Goel V K, Clark C R, Harris K G, Schulte K R
Department of Biomedical Engineering, University of Iowa, Iowa City.
J Orthop Res. 1988;6(4):611-9. doi: 10.1002/jor.1100060419.
The effect of multiple-level total laminectomies followed by stabilization on the load-deformation behavior of the cervical spine is described. Fresh human ligamentous cervical spines (C2-T2) were potted and clinically relevant load types applied via a loading frame attached to the C-2 vertebra of the specimen. A set of three infrared light-emitting diodes (LEDs) were attached rigidly to each of five vertebrae (C3-7) to record their spatial locations after each load step application, using a Selspot II system. The specimen was tested again after total laminectomy performed on C5. The supraspinous, interspinous, and flavum ligaments between the C4-5 and C5-6 motion segments were cut; thereafter, the vertebral arch was removed. The specimen testing was resumed after inducing injury at C-6 in a similar fashion. The specimen was stabilized, using a facet wiring construct, across the C4-7 segment before testing for the final time. The load-deformation data of the injured and stabilized tests were normalized with regard to the corresponding results of the intact test. In flexion-extension mode, an increase in motion of about 10% after laminectomies was observed. Facet wiring was found to be an effective technique to stabilize injured cervical spines (approximately equal to 80% reduction in motion, compared with intact spines, was observed.
描述了多级全椎板切除术后进行固定对颈椎负荷-变形行为的影响。将新鲜的人体颈椎韧带标本（C2-T2）进行固定，并通过连接到标本C-2椎体的加载框架施加与临床相关的负荷类型。在五个椎体（C3-7）中的每个椎体上牢固地连接一组三个红外发光二极管（LED），以便在每次施加负荷步骤后使用Selspot II系统记录它们的空间位置。在对C5进行全椎板切除术后再次对标本进行测试。切断C4-5和C5-6运动节段之间的棘上韧带、棘间韧带和黄韧带；此后，切除椎弓。以类似方式在C-6造成损伤后恢复标本测试。在最后一次测试之前，使用小关节钢丝固定结构对C4-7节段的标本进行固定。将损伤和固定测试的负荷-变形数据相对于完整测试的相应结果进行归一化。在屈伸模式下，观察到椎板切除术后运动增加约10%。发现小关节钢丝固定是稳定受伤颈椎的有效技术（与完整脊柱相比，观察到运动减少约80%）。
