尸体腰椎研究中的肌肉模拟
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IMPORTANCE OF MUSCLE SIMULATION FOR CADAVERIC STUDY OF LUMBER SPINE
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    摘要:

    如果我们在体外脊柱运动研究中没有对肌肉作用进行适当的模拟则研究结果无多大的临床意义。腰椎部位的椎间关节主要承载身体的重量和背部肌肉产生的张力。背部肌肉的主要功能是产生与外力和惯性刀相抗衡的弯矩。椎间盘在矢状面运动中起支点作用。由于杠杆臂是恒定的,所以为身体重心前移产生的较大弯矩将对背部肌肉拖加较大的压力,相应地,椎间盘的承载也增大了,虽然我们知道肌肉运动对维持腰椎的稳定性起很重要的作用,但在体外对其进行模拟研究却较少见。本文选用一些研究者使用过的模型,探讨它们的生理意义,另外还提供了一种新的可结合对肌肉运动进行模拟的新模型,旨在对整个腰椎的矢状面运动情况进行模拟。为了证实模型的有效性,我们测试了一些腰椎尸体标本,将获得的节段间运动数据和椎间盘压力值与一些研究者的临床结果作了比较。

    Abstract:

    Parasplnal muscle action was included in the simulation of flexlon and extension of the lumbar spine in an in-vitro biomechanical study. An axial preload was applied anteriorly to a lumbar spine specimen to simulate the body weight with balance being maintained by a pair of cables attached to the posterior of the specimen, simulating the action of the erector spinae muscle in vivo. In each simulated posture, the three-dimensional orientation of each vertebra and intradiscal pressures of intervertebral discs were determined and analyzed. Six human cadaveric specimens were tested. The results showed that the L4-5 segment was the principle contributor to flexion while in extension the L5-S1 level contributed most. The relative contribution of each segment to the total flexion and extension of the lumbar spine varied with level. These data suggested that inter-segmental mobility of each level in flexion and extension ranges should not be combined as a single quantity I)ut should be studied separately. This study also Indicates that muscle simulation is important for cadaveric study of the lumbar spine. The magnitudes of intradiscal pressures recorded in this study were found to be similar to that measured in vivo of normal lumbar discs. Although the authors recognize that the conditions simulated in this investigation are not truly physiological, they maintain that the spinal motions obtained in this study are closer to those occurring in vivo than would he the case if experiments were conducted without muscle simulation.

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周鸿奇,颜忠熙,陆瓞骥,梁智仁.尸体腰椎研究中的肌肉模拟[J].医用生物力学,1999,14(1):7-10

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