摘要
目的分析椎问盘髓核摘除后腰椎小关节受力大小及变化情况。方法采用8具新鲜脊柱腰骶段（L1-S1）标本，在MTS系统上用压敏片分别测量L3—L4、L4-L5两个节段小关节面在中立位和前屈、后伸位时受力大小；摘除L4-L5椎间盘髓核，重复测量。结果完整脊柱标本中，L4-L5与L3-L4节段关节面受力大小相似：中立位时受力占轴向压缩载荷的15％；前屈10°、20°时受力占压缩载荷的比例减为9％、5％；后伸10°、20°时受力占压缩载荷的比例增至23％、33％。L4-L5椎间盘髓核摘除后，L4-L5节段小关节面在各个运动状态下受力均显著增大，而L3-—L4节段小关节受力也有增加的趋势。结论腰椎小关节有一定的承载功能。腰椎间盘切除术后，同一平面及相邻平面小关节受力增加，可能引发腰痛。
Objective To study the force of lumbar facet joints before and after lumbar disc excision. Methods Totally 8 fresh lum- bar - sacral spines （ L1 - S1 ） were placed on the MTS system. The compressive stress of the facet joints of the L3 - L4 and L4 - L5 motion segments was measured using pressure-sensitive films. The compressive stress on lumbar facet joints was measured in the position of erection, flexion and extension. Then L4 - L5 nucleus was resected and and the tbrce was measured when the same positions were repeated. Results L3 -L4 and L4 -L5 segments could bear the same force before operation, In neutral position, the facet joints could carry about 15% axial compressive stress. In flexion posture, the force borne by the facet joints decreased. In flexion at 10 , 20 , the force was about 9% and 5% of the compressive force. In extension position, the force of the facet joints increased. In extention at 10 , 20 , the force was about 23% and 33% , respectively. After disc excision, the force of facet joints of L4 - L5 increased remarkably, and the force of L3 - L4 also had the trend of increase. Conclusion The lumbar facet joints can share some of the compressive forces of the spine. The force of facet joints of the discreseeted segment and the adjacent segment increases, which may be a reason of lumbar pain after disc excision.
出处
《局解手术学杂志》
2006年第1期4-6,共3页
Journal of Regional Anatomy and Operative Surgery
关键词
腰椎
小关节
压敏片
生物力学
髓核摘除
lumbar spine
facet joint
pressure-sensitive film
biomechanics
lumbar disc excision
