摘要
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1．53Nm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）。在控制屈伸和侧屈方向上，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。
Objective To investigate the biomechanical performance of stability and three-dimensional movements for atlanto-axial joint following artificial atlanto-odontoid joint arthroplasty. Methods Twelve human cadaveric specimens CO-CA were loaded nondestructively with 1.53 Nm in the uncon- strained testing apparatus. The tested states were intact specimen, after odontoideetomy, posterior transartieular screws, after artificial atlanto-odontoid joint 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 joint arthroplasty were proven to get close normal ROM. But there was significant difference in flexion ,extension,lateral bending at C1-C2 as compared with odontoideetomy and intact spine. There were smaller ROM during flexion, extension and lateral bending at C1-C2 after artificial atlanto-odontoid joint arthroplasty and transartieular screws, but there was significant difference in axial rotation after artificial atlanto-odontoid joint arthroplasty and transarticular screws. No abrasion and abnormal mobilization were observed after 2000 cycles of flexion, extension, lateral bending and axial rotation in fatigue test. Conclusion The self-designed artificial atlanto-odontoid joint arthroplasty can basically restore excellent stability, and reserve the movement of atlanto-axial joint instantly after operation.
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2009年第6期715-717,共3页
Chinese Journal of Experimental Surgery
基金
浙江省卫生厅医药卫生科学研究基金资助项目（2007A174）
关键词
生物力学
寰齿关节
寰枢关节
关节形成术
Biomechanics
Atlanto-odontoid joint
Atlanto-axial joint
Arthroplasty
