椎间盘髓核摘除对腰椎间小关节承载功能影响的实验研究.DOCVIP

临床医学论文-椎间盘髓核摘除对腰椎间小关节承载功能影响的实验研究 ?????????? 作者：徐力鹏，肖进，原林，赵卫东，樊继宏 【关键词】? 椎间盘 　　[摘 要] 目的?? 分析椎间盘髓核摘除后腰椎小关节受力大小及变化情况。方法 采用8具新鲜脊柱腰骶段（L1～S1）标本，在MTS系统上用压敏片分别测量L3－L4、L4－L5两个节段小关节面在中立位和前屈、后伸位时受力大小；摘除L4－L5椎间盘髓核，重复测量。结果 完整脊柱标本中，L4－L5与L3－L4节段关节面受力大小相似：中立位时受力占轴向压缩载荷的15%；前屈10°、20°时受力占压缩载荷的比例减为9%、5%；后伸10°、20°时受力占压缩载荷的比例增至23%、33%。L4－L5椎间盘髓核摘除后，L4－L5节段小关节面在各个运动状态下受力均显著增大，而L3－L4节段小关节受力也有增加的趋势。结论???????????????????????????????????????? 腰椎小关节有一定的承载功能。腰椎间盘切除术后，同一平面及相邻平面小关节受力增加，可能引发腰痛。 　　[关键词]? 腰椎；小关节；压敏片；生物力学；髓核摘除???????????????????????????????????????????????????????????????????????????????? 　　Changes of force of the lumbar facet joints after lumbar disc excision: an in vitro study ????????? Abstract: Objective　To study the force of lumbar facet joints before and after lumbar disc excision. Methods Totally 8 fresh lumbar-sacral spines (L1-S1) were placed on the MTS system. The compressive stress of the facet joints of the L3－L4 and L4－L5 motion segments was measured using pressuresensitive films. The compressive stress on lumbar facet joints was measured in the position of erection, flexion and extension. Then L4－L5 nucleus was resected and and the force was measured when the same positions were repeated. Results? L3－L4 and L4－L5 segments could bear the same force before operation. In neutral position, the facet joints could carry about 15% axial compressive stress. In flexion posture, the force borne by the facet joints decreased. In flexion at 10 , 20 , the force was about 9% and 5% of the compressive force. In extension position, the force of the facet joints increased. In extention at 10 , 20 , the force was about 23% and 33%, respectively. After disc excision, the force of facet joints of L4－L5 increased remarkably, and the force of L3－L4 also had the trend of increase. Conclusion The lumbar facet joints can share some of the compressive forces of the spine. The force of facet joints of the discresected segment and the adjacent segment increases, which may be a reason of lumba