| 模拟肿瘤对颈胸段脊柱不同部位破坏后的生物力学研究 |
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Received:September 18, 2004
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| 作者 | Author | 单位 | Unit | E-Mail |
| 滕红林 |
TENG Hong-lin |
温州医学院附属第一医院骨科,浙江温州325000 |
Department of Orthopaedics,the 1th Affliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
honlinten@yahoo.com.cn |
| 杨胜武 |
YANG Sheng-wu |
温州医学院附属第一医院骨科,浙江温州325000 |
Department of Orthopaedics,the 1th Affliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 吴春雷 |
WU Chun-lei |
温州医学院附属第一医院骨科,浙江温州325000 |
Department of Orthopaedics,the 1th Affliated Hospital of Wenzhou Medical College,Wenzhou 325000,Zhejiang,China |
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| 池永龙 |
CHI Yong-long |
温州医学院附属第二医院骨科 |
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| 徐华梓 |
XU Hua-zi |
温州医学院附属第二医院骨科 |
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| 肖建如 |
XIAO Jian-ru |
上海长征医院骨科 |
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| 贾连顺 |
JIA Lian-shun |
上海长征医院骨科 |
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| 王以进 |
WANG Yi-jin |
上海大学生物力学研究所 |
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| 期刊信息：《中国骨伤》2006年19卷，第2期，第91-93页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:评价颈胸段脊柱T1在模拟溶骨性肿瘤不同部位(肋椎关节、椎弓根和关节突)的破坏情况下的生物力学特性,从而为采取预防性稳定手术提供理论依据,减少脊柱不稳发生神经损害的可能性,指导临床工作。
方法:取6具新鲜冷藏人体尸体脊柱标本(C7-T2),测量胸椎在不同部位损伤后对脊柱稳定性的影响。按照不同的破坏部位分别为正常标本组(IS),椎体破坏(30%椎体面积破坏,下同)+椎体后壁破坏(VB+PW),椎体破坏+肋椎关节破坏(VB+CVJ),椎体破坏+椎弓根破坏(VB+P),椎体+肋椎关节+椎弓根破坏(VB+CVJ+P),椎体+肋椎关节+椎弓根+关节突破坏(VB+CVJ+P+FJ)。
结果:椎体按照不同的部位破坏后,其屈服载荷按照完整标本、VB+PW、VB+CVJ、VB+P、VB+CVJ+P和VB+CVJ+P+FJ依次分别为(3549±254)、(3043±204)、(2680±164)、(2440±146)、(2168±110)和(1734±74)N,依次比正常标本下降了14.2%、24.5%、32.8%、40.0%和52.8%。
结论:椎体和椎弓根同时破坏比单纯椎体破坏更加不稳,此时如有关节突关节破坏,后方承受载荷的结构如关节突关节将不能从后方支持椎体,发生椎体塌陷的危险性更高,可考虑采取预防性稳定手术。 |
| [关键词]:胸椎 颈椎 肿瘤,骨组织 生物力学 |
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| Biomechanical evaluation on the cervicothoracic spine stability after destruction induced by simulated osteolytic tumor at different sites of cervicothoracic vertebrae |
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Abstract:
Objective:To evaluate the biomechanical alteration after the destruction induced by simulated osteolytic tumor at different sites of cervicothoracic vertebrae,including costovertebral joints,pedicles and facet joints,so as to provide the evidence to support the decision of operations for prophylactic stabilization.
Methods:Six specimens obtained from human cervicothoracic spine were used.Each specimen consisted of three vertebrae（C7-T2）with intervertebral discs and ribs.To evaluate the effect of tumor at different locations on the spinal stability, metastatic involvement were simulated as follows: intact specimen( IS), vertebral body defect
( 30%) + posterior wall violation( VB+ PW), vertebral body defect+ costovertebral joints violation( VB+ CVJ), vertebral body+ pedicle violation( VB+ P), vertebral body+ costovertebral joints+ pedicle violation( VB+ CVJ+ P), vertebral body+ costovertebral joints+ pedicle+ facet joints violation( VB+ CVJ+ P+ FJ).
Results:It was demonstrated that the failure loads of the intact specimen(IS) 、VB+ PW, VB+ CVJ, VB+ P, VB+ CVJ+ P and VB+ CVJ+ P+FJ were (3549±254), (3043±204), (2680±164), (2440±146), (2168±110) and (1734±74) N,respectively.
Conclusion:The destructions of both vertebral body and pedicles will be more unstable than the destruction of vertebral body merely. When the destructions of vertebral body, pedicles and facets joints simulta neously happened, the vertebra would potentially be more unstable and easier to collapse, therefore the surg ical prophylactic stabilization should be operated. |
| KEYWORDS:Thoracic vertebrae Cervical vertebrae Neoplasms,bone tissue Biomechanics |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 滕红林,杨胜武,吴春雷,池永龙,徐华梓,肖建如,贾连顺,王以进.模拟肿瘤对颈胸段脊柱不同部位破坏后的生物力学研究[J].中国骨伤,2006,19(2):91~93 |
| 英文格式: | TENG Hong-lin,YANG Sheng-wu,WU Chun-lei,CHI Yong-long,XU Hua-zi,XIAO Jian-ru,JIA Lian-shun,WANG Yi-jin.Biomechanical evaluation on the cervicothoracic spine stability after destruction induced by simulated osteolytic tumor at different sites of cervicothoracic vertebrae[J].zhongguo gu shang / China J Orthop Trauma ,2006,19(2):91~93 |
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