CAJ | 학술논문

目的探讨人工寰齿关节置换后对寰枢关节稳定性和三维运动的生物力学性能.方法选用12具新鲜尸体颈椎标本(包括枕骨基底部和C1～C4颈椎节段)置入1.53 Nm载荷下,依次轮流测试其完整状态、前路减压术后、Magerl螺钉固定后、人工寰齿关节置换后、疲劳实验后C1、C2节段标本的三维运动范围(ROM).结果人工寰齿关节置换后,寰枢关节旋转运动范围和中性区接近正常状态,但屈伸和侧屈运动范围较前路减压术后和正常状态明显减少,差异有统计学意义(P＜0.05).在控制属伸和侧屈方向上,人工寰齿关节置换后同Magerl螺钉固定后表现出了最小的ROM(P＞0.05),但在控制寰枢关节旋转方向上,两者差异有统计学意义(P＜0.05).各进行2000次屈伸、侧屈和旋转疲劳实验后对人工寰齿关节置换后三维运动范围无明显影响,差异无统计学意义(P＞0.05).结论自行研制的人工寰齿关节置换后既能重建寰枢关节良好的即刻稳定性又能保留其关节运动功能.
목적 탐토인공환치관절치환후대환추관절은정성화삼유운동적생물역학성능.방법 선용12구신선시체경추표본(포괄침골기저부화C1～C4경추절단)치입1.53 Nm재하하,의차륜류측시기완정상태、전로감압술후、Magerl라정고정후、인공환치관절치환후、피로실험후C1、C2절단표본적삼유운동범위(ROM).결과 인공환치관절치환후,환추관절선전운동범위화중성구접근정상상태,단굴신화측굴운동범위교전로감압술후화정상상태명현감소,차이유통계학의의(P＜0.05).재공제속신화측굴방향상,인공환치관절치환후동Magerl라정고정후표현출료최소적ROM(P＞0.05),단재공제환추관절선전방향상,량자차이유통계학의의(P＜0.05).각진행2000차굴신、측굴화선전피로실험후대인공환치관절치환후삼유운동범위무명현영향,차이무통계학의의(P＞0.05).결론 자행연제적인공환치관절치환후기능중건환추관절량호적즉각은정성우능보류기관절운동공능.
Objective To investigate the biomechanical performance of stability and three-dimensional movements for athmto-axial ioint following artificial atlanto-odontoid ioint arthroplasty.Methods Twelve human cadaveric specimens CO-C4 were loaded nondestructively with 1.53 Nm in the unconstrained testing apparatus.The tested states were intact specimen,after odontoidectomy,posterior transarticular screws,after artificial atlanto-odontoid ioint arthroplasty,and after fatigue test in order.After each state,the range of motion(ROM)at the level of C1,2 Was measured in flexion-extension,lateral bending,and axial rotation direction.Results The angular range of motion and neutral zone during axial rotation at C1-C2 after artificial atlanto-odontoid ioint arthroplasty were proven to get close normal ROM.But there was significant difierence in flexion,extension,lateral bending at C1-C2 as compared with odontoidectomy and intact spine.There were smaller ROM during flexion.extension and lateral bending at C1-C2 after artificial atlanto-odontoid ioint arthroplasty and transarticular screws,but there was significant difference in axial rotation after artificial atlanto-odontoid ioint arthroplasty and transarticular screws.No abrasion and bnormal mobilization were observed after 2000 cycles of flexion,extension,lateral bending and axial rotation in flatigue test.Conclusion The serf-designed artificial atlanto-odontoid ioint arthroplasty Call basically restore excellent stability,and reserve the movement of atlanto-axial ioint instantly after operation.