The Department of Orthopedics, The Third Medical Center of PLA General Hospital, Beijing 100039, China.
Senior Department of Orthopedics, The Fourth Medical Center of PLA General Hospital, Beijing 100048, China.
J Healthc Eng. 2021 Oct 29;2021:2869488. doi: 10.1155/2021/2869488. eCollection 2021.
Lumbar disc herniation is one of the common clinical diseases of the lower lumbar spine in orthopedics. The purpose is to remove the herniated disc nucleus pulposus tissue, remove the compressed part of the disease, and relieve symptoms, such as nerve pain. In the past, biomechanics research mostly relied on in vitro measurements, but the complicated internal environment of the human body prevented us from further measurement and research. However, with the development of computer technology, the use of computer CT scanning, software three-dimensional reconstruction, and displacement study three-dimensional spine biomechanics method makes the research of biomechanics into in vitro simulation stage and has gradually become the focus of current research. The postoperative biomechanics was simulated and the comparison model was established at the same time. At the same time, we combined the clinical follow-up data and studied the clinical data for the treatment of postoperative recurrence of lumbar disc herniation. We compared and analyzed the initial operation method and the experimental results and obtained the prevention of recurrence. The results showed that when one inferior articular process was removed, the lumbar spine appeared unstable to rotate to the opposite side; when one inferior articular process was completely removed, the movement of the lumbar spine in all directions was unstable. Better research on the biomechanical properties of the spine will help the diagnosis and treatment of clinical lumbar disc herniation. Therefore, when performing posterior lumbar spine surgery, not only should the exposure of the surgical field and thorough decompression be considered, but also the biomechanical properties of the lumbar spine should be comprehensively evaluated.
腰椎间盘突出症是骨科下腰椎常见的临床疾病之一。其目的是切除突出的椎间盘髓核组织，切除病变的受压部分，缓解神经疼痛等症状。过去，生物力学研究主要依赖于体外测量，但人体内部复杂的环境阻止了我们进一步的测量和研究。然而，随着计算机技术的发展，利用计算机 CT 扫描、软件三维重建和位移研究三维脊柱生物力学方法，使生物力学研究进入了体外模拟阶段，并逐渐成为当前研究的焦点。同时模拟术后生物力学并建立对比模型，结合临床随访资料，对腰椎间盘突出症术后复发的临床资料进行研究，对比分析初始手术方法与实验结果，得出预防复发的结论。结果表明，当一个下关节突被切除时，腰椎会向对侧旋转不稳定；当一个下关节突被完全切除时，腰椎在各个方向的运动都不稳定。更好地研究脊柱的生物力学特性将有助于临床腰椎间盘突出症的诊断和治疗。因此，在进行后路腰椎手术时，不仅要考虑手术野的暴露和彻底减压，还要全面评估腰椎的生物力学特性。
