椎间盘摘除术对腰椎稳定性的影响

Effects of discectomy on the stability of the lumbar spine

本实验研究应用Ｅｌｉｔｅ三维立体摄像运动分析系统观察一个节段和多个节段椎间盘摘除对整个腰椎稳定性的影响。结果表明，单纯Ｌ４～５椎间盘摘除术后于屈曲３０°时，Ｌ４～５水平位移（Ｔｚ）及旋转位移（Ｒｘ）有明显增加。Ｌ４～５及Ｌ５～Ｓ１椎间盘同时摘除术后于屈曲１０°时，不但Ｌ４～５及Ｌ５～Ｓ１节段Ｔｚ和Ｒｘ显著增加，同时亦有相邻的Ｌ３～４节段活动显著增加。实验结果提示，椎间盘摘除术后，特别是多个椎间盘摘除术后，有导致腰椎在生理活动范围内出现手术节段及相邻节段不稳的倾向。

The biomechanical effect of discectomy on the motion behavior of whole lumbar spine were investigated using an Elite motion analyzer system. Four fresh human specimen were fixed at the sacrum and a physiological loads applied through a loading frame. The motion behavior of the specimens after each discectomy was recorded. Antero-posterior translation(Tz) and saggittal rotation (Rx) were increased at L4-5 level after L4-5 discectomy subject to flexion 30 degree. Tz and Rx were increased at L4-5 level subject to flexion 20-30 degree and at L2-S1 level subject to 10-30 degree after L4-5 and L5-S1 discectomy, meanwhile, Tz and Rx were increased at adjacent L3-4, level subject to flexion 30 degree. The clinical relevance of these findings were discussed.