CAJ | 학술논문

目的通过模拟颈椎间盘突出合并黄韧带病变所致的急性颈脊髓损伤,观察颈脊髓受压时前后方压应力的变化趋势,探讨前后方压应力与致压深度的关系.方法采用10具新鲜成人尸体颈脊柱标本(C1 ～T1),通过前后方C4 ～ C5间骨窗伸入两根半球形测压杆,模拟颈椎间盘退变突出合并黄韧带病变时对颈脊髓前后方所形成的压迫.实验对颈脊髓前后方同时致压,致压深度最大和为椎管矢状径的60％,逐渐增加致压深度,分别测量不同致压深度下,颈脊髓脊膜前后方所受压应力的变化.结果 (1)前方致压深度一定,后方致压深度逐渐增加时,颈脊膜前方压应力无明显变化;颈脊膜后方压应力明显增大,其中致压深度为椎管中矢径的10％～ 20％时各相邻致压深度间颈脊髓后方压应力两两比较差异无统计学意义(P＞0.05);致压深度为椎管中矢径的30％～60％时各相邻致压深度间颈脊髓脊膜后方压应力两两比较差异有统计学意义(P＜0.05);(2)后方致压深度一定,前方致压深度依次递增时,颈脊膜前方压应力明显增大,其中致压深度为椎管中矢径的10％～20％时各相邻致压深度间颈脊髓后方压应力两两比较差异无统计学意义(P＞0.05);致压深度为椎管中矢径的30％～ 60％时各相邻致压深度间颈脊髓脊膜后方压应力两两比较差异有统计学意义(P＜0.05);颈脊膜后方压应力无明显变化.结论颈脊髓脊膜前、后方所受压应力与致压深度呈非线性关系,所受压应力随致压深度增加而增大,前方或后方致压深度超过椎管中矢径的30％临界值后差异有统计学意义.
목적 통과모의경추간반돌출합병황인대병변소치적급성경척수손상,관찰경척수수압시전후방압응력적변화추세,탐토전후방압응력여치압심도적관계.방법 채용10구신선성인시체경척주표본(C1 ～T1),통과전후방C4 ～ C5간골창신입량근반구형측압간,모의경추간반퇴변돌출합병황인대병변시대경척수전후방소형성적압박.실험대경척수전후방동시치압,치압심도최대화위추관시상경적60％,축점증가치압심도,분별측량불동치압심도하,경척수척막전후방소수압응력적변화.결과 (1)전방치압심도일정,후방치압심도축점증가시,경척막전방압응력무명현변화;경척막후방압응력명현증대,기중치압심도위추관중시경적10％～ 20％시각상린치압심도간경척수후방압응력량량비교차이무통계학의의(P＞0.05);치압심도위추관중시경적30％～60％시각상린치압심도간경척수척막후방압응력량량비교차이유통계학의의(P＜0.05);(2)후방치압심도일정,전방치압심도의차체증시,경척막전방압응력명현증대,기중치압심도위추관중시경적10％～20％시각상린치압심도간경척수후방압응력량량비교차이무통계학의의(P＞0.05);치압심도위추관중시경적30％～ 60％시각상린치압심도간경척수척막후방압응력량량비교차이유통계학의의(P＜0.05);경척막후방압응력무명현변화.결론 경척수척막전、후방소수압응력여치압심도정비선성관계,소수압응력수치압심도증가이증대,전방혹후방치압심도초과추관중시경적30％림계치후차이유통계학의의.
Objective To observe the anterior and posterior pressure change of the cervical spinal cord and to evaluate the relationship between the stress on cervical cord-meningeal complex (CCMC) compressed anteroposterior and the degree of canal occlusion by simulating cervical disc degeneration and cervical abnormal hgamentum flavum.Methods Specimens of 10 intact fresh cervical spine (C1-T1) from adult cadavers were collected in order to simulate cervical disc degeneration and abnormal ligamentumflavum by placing two hemispherical steel ball into the anterior and postierior side of the cervical spinal cordthrough the bone window of the C4-C5.The maximum depth of compression was 60％ of the spine canal anteroposterior diameter.Results (1) Under the anterior depth of a certain pressure with the increase of posterior pressure depth,the stress on the anterior of the CCMC had no significant change,and the stress on the posterior of the CCMC increased greatly with the increase of the degree of canal occlusion.The stress on the posterior of the CCMC varied insignificantly between neighboring depth of canal occlusion from 10％ to 20％ (P ＞ 0.05),while there was remarkably significant difference between 30％ and 60％ (P ＜0.05).(2) Under the posterior depth of a certain pressure with the increase of anterior pressure depth,the stress on the anterior of the CCMC was increased greatly with the increase of the degree of canal occlusion,and the stress on the anterior of the CCMC varied insignificantly between neighboring depth of canal occlusion from 10％ to 20％ (P ＞ 0.05),while there was remarkably significant difference between 30％ and 60％ (P ＜ 0.05).The stress on the posterior of the CCMC had no significant change.ConclusionThe stress on the anterior and the posterior of the CCMC has a close relationship with the depth of canal occlusion,but presents nonlinear relationship.With the increase of the depth of canal occlusion,the stress is increased,especially running over the 30％ depression of canal occlusion.