摘要
目的:通过模拟颈黄韧带病变对颈脊髓后方致压,观测颈脊髓前后方所受压力与致压深度的关系,为临床手术方式的选择提供生物力学依据。方法:采用5具新鲜成人尸体颈脊柱标本(C2～C7)通过后方C4/5间骨窗置入直径9.58mm的半球形致压物模拟颈椎黄韧带病变时对颈脊髓后方所形成的压迫,硬膜囊前方测压杆与硬膜囊接触端为直径18mm弧形圆柱形面,圆柱形面纵轴与颈脊髓纵轴相吻合。实验对颈脊髓由后向前致压,致压深度分别为椎管中矢径的10%～60%,依次增加10%,分别测量不同致压深度下,颈脊髓前后方所受压力。结果:不同致压深度时,脊髓前方所受压力变化为0.0003±0.0028N～0.1065±0.0628N,各相邻致压深度间颈脊髓前方所受压力两两比较无统计学差异(P>0.05);脊髓后方所受压力变化为0.0003±0.0032N～0.7355±0.3340N,致压深度为椎管中矢径的10%～30%时各相邻致压深度间颈脊髓后方所受压力两两比较差异无显著性(P>0.05),致压深度为椎管中矢径的30%～60%时各相邻致压深度间颈脊髓后方所受压力两两比较差异有显著性(P<0.05)。随致压深度的增加颈脊髓后方所受压力明显加大,二者呈非线性关系,相同致压深度时脊髓前、后方所受压力比较均有显著性差异(P<0.05)。结论:颈脊髓后方致压时脊髓前后方所受压力比较差异显著,脊髓前后方所受压力与致压深度密切相关呈非线性关系,以致压局部所受压力最大,提示临床手术方式选择应以直接减压为主。
Objective：To evaluate the relationship between the stress on cervical cord-meningeal complex （CCMC） compressed posteriorly and the degree of canal occlusion by simulating cervical abnormal ligamentum flavum and provide the biomechanical evidence for the choice of operation.Method：Specimens of five intact fresh cervical spine （C2-C7） from adult cadavera were collected and abnormal ligamentum flavum was simulated by placing a hemispherical steel ball（diameter 9.58mm） in the back of the canal through the C4-5 bone window.Compress the CCMC from posterior with the degree of canal occlusion varying from 10% to 60% （with an interval of 10%）,and then measure the stress on the CCMC from anterior simultaneously under different conditions of canal occlusion with pressure transducer.Collect and analyse the data using SAS 8.0 statistical program package.Significance was set on the level of（P〈0.05）.Result：The stress on the anterior of the CCMC was changed from 0.0003±0.0028N to 0.1065±0.0628N with the degree of canal occlusion varying from 10% to 60%（with an interval of 10%）;There was no significance between neighboring degree of canal occlusion （P〉0.05）.The stress on the posterior of the CCMC was varied from 0.0003±0.0032N to 0.7355±0.3340N in different depth.There was no significance between the 10% and 30%（P〉0.05）,while remarkable significance between 30% and 60% （P〈0.05 ）.The stress on the posterior of the CCMC increased greatly with the increasing of the degree of canal occlusion.With nonlinear relationship between them.Conclusion：The significance is remarkable between the anterior and posterior stress on spinal meninges by CMCC compressed posteriorly.The stress is strongly associated with the degree of canal occlusion but present nonlinear relationship,especially at the compression site which suggest that the direct decompression should be performed.
出处
《中国脊柱脊髓杂志》
CAS
CSCD
2007年第2期129-132,共4页
Chinese Journal of Spine and Spinal Cord
关键词
颈脊髓
后方致压
生物力学
Cervical cord
Compressed posteriorly
Biomechanics
