腰椎间盘突出症不同术式的三维运动范围研究

Three dimensional movements of lumbar spine-An mechanical evalua-tion on different surgical methods in lumbar disc herniation

采用６具新鲜腰段脊柱标本，制成腰椎间盘突出的三种不同术式（开窗、半椎板及全椎板术）的模型，施以１０．０Ｎｍ的最大纯力矩，用摄影记录腰椎的运动，测量三种术式的腰推各节段的前屈／后伸、左／右侧弯、左／右轴向旋转运动。计算得到运动范围ＲＯＭ（Ｒａｎｇｅｏｆｍｏｔｉｏｎ）和中世区ＮＺ（Ｎｅｕｔｒａｌｚｏｎｅ）。将三种术式的ＲＯＭ及ＮＺ进行比较。结果表明：三种不同的腰椎间盘突出症手术方法间对腰椎的稳定性影响无明显的差异。对临床手术治疗椎间盘突出症有指导意义。

hree surgical methods,laminal fenestration,hemilaminectomy and total laminectomy,were simulated for the treatment of lumbar disc herniation in six fresh lumbar spine specimens ofyoung cadavers,A maximum of 10Nm pure moments were loaded increasingly.The flexion/ex-tension,right/left lateral bending and right/left axial rotation movements were recorded by pho-tography technique.The parameters of neutral zone(NZ)and the range of motion(ROM)werecalculated.The results showed that there is no significant difference among the three differentsurgical methods for lumbar disc herniation.