摘要
背景:日常生活中较多的活动有坐位前屈运动参与,然而,关于坐位前屈过程对腰椎间盘形变及应变特征的影响报道较少。目的:分析坐位时腰椎间盘的在体形态和应变特征。方法:采用双透视成像系统和CT对10名无症状受试者的L4-5和L5-S1水平进行椎间盘应变特征分析,男5例,女5例,年龄25-35岁,体质量指数(22.4±1.8)kg/m^(2)。测定受试者在直立坐位和前屈坐位时椎间盘整体、纤维环内外侧的高度改变,以及坐位最大前屈运动中椎间盘的轴向、剪切应变范围。结果与结论:①直立坐位和前屈坐位下L4-5、L5-S1各区域纤维环内外侧高度比变化规律相似,前屈运动中L4-5各区域高度比的变化范围在0-0.1之间,然而,L5-S1椎间盘高度显著降低,变化范围为0.02-0.39;②坐位前屈运动过程中,L5-S1在各个区域均处于压缩应变,尤其在右侧较L4-5显著压缩了28.3%(P=0.011);而L5-S1的剪切应变均大于上位椎间盘,在中心区域较L4-5应变显著增大14.8%(P=0.011);③提示坐位前屈运动对L5-S1椎间盘各部分高度及应变模式均有较大的影响,而对L4-5影响较小;L5-S1在该过程中整体处于压缩状态,左右两侧压缩不对称,并且各个区域具有更大的剪切应变;这些特征有助于对椎间盘应变改变所致的退变有更深入的了解,也有助于帮助术后患者达到更好的康复状态。
BACKGROUND:More activities in daily life involve sitting forward motion;however,the effect of the sitting forward process on lumbar disc deformation and strain characteristics has been less reported.OBJECTIVE:To analyze the morphological changes of the lumbar disc during sitting forward flexion and the characteristics of strain.METHODS:Dual fluoroscopic imaging system and computed tomography were used to determine the strain characteristics of the intervertebral discs.L4-5 and L5-S1 levels were studied in 10 asymptomatic subjects(male/female:5/5,age:25-35 years,body mass index:22.4±1.8 kg/m^(2)).The height changes of the disc as a whole,the medial and lateral annulus fibrosus in upright sitting and forward flexion sitting was measured.The ranges of tensile and shear strains in the disc during maximum forward flexion motion were determined in the sitting position.RESULTS AND CONCLUSION:(1)During sitting and forward flexion,L4-5 and L5-S1 showed similar patterns of change in the medial to lateral height ratios in each region of the annulus fibrosus,with a range of 0-0.1 for L4-5 in forward flexion,but a significant decrease in disc height in L5-S1,with a range of 0.02-0.39.(2)During sitting in forward flexion,L5-S1 was under compressive strain in all regions,especially on the right side,where it was 28.3%more compressed than L4-5(P=0.011).The shear strain of L5-S1 was greater than that of the superior disc,with a significant increase of 14.8%in the central region compared to L4-5(P=0.011).(3)It is indicated that forward flexion movement during sitting has a greater effect on the height and strain pattern of all parts of the disc at L5-S1,but less at L4-5.L5-S1 is in compression as a whole during the process,with asymmetric compression on the left and right sides,and with greater shear strain in each region.These characteristics help us to gain a better understanding of degeneration due to altered disc strain and to help postoperative patients achieve a better state of recovery.
作者
寇博文
韩晔
郝一光
徐浩翔
文王强
张泽佩
兰杰
苗军
Kou Bowen;Han Ye;Hao Yiguang;Xu Haoxiang;Wen Wangqiang;Zhang Zepei;Lan Jie;Miao Jun(Tianjin Medical University,Tianjin 300000,China;Department of Spine Surgery,Tianjin Hospital,Tianjin University,Tianjin 300211,China)
出处
《中国组织工程研究》
CAS
北大核心
2022年第36期5792-5797,共6页
Chinese Journal of Tissue Engineering Research
基金
国家自然科学基金(81472140),项目负责人:苗军。
关键词
腰椎
椎间盘应变
坐位
前屈
形态学
应变
lumbar spine
intervertebral disc deformation
sitting position
forward flexion
morphology
strain
