颈椎在体运动学研究方法的进展

The research processes of in vivo kinematics of the cervical spine

背景:颈椎在体运动学研究能够通过侵袭性或非侵袭性方法获取生理载荷下活体颈椎的活动特性,可为颈椎疾病的诊断和治疗提供指导和参考。目的:对目前有关颈椎在体运动学的研究方法和各自特点进行归纳总结。方法:应用计算机检索Pubmed数据库(http://www.ncbi.nlm.nih.gov/pubmed/)及万方数据库(http://www.wanfangdata.com.cn),英文检索词为"Spine,cervical,invivomotion",中文检索词为"脊柱,颈椎,测量,活动度"。检索文献总计238篇,最终选取30篇作为综述文献。结果与结论:颈椎在体运动学研究可获取活体颈椎各个关节6个自由度(6DOF)的量化数据,对提高生理载荷下颈椎运动状况的认识水平,进一步了解颈椎退变的运动学特点,以及优化临床颈椎疾患的诊疗方案有重要作用,同时可为人工椎间关节及内固定器尤其是非融合内固定物的研制提供不可或缺的参考数据。其主要通过X射线、CT、MRI、超声、电磁等方法实现,但目前仍缺乏颈椎各节段在体运动范围公认的数值,颈椎在体运动学研究仍需不断深入。

BACKGROUND：The research of in vivo kinematics of the cervical spine can obtain the characteristics of cervical motion in physiological load by invasive or non-invasive method,which will provide the guidelines and reference for the diagnosis and treatment of patients with cervical degeneration diseases.OBJECTIVE：To summarize the current research methods and their respective characteristics of in vivo kinematics of the cervical spine.METHODS：The computer-based search was done in PubMed database（http：//www.ncbi.nlm.nih.gov/pubmed/） and Wanfang database（http：//www.wanfangdata.com.cn） for articles published with the English key words of ＂Spine,cervical,in vivo motion＂ and the Chinese key words of ＂Spine,cervical,measurement,rang of motion＂.Ultimately a total of 238 literatures were searched and 30 literatures were included for review according to inclusion and exclusion criteria.RESULTS AND CONCLUSION：The research of in vivo kinematics of the cervical spine can obtain the quantitative data of each joint 6DOF of the cervical vertebra.It has an important role in improving the level of awareness of cervical movement in physiological load,knowing more about the kinematic characteristics of cervical spine degeneration and optimizing the clinical diagnosis and treatment programme of cervical diseases.At the same time,it can provide indispensable data for the development of artificially vertebral articulatory and internal fixation,especially the fusion of internal fixation.The research of in vivo kinematics of the cervical spine has been investigated by using X-ray,CT,MRI,ultrasound,electromagnetism and so on.However,the present data cannot provide a reference standard for understanding normal conditions.The future research of in vivo kinematics of the cervical spine needs to be advanced gradually.