重建颈后方韧带复合体单、双开门椎板成形术的生物力学比较研究

A biomechanical comparison of single or double-door laminoplasty with reconstruction of the posterior cervical ligamentous complex in goat

目的:比较重建颈后方韧带复合体单、双开门椎板成形术后生物力学的差异。方法:新鲜山羊颈椎标本24具,随机分成3组,每组8具。A组,完整标本组,保留后方项韧带、伸肌等伸颈结构,切除前方结构;B组,在A组基础上行重建颈后方韧带复合体单开门椎板成形手术;C组,在A组基础上行重建颈后方韧带复合体双开门椎板成形术。在电子万能试验机上行生物力学实验,测试项目包括三点折弯试验、轴向拉伸试验和压缩试验,分析比较三组间的差异性。结果:三点折弯试验中标本变直时的位移、加载力,A、B、C三组间无显著性差异(P>0.05)。拉伸试验中各拉伸负荷下与变直时的位移,A、B、C三组间无显著性差异(P>0.05)。压缩试验中,A、B、C三组间位移无显著性差异(P>0.05)。结论:在对抗颈椎变直和前屈的应力方面,重建颈后方韧带复合体单、双开门颈椎板成形术间无明显差别,都最大限度保留了颈后方韧带复合体的功能。

Objective：To compare the biomechanical effects of single or double-door laminoplasty with reconstruction of the posterior cervical ligamentous complex in goat.Method：24 fresh cervical spine specimens of goat were randomly divided into three groups（8 specimens in each group ）.Group A,all anterior elements of the cervical spine were removed,leaving the posterior muscles intact.Group B,based on the group A,single- door laminoplasty with reconstruction of posterior cervical ligamentous complex was performed.Group C,based on the protocol of group A,double-door laminoplasty with reconstruction of posterior cervical ligamentous complex was performed.Lateral bending compression and axial extension were tested respectively in each group under electric muhipotential machine.Result：With deformation of the specimen and loading stress in flexion experiment,there was no significant difference among group A,B and C （P〉0.05）.When loading stress made the specimen straight in axial extension experiment,there was no significant difference among group A,B and C either（P〉0.05）.In anterior loading experiment,there was also no significant difference among group A,B and C （P〉0.05）.Conclusion：Both single and double-door laminoplasty with reconstruction of the posterior cervical ligamentous complex utmostly reserved the function of the posterior cervical ligamentous complex.Compared with the intact specimens,the function of tensile stress of the posterior cervical ligamentous complex was no significant different in both single or double-door laminoplasty with reconstruction of the posterior cervical ligamentous complex.