后部结构逐级切除对腰椎三维稳定性的影响

Effects of gradual resection of spinal posterior structure on the three-dimensional stability of lumbar spine

目的 :研究后部结构逐级切除对腰椎三维稳定性的影响。方法 :选用 7具新鲜成人尸体脊柱标本 (L1～S1) ,通过逐级切除L4～ 5节段的后部结构 ,共形成 7种减压状态 ,运用脊柱三维运动实验机测试各模型的稳定性。结果 :全椎板加双侧小关节部分切除 ,脊柱的前屈及左 /右轴向旋转稳定性即已受到显著性破坏。结论 :腰椎后部韧带结构对脊柱的稳定性有重要作用。减压治疗时 ,在尽可能维持小关节完整性的同时 ,亦应尽量保留椎板及后部韧带等结构。

Objective: To evaluate the influence of gradual resection of the spinal posterior structure on the three-dimensional stability of lumbar spine. Methods: Seven experimental models were established by gradually resecting L_ 4～5 posterior structure of 7 fresh cadaver lumbar spine specimens (L_1～S_1). A three-dimensional movement device with the maximum load of 10.0N·m was used to produce movement. Results: The range of motion increased significantly after total laminectomies and partial resection of zygapophyseal joints. Conclusion: Besides zygapophyseal joints, laminae and posterior ligaments play an important role in restricting the three-dimensional movement of lumbar spine. The spinal posterior structure must be reserved as intact as possible in surgeries.