小关节分级切除对腰椎间盘突出症稳定性影响的生物力学研究

THE BIOMECHANIC RESEARCH FOR STABILITY IN THE LUMBAR DISC PROTRUSION WITH GRADED FACETECTOMY

目的：研究腰椎间盘突出症手术中小关节、椎间盘切除对腰椎稳定性的影响。方法：采用八具新鲜腰椎尸体标本进行生物力学应力分析，比较前屈、后伸、左侧屈、右侧屈等不同工况下Ｌ４～５双侧小关节分级切除后的稳定性的变化。结果：试验表明腰椎间盘突出症手术中小关节切除范围在侧隐窝减压至小关节１／２切除内应变强度、位移、 ＲＯＭ与正常标本相比有显著性差异（ｐ＜０．０５）。结论：（１）腰椎间盘突出症手术中小关节切除范围应以侧隐窝减压为最大切除范围。（２）如手术需要切除１／２小关节时应考虑加用内固定以提高稳定性。

Object: To study the effect of Resection of the facets and discs on the lumbar Stability in lumbar disc protrusion. Method: Lumbar specimens from eight fresh cadavers were biomechaniclly analysed and compared in flexion, extension and left and right lateral bendings. There was a variety of stability after L4-5 bilateral graded facetectomy. Result: The decompressed recess with resection of a half of the processes in lumbar disc protrusion was significantly different from the normal subjects in the stress, the displacement and ROM(P<0.05). Conclusion: (1)The ertent of resection to the decompression of the recess is completely enough in the treatment of lumbar disc protrusion. (2)If facetectomy of a half of the processes is needed, there an internal fixation should be added.