| 吴运昌,王征,宋凯,吴兵,张国莹,赵永飞.椎间盘减压在椎体去旋转中的作用[J].脊柱外科杂志,2018,16(5):297-301. |
椎间盘减压在椎体去旋转中的作用  点此下载全文 (Fulltext) |
| 吴运昌 王征 宋凯 吴兵 张国莹 赵永飞 |
| 中国人民解放军总医院骨科, 北京 100853 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2018.05.010 |
| 摘要点击次数: 523 |
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| 摘要： |
| 目的 利用成年猪脊柱标本探讨椎间盘减压在椎体去旋转中的作用。方法 采集6具新鲜成年猪脊柱制作成包括2个相邻椎体及1个椎间盘的标本36个（T8~L6 12个椎间盘各3个标本），用聚甲基丙烯酸甲酯（PMMA）包埋固定。将标本固定在Instron拉扭试验机上，轴向逆时针旋转上位椎体6°，复位后再顺时针旋转6°，记录不同旋转方向的扭矩最大值（绝对值）。之后在椎间盘右后侧（棘突的逆时针方向）进行初步椎间盘减压，重复测量并记录扭矩最大值（绝对值）。最后行扩大切开纤维环减压，再次测量并记录数据。计算2次减压在逆时针方向及顺时针方向上分别造成的扭矩最大值降幅。结果 逆时针方向旋转所需扭矩最大值在减压前、初次减压后、扩大减压后分别为（12.43±3.71）N·m、（10.44±3.32）N·m、（8.12±2.90）N·m，顺时针方向分别为（12.57±4.12）N·m、（10.94±3.81）N·m、（7.97±3.52）N·m。扩大减压在顺时针方向造成的降幅值为（2.97±1.90）N·m，高于初次减压的降幅[（1.63±0.74）N·m]，也高于扩大减压在逆时针方向的降幅[（2.32±1.56）N·m]，差异均有统计学意义（P<0.05）。结论 椎间盘减压能够显著降低椎体轴向旋转所需扭矩，并且其效果存在"递减效应"。 |
| 关键词：胸椎 腰椎 脊柱侧凸 减压术,外科 生物力学 猪 |
| Role of disc decompression in resistance to vertebral rotation Fulltext |
| WU Yun-chang WANG Zheng SONG Kai WU Bing ZHANG Guo-ying ZHAO Yong-fei |
| Department of Orthopaedics, General Hospital of Chinese People's Liberation Army, Beijing 100853, China |
| Fund Project: |
| Abstract: |
| Objective To investigate the effect of disc decompression on resistance to vertebral rotation torque in the spine of adult pigs. Methods Six fresh adult porcine spines were involved and made into 36 specimens which consisted of 2 adjacent vertebral bodies and 1 intervertebral disc from T8 to L6,with 3 specimens each of 12 vertebral discs. The specimens were embedded with polymethylmethacrylate(PMMA). Then the specimens were fixed on the Instron tensile torsion test machine. The caudal vertebra was immobilized,while the upper vertebra was rotated 6° counterclockwise and clockwise(first test),and the maximum torques were recorded in both directions. Then,the initial disc decompression(second test) was performed on the right posterior side of the disc(the counterclockwise direction of the spinous process),and the maximum torque(absolute value) was measured and recorded. Finally,the extended annulus decompression(third test) was performed,and data were measured and recorded again. The maximum torque reduction caused by the 2 decompressions in counterclockwise direction and clockwise direction was calculated. Results The maximum torques required for counterclockwise rotation were (12.43±3.71)N·m,(10.44±3.32)N·m and (8.12±2.90)N·m in 3 tests,respectively;the maximum torques for clockwise were (12.57±4.12)N·m,(10.94±3.81)N·m and (7.97±3.52)N·m,respectively. The torque reduction by the extended decompression was (2.97±1.90)N·m in the clockwise direction,which was significantly higher than that by the initial decompression in the same direction[(1.63±0.74)N·m],and significantly higher than that in the opposite direction[(2.32±1.56)N·m] as well,both with significant difference(P<0.05). Conclusion Disc decompression can significantly reduce torque required for axial deflection. The effect of disc decompression on reducing torque follows the law of diminishing. |
| Keywords:Thoracic vertebrae Lumbar vertebrae Scoliosis Decompression,surgical Biomechanics Swine |
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