摘要
目的借鉴腰椎人工椎间盘置换成熟的经验,评价颈椎人工椎间盘置换对失稳颈段脊柱稳定性的重建作用。方法在6具新鲜尸体的颈椎标本上切除C5～6椎间盘,将人工颈椎间盘假体植入该间隙内。对该颈椎节段进行前屈/后伸、左/右侧弯和左/右旋转运动稳定性评价,经颈椎三维运动测量系统测出该节段的运动范围(ROM)。随后施加2Nm,0.6Hz的疲劳载荷共2500次,评定其稳定性,并与标准的C5～6椎间盘破坏后稳定性值相比较。结果正常C5～6前屈、后伸运动范围平均值为17.03°;人工椎间盘植入后前屈、后伸运动范围7.80°,疲劳载荷后前屈、后伸运动范围9.98°;椎间盘破坏后前屈、后伸运动范围25.53°,人工椎间盘植入具有显著的稳定性。正常左右侧弯运动范围平均值为10.75°;人工椎间盘植入后和疲劳载荷后左右侧弯运动范围分别为8.43°和9.43°,椎间盘破坏后左、右侧弯运动范围20.70°。正常左、右旋运动范围平均值为14.82°;人工椎间盘植入后和疲劳载荷后左、右旋运动范围分别为13.38°和13.83°,椎间盘破坏后左右旋运动范围25.88°。结论颈椎间盘破坏后椎节稳定性显著性破坏。人工椎间盘植入后脊柱在前屈、后伸,左右侧弯方向上稳定性显著性改善,左右旋转接近正常值,并可提供59%正常屈伸活动,88%正常左右侧弯活动,93%正常左右旋?
Aim To evaluate the stability of the cervical intervertebral disc prosthesis. Methods Six fresh frozen cadaveric C5- 6 motion segments with intact ligaments were used. The C? - 6 discs were resected and implanted with cervical intervertebral disc prosthesis. A cyclic load was applied to the specimens at the rate of 0.6 Hz up to 2 500 cyclis. The ranges of motion (ROMs) of the segments were measured using stereophotogrammetry before and after the prosthesis replacement. Results The normal mean ROM of C? 6 anteoflexion/post extension was 17.03° and 7.8° respectively before and after the prosthesis replacement. After fatigue load it was 9.98° , and after disc damage it was 25.53° ( P< 0.01) . The normal mean ROM of C5? 6 left/right lateral bending was 10.75° . The mean ROMs of C5- 6 left/right lateral bending were 8.43° , 9.43° and 20.70° after the prosthesis replacement, fatigue load and disc damage respectively( P< 0.01) . The normal mean ROM of C5? 6 left/right axial rotation was 14.82° . The mean ROMs of C5? 6 left/right axial rotation were 13.38° , 13.83° and 25.88° after the prosthesis replacement, fatigue load and disc damage( P< 0.01) . Conclusion After the disc destroyed, the stability of the motion segment decreased significantly. After cervical intervertebral disc prosthesis replacement, it is significantly improved in the stability of anteflexion/post extension and left/right lateral bending. The mean ROM of C5- 6 left/right axial rotation is close to the normal value. <P>
出处
《中国临床康复》
CSCD
2003年第17期2388-2389,共2页
Chinese Journal of Clinical Rehabilitation
基金
上海市科技发展基金资助项目(编号:024419075)~~
