脊柱阶段性解剖特点及其损伤的力学机制与诊疗策略

From anatomy to injury mechanism and clinical strategy, a systemic review

脊柱在结构支撑、力学传递及神经保护方面发挥着重要的作用。脊柱损伤及其造成的畸形、残疾在现代社会日益引起临床工作者的重视,但由于其解剖结构和损伤的生物力学机制复杂,损伤后往往难以判断其稳定性,为精准的临床治疗带来困难。此外,临床医生少有机会通过常规渠道系统地学习生物力学知识,导致其对脊柱损伤机制及损伤后结构改变所带来的力学影响,认识不深刻,判断不准确,容易造成治疗效果不佳、愈后差等问题。为了简明地了解相关的生理力学特点及损伤机制,本文综述了脊柱的解剖结构和受力时的生物力学特点,并以常见的脊柱骨折为例阐述了颈椎、胸椎、腰椎损伤的发生机制,着重分析了影响脊柱稳定性的相关因素,为临床决策提供理论参考。

The spine plays an important role in structural support,mechanical transmission and neuroprotection.In modern society,spinal injury and its resulting disability have attracted increasing attention from clinical workers.However,due to the complex of anatomical structures and biomechanical mechanism of trauma,it is often difficult to judge its stability after injury,which brings difficulties for accurate clinical treatment.In addition,clinicians seldom have the opportunity to systematically study biomechanics through conventional channels,which makes them cannot sufficiently understand the mechanism of spinal injury and the following structural changes,for which proper treatment and satisfied recovery are never easy to be achieved.To simply review related anatomic and mechanical characteristics,this paper expounds the injury mechanism of cervical vertebra,thoracic vertebra,lumbar and analyzes the related factors which influence the stability of the spine,providing theoretical reference for clinical decision making.