黄韧带致压颈脊髓的生物力学实验研究
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Biomechanical Study on Cervical Spinal Cord Compressed by Ligamentum Flavum in Human Cadaver
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    摘要:

    目的观察不同姿势下黄韧带致压颈脊髓时,不同压缩比和不同压缩面积与硬膜囊前后方压力变化的关系。方法C4-C5间钻圆形骨孔,设计一致压棒穿过该骨孔来模拟黄韧带突出物的致压作用。最大压缩比为椎管前后径的60%。同时用压力传感器通过前方开孔记录前方压力变化,改变颈椎姿势后重复实验。结果当压缩比较小时(10%~20%),压缩力在左弯(30°)时最大,当压缩比较大时(50%~60%),压缩力在前屈(30°)时最大。前方测得的压力大约是后方压力的27.8%,且随着压缩头直径的增大而增大。结论硬膜囊上所受的压力同压缩比、压缩头直径以及颈椎姿势关系密切。已受压的颈脊髓在全前屈及全后伸运动中更容易受到伤害。

    Abstract:

    Objectives To determine compressive force on anterior and posterior wall of the dura under posterior compression by ligamentum flavum with incremental compression ratios and different compression shapes in all posture. Methods Round bone window was drilled between C4 and C5 vertebral body of five fresh C2-C7 cervical spines. A compression-inducing pole (CIP) was made and slided into the bone window to simulate the hernia of ligamentum falvum. The compression ratio ranged from 10% to 60% of the canal diameter, a force record pole (FRP) and an anterior window were also made to record the compressive force caused by posterior compression. Results When the compression ratio is low (10%-20%), the compressive force is the biggest in left bending (30°). When the compression ratio is high (50%-60%), the compressive force is the biggest in flexion (30°). The compressive force on anterior wall of the dura is around 27.8% of that on posterior wall in all compression ratios, which enlarged with increase of the diameter of the CIP. Conclusion The force induced on the dura relate strongly with the compression ratio, the diameter of CIP and the posture of the cervical spine. Compressed spinal cords are easy to be deteriorated in full flexion and full extension.

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陈维毅,张学锋,赵斌,马讯,范永贵.黄韧带致压颈脊髓的生物力学实验研究[J].医用生物力学,2005,20(1):5-10

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