Oxland T R, Lund T, Jost B, Cripton P, Lippuner K, Jaeger P, Nolte L P
M.E. Müller Institute for Biomechanics, University of Bern, Switzerland.
Spine (Phila Pa 1976). 1996 Nov 15;21(22):2558-69. doi: 10.1097/00007632-199611150-00005.
An in vitro biomechanical investigation in the human lumbar spine focuses on the functional significance of vertebral bone density and intervertebral disc degenerations.
To determine that interrelationship between vertebral bone density and intervertebral disc degeneration, their effect on normal spine motion, and their significance in the biotechnical performance of interbody fixation techniques.
A relationship between vertebral bone density and intervertebral disc degeneration has been suggested, but a definitive relationship has not been established. The effect of vertebral bone density and intervertebral disc degeneration on interbody stabilization remains unknown despite the rapidly increasing use of this surgical method for patients with chronic low back pain.
The vertebral bone density and intervertebral disc degeneration of 72 functional spinal units were determined using dual energy x-ray absorptiometry scans and macroscopic grading, respectively. A three-dimensional flexibility test was performed on 24 functional spinal units in the intact and stabilised conditions. The compressive behavior of the bone-implant interface was evaluated in 48 functional spinal units.
The vertebral bone density in moderately degenerated disc was significantly lower than at all other levels of intervertebral disc degeneration. Increasing intervertebral disc degeneration resulted in more axial rotation and less lateral bending. In flexion-extension and lateral bending, better vertebral bone resulted in significantly better stabilization. This trend was observed also in axial compression in which higher failure loads were observed with greater bone densities.
The authors conclude a significant relationship exists between bone density and disc degeneration, bone density is a highly important factor in the performance of interbody stabilization, and disc degeneration, is of moderate importance in signal motion.
一项针对人类腰椎的体外生物力学研究聚焦于椎体骨密度和椎间盘退变的功能意义。
确定椎体骨密度与椎间盘退变之间的相互关系、它们对正常脊柱运动的影响以及它们在椎间融合固定技术生物力学性能中的意义。
已有研究提示椎体骨密度与椎间盘退变之间存在关联，但尚未确立明确的关系。尽管这种手术方法在慢性下腰痛患者中的应用迅速增加，但椎体骨密度和椎间盘退变对椎间融合固定的影响仍不明确。
分别使用双能X线吸收测定扫描和宏观分级法测定72个功能脊柱单元的椎体骨密度和椎间盘退变情况。对24个功能脊柱单元在完整和稳定状态下进行三维柔韧性测试。对48个功能脊柱单元评估骨-植入物界面的压缩行为。
中度退变椎间盘处的椎体骨密度显著低于所有其他椎间盘退变程度的水平。椎间盘退变加重导致更多的轴向旋转和更少的侧方弯曲。在屈伸和侧方弯曲时，更好的椎体骨质导致显著更好的稳定性。在轴向压缩中也观察到这种趋势，即骨密度越高，失败载荷越高。
作者得出结论，骨密度与椎间盘退变之间存在显著关系，骨密度是椎间融合固定性能的一个非常重要的因素，而椎间盘退变在脊柱运动中具有中等重要性。
