运动学、动力学以及对首次在实验室中产生颈椎面脱位的实验进行当代分析后得出的新见解

IF 3.4 3区 医学 Q1 ORTHOPEDICS
JOR Spine Pub Date : 2024-05-27 DOI:10.1002/jsp2.1336
Ryan D. Quarrington, Robert Bauze, Claire F. Jones
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引用次数: 0

摘要

背景 首次在尸体标本中进行颈椎面脱位(CFD)的实验研究捕捉到了对了解损伤力学非常重要的椎体运动和轴向力。然而,这些数据并未在原稿中报告,也未在后续有限的 CFD 实验研究中呈现。因此,本研究旨在重新审查第一项实验研究中的模拟数据,以确定 CFD 时和之前的局部和整体脊柱运动以及施加的轴向力。 方法 在最初的研究中,通过将 14 根颈椎压缩在两块金属板之间,对其施加等静态轴向负荷。通过椎管内的钢轴和穿过最下椎体的骨针将标本固定在尾部。枕骨的整体旋转受到限制,但其前移不受任何限制。在矢状面放射摄影胶片上确定 CFD 的瞬间(N = 10),并从中计算出整体和椎体间的运动学数据。提取了相应的轴向力数据(N = 6),并确定了峰值力和损伤瞬间的力。 结果 8 个标本出现了 CFD,受伤水平的椎体间屈曲角度为 34.8 ± 5.6 度,前移增加了 3.1 ± 1.9 毫米。七个标本的 CFD 是在上颈椎前凸过渡到下颈椎后凸的水平制作的。五个有受力数据的标本在 545 ± 147 牛顿时进行了 CFD,在此之前的轴向力峰值(755 ± 233 牛顿)似乎与骨折或软组织破坏相吻合。 结论 对这一丰富数据集的重新研究提供了定量证据,证明较小的轴向压缩力加上前偏心和上颈部伸展,可导致下颈部弯曲和剪切,从而导致软组织断裂和 CFD。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Kinematics, kinetics, and new insights from a contemporary analysis of the first experiments to produce cervical facet dislocations in the laboratory

Kinematics, kinetics, and new insights from a contemporary analysis of the first experiments to produce cervical facet dislocations in the laboratory

Background

The first experimental study to produce cervical facet dislocation (CFD) in cadaver specimens captured the vertebral motions and axial forces that are important for understanding the injury mechanics. However, these data were not reported in the original manuscript, nor been presented in the limited subsequent studies of experimental CFD. Therefore, the aim of this study was to re-examine the analog data from the first experimental study to determine the local and global spinal motions, and applied axial force, at and preceding CFD.

Methods

In the original study, quasistatic axial loading was applied to 14 cervical spines by compressing them between two metal plates. Specimens were fixed caudally via a steel spindle positioned within the spinal canal and a bone pin through the inferior-most vertebral body. Global rotation of the occiput was restricted but its anterior translation was unconstrained. The instant of CFD was identified on sagittal cineradiograph films (N = 10), from which global and intervertebral kinematics were also calculated. Corresponding axial force data (N = 6) were extracted, and peak force and force at the instant of injury were determined.

Results

CFD occurred in eight specimens, with an intervertebral flexion angle of 34.8 ± 5.6 degrees, and a 3.1 ± 1.9 mm increase in anterior translation, at the injured level. For seven specimens, CFD was produced at the level of transition from upper neck lordosis to lower neck kyphosis. Five specimens with force data underwent CFD at 545 ± 147 N, preceded by a peak axial force (755 ± 233 N) that appeared to coincide with either fracture or soft tissue failure.

Conclusions

Re-examining this rich dataset has provided quantitative evidence that small axial compression forces, combined with anterior eccentricity and upper neck extension, can cause flexion and shear in the lower neck, leading to soft tissue rupture and CFD.

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来源期刊
JOR Spine
JOR Spine ORTHOPEDICS-
CiteScore
6.40
自引率
18.90%
发文量
42
审稿时长
10 weeks
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