Background: Infants with congenital muscular torticollis are born with an asymmetric range of motion and a muscular imbalance in the cervical spine, as a result of a shortening or excessive contraction of the sternocl...Background: Infants with congenital muscular torticollis are born with an asymmetric range of motion and a muscular imbalance in the cervical spine, as a result of a shortening or excessive contraction of the sternocleidomastoid muscle. Purpose: The study aimed to investigate passive range of motion (PROM) for rotation and lateral flexion, and muscle function of the cervical spine in children that had a history of CMT as infants. Study design: a prospective cohort study. Patient sample: 58 children at the age of 3.5 to 5 years that had been treated for CMT have infants participated in the study. Method: PROM was measured with protractors and muscle function was estimated with a modified Muscle Function Scale. Data from infancy were taken from earlier records. Result: PROM in rotation of the neck was mean 98.7° and PROM in lateral flexion of the neck was mean 69.1°. Symmetric PROM of the neck was found in 74% of the children for rotation and in 88% of the children for lateral flexion. Multiple regression showed that gender and PROM in rotation as infants had a significant impact on asymmetric PROM. Forty-five percent of the children had some degree of muscular imbalance in the lateral flexors of the neck. Conclusion: Possible risk factors for later asymmetric PROM are: gender, birth weight, gestation week and PROM in rotation as infants. These factors ought to be taken into consideration when developing guidelines for long-term follow-up.展开更多
目的研究Discover、Prodisc-C人工椎间盘置换术与植骨融合术后下颈椎活动度（range of motion,ROM）、椎间盘应力、韧带张力的生物力学特性以及植入假体力学性能的改变。方法建立C5-6椎间盘退变3种手术方案：Discover、Prodisc-C人工椎...目的研究Discover、Prodisc-C人工椎间盘置换术与植骨融合术后下颈椎活动度（range of motion,ROM）、椎间盘应力、韧带张力的生物力学特性以及植入假体力学性能的改变。方法建立C5-6椎间盘退变3种手术方案：Discover、Prodisc-C人工椎间盘置换和自体髂骨植骨融合有限元模型,同时建立C4-7节段下颈椎原始模型。分析术后下颈椎C4-7节段在矢状面、冠状面及横断面上椎体的生物力学特性变化。结果术后手术节段关节ROM变化：Discover模型增加12.7%-73.1%,Prodisc-C模型增加74%-98%,植骨融合模型下降55.8%-71.8%。Discover置换后上邻近椎间盘应力无明显增加,下邻近椎间盘应力在前屈、后伸、轴向旋转工况下减少33.2%-54.2%,囊韧带张力增幅比Prodisc-C置换后减少30%-40%。Discover假体最大应力（36.72 MPa）出现在前屈工况下,小于Prodisc-C假体的最大应力（42.66 MPa）。结论人工椎间盘置换术可以保留手术节段的运动性能,Discover作为新一代人工椎间盘假体,在减少韧带负担和维持脊柱稳定性方面有所进步。研究结果可为颈椎前路融合手术和人工颈椎间盘置换术的临床研究提供理论依据。展开更多
目的：探讨单节段及双节段颈椎融合手术对颈椎活动度的影响。方法：选取2010年6月～2012年6月在皖南医学院附属弋矶山医院脊柱外科行颈椎前路减压融合术的43例颈椎病患者，其中单节段融合29例，双节段融合14例。根据症状及x线片评价手...目的：探讨单节段及双节段颈椎融合手术对颈椎活动度的影响。方法：选取2010年6月～2012年6月在皖南医学院附属弋矶山医院脊柱外科行颈椎前路减压融合术的43例颈椎病患者，其中单节段融合29例，双节段融合14例。根据症状及x线片评价手术的有效率及融合节段的融合率。使用颈椎活动度测量仪（cervical range of motion device，CROM）测量患者术前及术后随访24个月时颈椎前屈、后伸、左右侧弯、左右旋转6个方向的活动度。结果：从患者主诉分析，所有患者临床症状均得到缓解，通过X线评价融合节段融合率为100％。与术前相比单节段融合术后患者颈椎左右侧弯方向活动度无明显差异（P〉0．05），而在前屈、后伸及左右旋转方向的活动度均较术前明显减低（P〈0．05）。行双节段融合手术后患者颈椎在6个方向的活动度较术前均明显减低（P〈0．05）。对两种不同融合术后患者颈椎活动度的差异进行统计学分析后发现双节段融合患者术后颈椎活动度在6个方向均较单节段融合患者降低（P〈0．05）。结论：颈椎融合手术能够降低患者颈椎的活动度，与单节段融合相比双节段融合术后颈椎活动度的降低更为明显。展开更多
目的建立寰椎横韧带损伤上颈椎C0-C3不稳定节段的三维有限元模型,探究横韧带损伤对上颈椎关节活动度ROM(the range of motion)和椎骨应力分布的影响。方法基于CT图像数据结合临床寰椎横韧带损伤特征,建立人体寰椎横韧带损伤上颈椎不稳...目的建立寰椎横韧带损伤上颈椎C0-C3不稳定节段的三维有限元模型,探究横韧带损伤对上颈椎关节活动度ROM(the range of motion)和椎骨应力分布的影响。方法基于CT图像数据结合临床寰椎横韧带损伤特征,建立人体寰椎横韧带损伤上颈椎不稳定的三维有限元模型,比较分析横韧带损伤后上颈椎在不同工况下的关节活动度及椎骨应力分布情况。结果横韧带损伤后上颈椎寰枢关节在前屈、后伸、侧弯和轴向旋转等工况下的关节活动度均比正常组有不同程度的增大,增值分别为:3.5°、4.8°、1.1°和4.7°;屈伸时横韧带损伤后模型最大应力均比无损模型的大。结论寰椎横韧带损伤后上颈椎模型相比正常模型稳定性差,符合横韧带损伤后的真实情况,建立的有限元模型可用于上颈椎生物力学特性的分析。展开更多
文摘Background: Infants with congenital muscular torticollis are born with an asymmetric range of motion and a muscular imbalance in the cervical spine, as a result of a shortening or excessive contraction of the sternocleidomastoid muscle. Purpose: The study aimed to investigate passive range of motion (PROM) for rotation and lateral flexion, and muscle function of the cervical spine in children that had a history of CMT as infants. Study design: a prospective cohort study. Patient sample: 58 children at the age of 3.5 to 5 years that had been treated for CMT have infants participated in the study. Method: PROM was measured with protractors and muscle function was estimated with a modified Muscle Function Scale. Data from infancy were taken from earlier records. Result: PROM in rotation of the neck was mean 98.7° and PROM in lateral flexion of the neck was mean 69.1°. Symmetric PROM of the neck was found in 74% of the children for rotation and in 88% of the children for lateral flexion. Multiple regression showed that gender and PROM in rotation as infants had a significant impact on asymmetric PROM. Forty-five percent of the children had some degree of muscular imbalance in the lateral flexors of the neck. Conclusion: Possible risk factors for later asymmetric PROM are: gender, birth weight, gestation week and PROM in rotation as infants. These factors ought to be taken into consideration when developing guidelines for long-term follow-up.
文摘目的研究Discover、Prodisc-C人工椎间盘置换术与植骨融合术后下颈椎活动度（range of motion,ROM）、椎间盘应力、韧带张力的生物力学特性以及植入假体力学性能的改变。方法建立C5-6椎间盘退变3种手术方案：Discover、Prodisc-C人工椎间盘置换和自体髂骨植骨融合有限元模型,同时建立C4-7节段下颈椎原始模型。分析术后下颈椎C4-7节段在矢状面、冠状面及横断面上椎体的生物力学特性变化。结果术后手术节段关节ROM变化：Discover模型增加12.7%-73.1%,Prodisc-C模型增加74%-98%,植骨融合模型下降55.8%-71.8%。Discover置换后上邻近椎间盘应力无明显增加,下邻近椎间盘应力在前屈、后伸、轴向旋转工况下减少33.2%-54.2%,囊韧带张力增幅比Prodisc-C置换后减少30%-40%。Discover假体最大应力（36.72 MPa）出现在前屈工况下,小于Prodisc-C假体的最大应力（42.66 MPa）。结论人工椎间盘置换术可以保留手术节段的运动性能,Discover作为新一代人工椎间盘假体,在减少韧带负担和维持脊柱稳定性方面有所进步。研究结果可为颈椎前路融合手术和人工颈椎间盘置换术的临床研究提供理论依据。
文摘目的：探讨单节段及双节段颈椎融合手术对颈椎活动度的影响。方法：选取2010年6月～2012年6月在皖南医学院附属弋矶山医院脊柱外科行颈椎前路减压融合术的43例颈椎病患者，其中单节段融合29例，双节段融合14例。根据症状及x线片评价手术的有效率及融合节段的融合率。使用颈椎活动度测量仪（cervical range of motion device，CROM）测量患者术前及术后随访24个月时颈椎前屈、后伸、左右侧弯、左右旋转6个方向的活动度。结果：从患者主诉分析，所有患者临床症状均得到缓解，通过X线评价融合节段融合率为100％。与术前相比单节段融合术后患者颈椎左右侧弯方向活动度无明显差异（P〉0．05），而在前屈、后伸及左右旋转方向的活动度均较术前明显减低（P〈0．05）。行双节段融合手术后患者颈椎在6个方向的活动度较术前均明显减低（P〈0．05）。对两种不同融合术后患者颈椎活动度的差异进行统计学分析后发现双节段融合患者术后颈椎活动度在6个方向均较单节段融合患者降低（P〈0．05）。结论：颈椎融合手术能够降低患者颈椎的活动度，与单节段融合相比双节段融合术后颈椎活动度的降低更为明显。
文摘目的建立寰椎横韧带损伤上颈椎C0-C3不稳定节段的三维有限元模型,探究横韧带损伤对上颈椎关节活动度ROM(the range of motion)和椎骨应力分布的影响。方法基于CT图像数据结合临床寰椎横韧带损伤特征,建立人体寰椎横韧带损伤上颈椎不稳定的三维有限元模型,比较分析横韧带损伤后上颈椎在不同工况下的关节活动度及椎骨应力分布情况。结果横韧带损伤后上颈椎寰枢关节在前屈、后伸、侧弯和轴向旋转等工况下的关节活动度均比正常组有不同程度的增大,增值分别为:3.5°、4.8°、1.1°和4.7°;屈伸时横韧带损伤后模型最大应力均比无损模型的大。结论寰椎横韧带损伤后上颈椎模型相比正常模型稳定性差,符合横韧带损伤后的真实情况,建立的有限元模型可用于上颈椎生物力学特性的分析。
