Nightingale R W, McElhaney J H, Richardson W J, Best T M, Myers B S
Department of Biomedical Engineering, Duke University, Durham, North Carolina, USA.
J Bone Joint Surg Am. 1996 Mar;78(3):412-21. doi: 10.2106/00004623-199603000-00013.
The purpose of this study was to analyze, with use of an impact model, the relationships among motion of the head, local deformations of the cervical spine, and the mechanisms of injury; the model consisted of the head and neck of a cadaver. Traditionally, the mechanisms of injury to the cervical spine have been associated with flexion and extension motions of the head and neck. However, the classification of the mechanisms is not always in agreement with the patient's account of the injury or with lacerations and contusions of the scalp, which indicate the site of the impact of the head. Eleven specimens were dropped in an inverted posture with the head and neck in an anatomically neutral position. Forces, moments, and accelerations were recorded, and the impacts were imaged at 1000 frames per second. The velocity at the time of impact was on the order of 3.2 meters per second. The angle and the padding of the impact surface varied. Observable motion of the head did not correspond to the mechanism of the injury to the cervical spine. Injury occurred 2.2 to 18.8 milliseconds after impact and before noticeable motion of the head. However, the classification of the mechanism of the injuries was descriptive of the local deformations of the cervical spine at the time of the injury. Accordingly, it is a useful tool in describing the local mechanism of injury. Buckling of the cervical spine, involving extension between the third and sixth cervical vertebrae and flexion between the seventh and eight cervical vertebrae, was observed. Other, more complex, buckling deformations were also seen, suggesting that the deformations that occur during impact are so complex that they can give rise to a number of different mechanisms of injury.
本研究的目的是使用一种冲击模型来分析头部运动、颈椎局部变形和损伤机制之间的关系；该模型由一具尸体的头部和颈部组成。传统上，颈椎损伤机制一直与头部和颈部的屈伸运动有关。然而，这种机制的分类并不总是与患者对损伤的描述一致，也与头皮的撕裂伤和挫伤不一致，而这些损伤表明了头部撞击的部位。11个标本以头颈部处于解剖学中立位置的倒置姿势掉落。记录了力、力矩和加速度，并以每秒1000帧的速度对撞击进行成像。撞击时的速度约为每秒3.2米。撞击表面的角度和衬垫有所不同。头部的可观察到的运动与颈椎损伤机制并不对应。损伤发生在撞击后2.2至18.8毫秒，且在头部明显运动之前。然而，损伤机制的分类描述了损伤时颈椎的局部变形。因此，它是描述局部损伤机制的一个有用工具。观察到颈椎的屈曲，包括第三和第六颈椎之间的伸展以及第七和第八颈椎之间的屈曲。还观察到其他更复杂的屈曲变形，这表明撞击过程中发生的变形非常复杂，可能会引发多种不同的损伤机制。
