模拟L4～5全椎板减压的生物力学实验研究.pdfVIP

江西医学院学报 2007年第47卷第6期 Acta Academiae Medicinae Jiangxi 2007，Vol 47，No6 · 27 · 模拟L4～5全椎板减压的生物力学实验研究 杨 东，舒 勇，李晓锋，刘东宁，黄勇全 (南昌大学第一附属医院骨一科，南昌330006) 摘要：目的 分析髓核摘除和全椎板减压对腰椎节段稳定的即刻效应。方法 6具T 。～s 人尸体腰椎标本用于 实验。对完整脊柱行载荷量250 N垂直压缩和10 Nm旋转实验，记录融合椎间隙L ～s及上下位相邻间隙L3～ ， Ls～s 的运动范围。L ～s后方髓核摘除加全椎板减压，再进行测试和比较。结果 L ～s髓核摘除及全椎板减压 后，L ～s节段压缩与旋转位移值明显增加，与完整脊柱比较有非常显著统计学差异(P0．01)；邻近节段运动变化 小。结论 髓核摘除及全椎板减压将导致减压节段即刻稳定性下降。 关键词：腰椎；减压术；生物力学；实验研究 中图分类号：R332．7 文献标识码：A 文章编号：10Oo一2294(2007)06--0027--03 Biomechanical Evaluation of Total Laminotomy of L4～5 in Vitro YANG Dong，SHU Yong，LI Xiao-feng，LIU Dong-ning，HUANG Yong-quan (1 st Department of Orthopaedic，the First A}}tliated Hospital of Nanchang University，Nanchang 330006，China) ABSTRACT：Objective To investigate immediately the stability of L4～5 after nucleus pulposus of intervertebral disc(RNP)and total laminotomy．Methods Six human cadaver specimens from T12～S1 were used in this study．The ranges of motions(R0M)of L4～5 and the adjacent segments (L3～4 and L5～S1)were recorded when the intact spine was tested under the axial compression of 250 N and torsion of 10 Nm respectively．The same indices were recorded and compared following RNP and total laminotomy．Results The R0M of L4～5 were increased significantly after RNP and total laminotomy and significant difference compared with the intact spine statistically(P0．O1)， the change of the adjacent segments was insignificant．Conclusion The stability of the decom- pressed segments reduce immediately following RNP and total laminotomy． KEY WORDS：lumbar spine；decompression；biomeehanics；experimental study 腰椎后路减压+髓核摘除术是治疗腰椎管狭窄 节与部分髂骨；L 椎体左右径在60～65 mm以内) 和椎间盘突出症的常见术式。由此产生的医源性失 的福尔马林浸泡标本，剔除脂肪及肌肉组织等软组 稳，已引起众多学者的重视；减压达何种程度须行融 织，保留韧带、