摘要
[目的]评价轴向循环载荷对腰椎间盘髓核摘除术后腰椎稳定性的影响。[方法]从6具新鲜猪腰椎标本上截取18个脊柱功能单位（FSU）,行单侧椎板开窗髓核摘除术,根据施加轴向循环载荷峰值的不同随机分为A、B、C三组（300~500 N、300~2 000 N、300~3 500 N）,每组6个标本,观察其轴向循环载荷前后椎间盘高度的变化,以及在轴向压缩、前屈后伸和左右侧弯等运动工况下,椎间盘的应变、位移和轴向压缩刚度变化。[结果]循环载荷前后,A组椎间盘高度、刚度、位移变化无显著性差异（P〉0.05）,应变增大有显著性差异（P〈0.05）;B、C组椎间盘高度和刚度的降低、应变和位移的增大均有显著性差异（P〈0.01）。循环载荷后三组间比较,椎间盘高度、应变、位移和刚度的变化幅度均随轴向循环载荷峰值的增大而变大（P〈0.05）。[结论]腰椎间盘髓核摘除术后轴向循环载荷使腰椎稳定性下降,并且随着峰值载荷的增大,稳定性逐渐降低。提示对于临床病例,腰椎间盘髓核摘除术后不宜过早下床负重活动,术后早期较小的椎间盘载荷有利于腰椎稳定性的修复。
[Objective]To elucidate the effect of axial cyclic loads on the motion stability of lumbar after discectomies. [Methods]Eighteen lumbar functional spinal units（FSU） from six fresh porcine lumbar specimens after unilateral vertebral plate discectomy were selected and randomly divided into three groups：groups A,B and C.Each group concluded 6 FSU.Three groups were subjected to cyclic axial loading at three different peak loads of 500 N,2 000 N and 3 500 N.Each FSU was measured of the height,strain,stiffness and displacement of intervertebral disc in axial compression,flexion,extension,left and right bending positions.[Results]After cyclic axial loads,the height,stiffness of the disc decreased and the strain,displacement increased significance than the initial value in group B and group C（P0.01）.There was no significance in group A than the initial value except the strain.Within three groups,changes after cyclic axial loads were not obvious with the augmentation of the peak loads（P0.05）.[Conclusion]These results demonstrate that the effect of cyclic axial loads after unilateral vertebral plate discectomy may lead to spinal instability,and the changes were more obviously with the augmentation of the peak loads.Clinically,the importance of minimum disc loads and strict bed confinement shonld be underscored in the early stage after surgery.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2011年第1期58-61,共4页
Orthopedic Journal of China
基金
南京军区医学科研"十一五"重点课题(编号:06Z07)
关键词
猪
腰椎
髓核摘除术
轴向循环载荷
脊柱稳定性
pig
lumbar vertebrae
discectomy
axial cyclic loads
spinal stability
