颈椎单侧关节突交锁脱位的软组织损伤及其相关因素

The soft tissue injury and its related factors in unilateral locked facet of cervical spine

目的研究颈椎单侧关节突交锁的软组织损伤、旋转角度、椎体脱位程度及其相关性。方法 4具C1-T1段40g/L甲醛浸泡成人颈椎标本,破坏C4-5双侧关节囊前侧、内侧部分。用自制夹具,分别在侧屈旋转、前屈旋转下模拟颈椎单侧关节突交锁,并部分模拟肌肉收缩。结果前屈旋转比侧屈旋转对软组织损伤大;单侧关节突交锁平均旋转角度为19.75°,椎体脱位均为Ⅰ度脱位。结论 屈曲旋转的复合暴力是颈椎单侧关节突交锁的力学机制,关节囊的破坏是成功建立模型的关键,交锁侧黄韧带、1/2以上纤维环的破坏是必须的,棘上、棘间韧带的阻力较小,软组织的损伤程度和椎体的旋转角度无关,与椎体的脱位程度相关。

Objective To study the soft tissue injury,vertebral body rotation angle,vertebral dislocation and their correlation in unilateral locked facet of cervical spine.Methods Four adult cervical spine specimens dipped in formalin including C1-T1,which were eliminated the double anterior and medial C4-5 articular capsule.We simulated unilateral locked facet of cervical spine under the flexion and rotation by using tailar-made clamp,simulating partially muscle contraction.Results The soft tissue injury caused by anteflexion and rotation was more severe than lateral flexion and rotation,the average rotary angle was 19.75°and the vertebral dislocation was Ⅰ°dislocation in unilateral locked facet of cervical spine.Conclusion The inflective and rotary force is necessary to establish unilateral locked facet of cervical spine,destroying the articular capsule is the key to establish model and the ipsilateral ligamentum flavum with more than 1/2 annular fibrosus destroy are necessary;the resistance of supraspinous and intraspinous ligamnents is small;soft tissue injury and vertebral body rotation angle have no correlation,which is related with vertebral dislocation.