颈前路椎间撑开的在体研究

In vivo research of intervertebral distraction during anterior cervical surgery

目的:研究颈椎前路手术中撑开的扭力变化,分析撑开扭力的构成原因,为椎间撑开有关问题提供量化依据。方法:用特制的能测定撑开扭力的颈椎前路撑开器,在41例三组病人颈椎前路次全椎体切除术中测定3种状态下撑开椎体时的扭力变化,统计分析其变化趋势,并分析其临床意义。结果:撑开扭力随着撑开的高度先平稳增加,前柱完全撑开时扭力急剧增加。不同病例组撑开的扭力增幅绝对值不等,但曲线类型相似,颈椎外伤病人最大撑开扭力较颈椎退变病人明显低(P<0.01)。结论:撑开扭力增幅曲线先缓慢增加后急剧增加,术中应逐步撑开,颈椎骨折时撑开力应相应减小,撑开扭力增幅明显增加的高度为合适椎间撑开高度。

Objective:To investigate the torsion variation during the anterior cervical surgery while distracting the cervical interverterbral space,to analyze the constitution of distracting torsion to provide quantified bases for anterior intervertebral distracting.Method:By use of self-built torsion displayable anterior cervical retractor in the anterior corpectomy operation we measured the torsion value in41patients of3groups in3different stages of the surgery.Analyzing the results and constructing the distraction variation curve,and then analyze the clinical significance.Result:The vertebral distracting torsion was increased slightly at first and dramatically when the intervertebral space was entirely distracted.There was no difference of curve type in different patient groups but torsion value.The maximal torsion needed to distract the space was much smaller in patient with cervical trauma than in splondylosis(P<0.01).Conclusion:Distracting curve is a smooth-slightly increasing line at first and a dramatical parabola when the intervertebral space is entirely distracted.Distraction should be gradually during the operation and more mildly in cervical fracture patients,the appropriate distracting height might be the height when distracting torsion increased dramatically.