CAJ | 학술논문

目的：探讨颈椎三维运动状态下颈脊髓所受压力与脊髓腹侧致压深度的关系。方法：采用10具新鲜成人尸体颈脊柱标本（C1~T1），于C4/5椎间隙水平前后开窗，通过腹侧置入半球形致压杆，模拟颈椎间盘退变时对颈脊髓腹侧致压。致压深度分别为椎管矢状径的10％～60％，逐次递增10％，分别测量三维运动状态下不同致压深度颈脊髓腹背侧所受压力。结果：（1）中立位、后伸30°位、侧弯30°位、旋转15°位时致压深度10%和20%颈脊髓腹侧压力差异无统计学意义（P＞0.05），致压深度30%时颈脊髓腹侧压力明显增加，30%~60%时颈脊髓腹侧压力随致压深度的增加而增大，相邻致压深度两两比较差异有统计学意义（P＜0.05）。前屈30°时，致压深度20%时颈脊髓腹侧压力即明显增加，20%~60%时颈脊髓腹侧压力随致压深度的增加而增大，各相邻致压深度两两比较差异有统计学意义（P＜0.05）。（2）中立位及各运动形式下硬脊膜背侧所受压力随致压深度的增加无明显增加，各相邻致压深度间两两比较差异无统计学意义（P＞0.05）。结论：颈脊髓腹侧所受压力与致压深度密切相关，并随着运动方式不同而改变，提示脊髓腹侧致压时颈椎前屈位脊髓损伤风险增大。
목적：탐토경추삼유운동상태하경척수소수압력여척수복측치압심도적관계。방법：채용10구신선성인시체경척주표본（C1~T1），우C4/5추간극수평전후개창，통과복측치입반구형치압간，모의경추간반퇴변시대경척수복측치압。치압심도분별위추관시상경적10％～60％，축차체증10％，분별측량삼유운동상태하불동치압심도경척수복배측소수압력。결과：（1）중립위、후신30°위、측만30°위、선전15°위시치압심도10%화20%경척수복측압력차이무통계학의의（P＞0.05），치압심도30%시경척수복측압력명현증가，30%~60%시경척수복측압력수치압심도적증가이증대，상린치압심도량량비교차이유통계학의의（P＜0.05）。전굴30°시，치압심도20%시경척수복측압력즉명현증가，20%~60%시경척수복측압력수치압심도적증가이증대，각상린치압심도량량비교차이유통계학의의（P＜0.05）。（2）중립위급각운동형식하경척막배측소수압력수치압심도적증가무명현증가，각상린치압심도간량량비교차이무통계학의의（P＞0.05）。결론：경척수복측소수압력여치압심도밀절상관，병수착운동방식불동이개변，제시척수복측치압시경추전굴위척수손상풍험증대。
Objectives: To investigate the relationship between the pressure sustained by cervical cord-meningeal complex(CCMC) and the strength under the 3D movement. Methods: 10 intact fresh cervical spines (C1-T1) from adult cadaver were collected, and a hemispherical steel ball was placed in the front of the spine canal through the C4/5 bone window to simulate the pressure of ventral side of CCMC caused by cer-vical disc herniation. The ventral side of CCMC was compressed with the depth of canal stenosis varying from 10% to 60%(with an interval of 10%), and the pressure change on the ventral and dorsal side of CCMC following different depths of stress under the 3D movement was measured. Results: (1)In neutral position, 30° of extension, 30° of lateral and 15° of rotation, the pressure on the ventral side of CCMC showed no signifi-cance with strength of stress between 10% and 20%(P>0.05); while the pressure on the ventral side of CCMC increased with increasing the depth when the stress depth ranged from 30% to 60%, there was significance between neighboring depths of stress (P<0.05). In 30° of flexion, the pressure on the ventral side of CCMC increased with increasing the depth from 10% to 60%, there was significance between neighboring depths(P<0.05). (2)The pressure on the dorsal side of CCMC showed no obvious increase with increasing the depth un-der any movement. There was no statistical significance between neighboring depths of stress (P>0.05). Con-clusions: The pressure on the ventral side of CCMC is closely related with the depth of stress. Under the 3D move-ment, the pressure varies with the movement position. Flexion position may aggravate the injury of spinal cord.