颈椎后部结构对颈椎稳定作用的实验研究

EXPERIMENT STUDY OF THE EFFECTS OF POSTERIOR STRUCTURES ON THE CERVICAL SPINE STABILITY

①目的研究颈椎后部结构对颈椎稳定所起的作用，为临床确定手术入路、病变切除范围及术后是否考虑重建稳定提供参考依据。②方法实验选用福尔马林固定尸体标本１０具，去除骨骼肌，保留骨性结构、椎间盘及韧带结构。依次破坏棘上、棘间韧带，黄韧带，椎板，椎间关节，前、后纵韧带。持续加载４ｋｇ行颈椎标本最大屈、伸实验，拍摄中立位及前屈、后伸位Ｘ线片。③结果椎板结构对椎板角度位移稳定起较大作用，而椎间关节对颈椎的水平稳定及旋转稳定起较大作用。前、后纵韧带分别在伸、屈位时起重要的稳定作用，破坏后均出现在最大屈、伸位时的椎体间断裂。④结论颈椎后部结构在颈椎稳定中起重要作用。

Objective To study the effects of posterior structures on the stability of cervical spine, and provid evidence for the clinical approache, range of structure removal and rebuilding of the cervical spine stability during operation. Methods Cadaver cervical spines were fixed by formalin with the muscle removed and were used to destroy the following structure one by one: supraspinous and interspinous ligaments and ligamentum flavum, laminae, facets, anterior and posterior longitudinal ligaments. 4 kg lose was applied to the spine on flexion and extension. Results The laminae structure played a more important role in AD stability. After destroying it, AD increased. Facets appeared to play a significant role in limiting rotation and HD, removing of the facets resulted in HD increasing and significant rotation, especially in C5 and C6. Anterior longitudinal ligament contributed more to stability of the spine in extension than the posterior ligaments. Cutting posterior ligaments limited flexion more effectively than the anterior ligaments. Destroying the anterior longitudinal ligaments caused fracture in all of the 5 specimens when extension was simulated. However, fracture occurred in another 5 specimens in flexion when posterior ligaments was transected. ConclusionThis study showed that the posterior structures of cervical spine played a very important role in stability of cervical spine. It provided the experiment evidences for clinical work.