0.03) than those on the right side (1.1 ± 0.7 mm). There were no statistical differences between different weights for either anteroposterior and cranio-caudal translations (P > 0.05). There were no statistical differences for mediolateral, anteroposterior, and cranio-caudal translations for 10 kg (P > 0.05).

CONCLUSION

Lumbar spine facet joint kinematics did not change significantly with increased loads. Anteroposterior translations for L were greater than those for L of the vertebral segments are related to the coronal facet joint surface. Changes in facet surface symmetry indicates that the biomechanical pattern between facet joints may change.

摘要

目的

探讨腰椎节段小关节在不同功能负荷下的运动生物力学变化及左右两侧的对称性。

方法

对10名进行站立位屈伸运动的参与者使用计算机断层扫描(CT)和双荧光透视成像系统进行扫描。采集L-S椎体的瞬时图像,通过将三维CT模型与双荧光透视图像的轮廓进行匹配,再现并分析体内小关节运动。比较不同负荷(0、5、10千克)下腰椎(L和L)小关节数据的平移和旋转情况。参与者在不同负重状态下进行屈伸运动,分别计算平移和角度变化。

结果

从站立位到伸展位,不同体重负荷下不同椎体节段水平的小关节突关节旋转角度无统计学差异(P>0.05)。不同体重负荷下椎体节段水平的内外侧轴和头尾向平移无统计学差异(P>0.05)。在不同负荷条件下,L的前后向平移(1.4±0.1毫米)大于L的前后向平移(1.0±0.1毫米)(P=0.04)。双侧,每个节段水平(L和L)在不同体重(0、10千克)下小关节的内外侧、前后向和头尾向平移是对称的(P>0.05)。从屈曲位到站立位,每个水平(L和L)在不同体重(0、5、10千克)下的旋转角度无统计学差异(P>0.05)。不同负荷下每个节段水平(L和L)的内外侧、前后向和头尾向平移无统计学差异(P>0.05)。在无负重(0千克)条件下,L左侧的内外侧平移(幅度为平均1.7±1.6毫米)显著大于右侧(平均1.6±1.6毫米)(P=0.03)。L左侧的内外侧平移(平均1.0±0.7毫米)显著小于右侧(平均1.1±0.7毫米)(P=0.03)。前后向和头尾向平移在不同体重之间无统计学差异(P>0.05)。10千克负荷下的内外侧、前后向和头尾向平移无统计学差异(P>0.05)。

结论

腰椎小关节运动学不会随负荷增加而发生显著变化。L椎体节段的前后向平移大于L椎体节段,这与冠状面小关节面有关。小关节面对称性的变化表明小关节之间的生物力学模式可能会改变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59f3/8126911/69d875577c07/OS-13-1047-g008.jpg

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