C 5/6 椎间隙不同撑开高度对临近椎间盘压力的研究分析
罗春山,赵国权,梁栋柱,欧阳北平,陆廷盛,姚书眈,蒲兴魏
中国临床解剖学杂志 ›› 2015, Vol. 33 ›› Issue (6) : 696-699.
C 5/6 椎间隙不同撑开高度对临近椎间盘压力的研究分析
Different C5/6 intervertebral distracting height on the adjacent intervertebral disc pressure analysis
目的 研究C5/6椎间隙不同撑开高度对临近椎间盘压力的影响，以期能对临床工作中选择合适的椎间撑开高度提供依据。 方法 选取6具新鲜成人尸体上的颈椎制作标本，将制作好的标本放在BOSE动/静态材料试验机上加载中立、屈伸、侧弯、旋转的多维运动，分别测试在不同运动载荷下C5/6椎间隙撑开前，C5/6椎间隙撑开基准高度100%、120%、140%、160%时C4/5及C6/7椎间盘压力变化，对测得的压力值进行多重统计学比较分析。 结果 所有撑开器位置安装满意,统计分析显示：6例标本C5/6的平均高度值为6.8 mm；在不同椎间撑开高度下，颈椎后伸30°位时椎间盘压力最小(P<0.05)，有统计学意义；在120%的基准高度时，颈椎后伸30°位、左右侧弯30°位时C4/5与C6/7椎间盘压力值分别比其它基准高度测得压力值小(P<0.05)，有统计学意义；颈椎中立位时C4/5与C6/7椎间盘压力均小于100%、140%、160%时基准高度测得压力值，而大于未撑开前测得的椎间盘压力值；左右侧屈时,120%平均高度时C4/5,C6/7椎间盘压力值小于140%平均高度(P<0.05)，且两者与其他3种高度两两比较均有显著性差异(P<0.05)；左右旋转：各状态两两比较无显著差异(P>0.05)；1例标本在撑开160%的基准高度行前屈30°位时，出现关节突的关节囊韧带轻微撕裂。 结论 C5/6椎间盘摘除行椎间植骨时，选取基准高度的120%作为椎间隙撑开高度，对临近椎间盘压力变化影响较小，为合适的椎间隙撑开高度。
Objective To study the impact of C5/6 intervertebral distraction height of adjacent disc pressure, so as to select the appropriate height of intervertebral distraction and provide the basis for clinical work. Methods Six fresh adult corpses were selected and the cervical spines were prepared and mounted to BOSE dynamic/static load testing machine. Neutral position, flexion and extension, lateral bending, multi-dimensional movement of rotation, were tested under different loads. neck movement of C5/6 before intervertebral distraction, C5/6 intervertebral distraction reference height of 100%, 120%, 140%, 160% and C4/5、C6/7 disc pressure changes. The measured pressure values were subjected for multiple comparative statistical analysis. Results Installation of all distraction position was satisfactory. Statistical analysis showed that: the average height of C5/6 in the six specimens was 6.8 mm; under the condition of different intervertebral distraction, the disc pressure was minimal with 30° cervical extension(P<0.05); under the condition of 120% of the reference height, C4/5 and C6/7 disc pressure values were larger when cervical spine was extended for 30°, laterally bended for 30°than the pressure values measured when the cervical spine was at any other reference height (P<0.05); when the cervical spine was in neutral position measured pressure values of C6/7 and C4/5 disc pressure was less than those of 100%, 140%, 160% reference height；When the cervical spine was in both the left and right lateral bending, the C4/5, C6/7 disc pressure value at 120% of the average height was less than 140% of the average height (P<0.05); while the former was not greater than the intervertebral disc distraction measured pressure value compared with the other three were between two highly significant difference (P<0.05); left rotation: each state was no significant difference (P>0.05); ligament of facet joint capsule was slightly teared in 1 specimens,when specimens at 160% of the benchmark distraction and the height of the line 30° flexion position. Conclusion C5/6 cervical interbody disc when the removal of the line, select the reference level of 120% of intervertebral distraction as the height of the adjacent intervertebral disc pressure changes less affected intervertebral distraction for proper height.
Cervical / Disc pressure / Distraction height / Adjacent segment
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