Ma Tao, Tu Xiaoshuang, Li Junyang, Wu Jingwei, Nong Luming
Orthopedics Department, The Third Affiliated Hospital of Nanjing Medical University, Changzhou 213164, China.
Orthopaedics Department, Nanjing Medical University, Nanjing 211103, China.
Bioengineering (Basel). 2025 Apr 14;12(4):414. doi: 10.3390/bioengineering12040414.
This study's purpose is to investigate the lumbar biomechanical effects of unilateral partial facetectomy (UPF) of different facet joint (FJ) portions under percutaneous endoscopy.
Forty fresh calf spine models were used to simulate UPF under a physiological load performed through three commonly used needle insertion points (IPs): (1) The apex of the superior FJ (as the first IP); (2) The midpoint of the ventral side of the superior FJ (as the second IP); (3) The lowest point of the ventral side of the superior FJ (as the third IP). The range of motion (ROM) and the L4/5 intradiscal maximum pressure (IMP) were measured and analyzed under a physiological load in all models during flexion, extension, left-right lateral flexion, and left-right axial rotation.
When UPF was performed through the second IP, the ROM of the lumbar spine and the L4/5 IMP in the calf spine models were not statistically different from the intact calf spine model.
UPF through the second IP resulted in a minimal impact on the biomechanics of the lumbar spine. Thus, it might be considered the most appropriate IP for UPF.
本研究旨在探讨经皮内镜下不同关节突关节（FJ）部分的单侧部分关节突切除术（UPF）对腰椎生物力学的影响。
使用40个新鲜小牛脊柱模型，通过三个常用的进针点（IP）在生理负荷下模拟UPF：（1）上关节突的顶点（作为第一个进针点）；（2）上关节突腹侧的中点（作为第二个进针点）；（3）上关节突腹侧的最低点（作为第三个进针点）。在所有模型的生理负荷下，测量并分析在屈曲、伸展、左右侧屈和左右轴向旋转过程中的活动范围（ROM）和L4/5椎间盘内最大压力（IMP）。
当通过第二个进针点进行UPF时，小牛脊柱模型中腰椎的ROM和L4/5 IMP与完整小牛脊柱模型相比无统计学差异。
通过第二个进针点进行UPF对腰椎生物力学的影响最小。因此，它可能被认为是UPF最合适的进针点。
