Goel V K, Nye T A, Clark C R, Nishiyama K, Weinstein J N
Spine (Phila Pa 1976). 1987 Mar;12(2):150-9. doi: 10.1097/00007632-198703000-00011.
A technique to study the effects of spinal injury and stabilization in terms of load-deformation behavior is described. Fresh human cadaveric ligamentous spine segments (T12-sacrum) were potted and clinically relevant loads applied through the loading frame attached to the topmost vertebra of the specimen. The resulting three-dimensional motion responses of each vertebra for the normal specimen were recorded with the Selspot II System. The specimen was injured at the L4-5 motion segment to represent a typical surgical decompression used in treating patients with spinal stenosis and tested again. The decompressed (or injured) motion segment was stabilized with a Luque closed-loop (Luque rectangle) system before repeating the test protocol. The data of these tests indicate that the injury (surgical decompression) at the L4-5 motion segment leads to a significant increase in motion--in flexion, extension, and axial modes--indicating the possible necessity for stabilization of the injured segment. The closed-loop system reduces the motion at the injured level, with respect to normal specimen behavior, by 35%. Therefore, the system does not provide complete immobilization (100% reduction with respect to normal specimen behavior). The stabilizing effects of the closed loop in lateral bending are not significant and are marginal in axial motion. The motion across the L3-4 motion segment in flexion increases significantly after stabilization. The clinical implications and the need for further studies are also discussed.
本文描述了一种通过负荷-变形行为来研究脊柱损伤及稳定效果的技术。将新鲜的人体尸体韧带性脊柱节段(T12-骶骨)进行固定,并通过连接到标本最上方椎体的加载框架施加与临床相关的负荷。使用Selspot II系统记录正常标本中每个椎体产生的三维运动响应。在L4-5运动节段对标本造成损伤,以模拟治疗腰椎管狭窄症患者时使用的典型手术减压过程,然后再次进行测试。在重复测试方案之前,用鲁克闭环(鲁克矩形)系统对减压(或损伤)的运动节段进行稳定处理。这些测试数据表明,L4-5运动节段的损伤(手术减压)导致在屈曲、伸展和轴向模式下的运动显著增加,这表明可能需要对损伤节段进行稳定处理。与正常标本行为相比,闭环系统使损伤节段的运动减少了35%。因此,该系统并不能提供完全固定(相对于正常标本行为减少100%)。闭环在侧弯中的稳定作用不显著,在轴向运动中作用微弱。稳定处理后,L3-4运动节段在屈曲时的运动显著增加。文中还讨论了其临床意义以及进一步研究的必要性。