脊柱三维运动分析和颈椎稳定性的实验研究
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ANALYSIS OF SPINAL THREE-DIMENSIONAL MOTIONS AND EXPERIMENTAL STUDY OF CERVICAL SPINAL STABILITY
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    摘要:

    本文研制了基于双平面立体测量和计算机图像处理的脊柱三维运动的分析系统,该系统可以确定椎体的空间位置和节段间的线位移和角位移。颈椎双侧小关节切除可导致颈椎不稳定,需植骨融合或内固定。本文对Halifax椎板夹和棘突钢丝固定进行了生物力学评价,作为恢复稳定性的一个指标,为临床上选择合适的固定形式提供依据。在9具新鲜成人颈椎标本(C3-T1)上、对双侧75%小关节切除后失稳的C4-5节段,安放了Halifax椎板夹和棘突钢丝固定,通过脊柱三维运动稳定性评价方法,评价它们重建颈椎稳定性的即刻效果。本文研究表明:(1)Halifax椎板夹能够在前屈、后伸和侧弯运动方向上加强节段的稳定性,恢复节段的轴向旋转运动的稳定性;(2)棘突钢丝固定在前屈运动方向上可加强节段的稳定性,可恢复节段在后伸、侧弯和轴向旋转运动方向上的稳定性;(3)棘突钢丝固定后节段的前屈、后伸和侧弯运动范围均大于Halifax椎板夹固定后的运动范围,尤其是在限制前屈运动时,Halifax椎板夹的固定作用更为明显,但两者限制颈椎轴向旋转运动的能力相近。

    Abstract:

    A system to measure and analyse three-dimensional movements of spine was developed, which is capable of determining the position of points on vertebral and calculating linear and angle displacements of spinal segment. Bilateral facetectomy of cervical spine, as a posterior decompression leading to the instability, must be applied the fusion or the internal fixation to stable the cervical spine. The stable capacity of Halifax Clamp and wire fixation to the instable cervical spine was studied in order to choose an suitable fixation in clinic. On nine fresh adult cervical spinal specimens (C 3-T1), the three-dimensional motions of C4-5 segment were analysed to evaluate the immediate stability following bilateral facetectomy, Halifax Clamp and wire fixation.The results showed that the stability with Halifax Clamp was greater than that of the intact state in flexion, extension and lateral bending, but the same asin axial rotation. The stability with wire fixation was greater and equal to inflexion and in extension,lateral bending and axial rotation respectively. The ROMs with Halifax Clamp were bigger than those with wire fixation in flexion, extension and lateral bending, but closed to in axial rotation.

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朱青安,钟世镇,胡庆茂,徐波.脊柱三维运动分析和颈椎稳定性的实验研究[J].医用生物力学,1996,11(4):193-198

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