颈伸肌群对颈椎间盘和小关节内压力变化的影响**☆
房 敏1，姜淑云1，洪水棕2，严隽陶1，孙武权1，刘玉超1，左亚忠3
课题背景：课题为国家自然科学基金资助项目（30472247）；上海市重点学科建设资助项目（T0302）。针对颈椎发病的研究，有临床、基础和应用研究3部分；研究方法有临床在体随机对照分析、生物力学、分子生物学、免疫学、电生理、数理模型分析等。就广度和深度而言，对颈椎的研究认识已有相当积累，目前及下一步，应更加关注颈椎病临床应用中关于预防、安全适宜高效的治疗手段及疗效再评价等问题。
应用要点：文章结果对颈椎病应用基础研究的思路、设计与测试方法有帮助；可以指导临床医生在治疗时更加重视颈部软组织的性能状态、颈椎骨结构与颈部软组织的功能关系，有助于提高临床治疗效果和安全性。如能进一步解决安全科学的在体无创观察测试方法，模拟半在体状态，更加接近在体生理状态等问题，可以预见应用于临床实践，将会产生良好的社会和经济效益。
相关链接：在颈椎病研究领域，临床随机对照，有效干预手段的安全性及疗效再评价，长期随访，相关基础研究中离体标本与活体状态的差异，实验室研究结果与临床应用差异，某种具体研究方法的局限性，重颈椎骨结构轻颈部软组织，重离体标本轻在体功能状态，重局部轻整体，重动物实验轻人体试验，安全科学的在体无创观察测试方法，盲法，多种研究方法之间的合理评价问题，亟待解决。
摘要
目的： 颈椎周围肌群是维系颈椎关节稳定和功能的动力系统，其性能改变对颈椎病发生发展具有重要意义。实验拟观察新鲜颈椎标本椎间盘和小关节内压力变化，探讨颈周肌群在颈椎发病机制中的作用。
方法：①实验材料：实验于2005-03/07在上海中医药大学附属岳阳中西医结合医院推拿生物力学实验室完成。5具新鲜尸体颈椎结构标本由原解放军第一军医大学提供。②实验方法：将C3~4、C4~5、C5~6、C6~7的颈椎间盘前缘和关节突关节C3~4、C4~5、C5~6、C6~7等处同时埋置8个微型压力传感器，并应用模拟颈伸肌正常生理段性能的弹簧。③实验评估：观察颈椎结构包括颈伸肌等在颈椎活动时的压力变化情况。
结果：随前屈角度的增加，颈椎间盘内的压力和颈伸肌的拉力明显增加。而随后伸角度的增加，小关节内的压力明显增加。加载模拟伸肌后，椎间盘和小关节的压力明显减低。
结论：颈伸肌群分担了一部分颈椎载荷，屈颈几率和强度的增加是颈椎病发生发展的关键因素。
关键词：颈伸肌；生物力学；颈椎病；椎间盘；小关节；组织构建
房敏，姜淑云，洪水棕，严隽陶，孙武权，刘玉超，左亚忠. 颈伸肌群对颈椎间盘和小关节内压力变化的影响 [J].中国组织工程研究与临床康复，2008，12(15):2847-2850 [www.zglckf.com/zglckf/ejournal/upfiles/08-15/15k-2847(ps).pdf]
1上海中医药大学附属岳阳中西医结合医院，上海市 200437；2上海交通大学工程力学系，上海市 200030；3上海交通大学附属第一人民医院推拿科，上海市 200080
房 敏☆，男，1965年生，山东省济南市人，汉族，2000年上海中医药大学毕业，博士，主任医师，主要从事脊柱及推拿生物力学的研究。
lhr_tcm@126.com
国家自然科学基金资助项目（30472247）*；上海市重点学科建设资助项目（T0302）*
中图分类号:R681.531
文献标识码:A
文章编号:1673-8225
(2008)15-02847-04
收稿日期：2008-01-15 修回日期：2008-02-16 （08-50-1-378/WL·A）
Abstract
AIM: Cervical muscles are power system for neck physiologic function and structure stabilization, and their pathological changes or dysfunction may result in cervical spondylosis. This study investigated the role of cervical muscles in cervical spondylosis by observing the alterations of fresh cervical vertebrae intervertebral cartilage and facet joint intra-articular pressure.
METHODS: ①The experiment was performed at Laboratory of Biomechanics, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine from March to July 2005. Five samples of fresh cadaver cervical vertebrae were provided by previous First Military Medical University of Chinese PLA. ②Eight micro-pressure transducers were embedded in the intervertebral disc and facet joints of C3-4, C4-5, C5-6, and C6-7. A spring was simulated as cervical extension muscles and the strength was measured when it was pulled. ③Pressure changes were measured.
RESULTS: The stress in the intervertebral discs of C3-4, C4-5, C5-6, C6-7 cervical spine increased obviously with the increasing of flexion degree. The pressure in the intervertebral facet joints in C3-4, C4-5, C5-6, C6-7 of cervical vertebrae increased remarkably with the increasing of extension degree. The pressure in intervertebral discs and facet joints significantly decreased under simulated extensor.
CONCLUSION: Cervical extensor muscles share partial load of cervical vertebrae. Neck flexion rate and increase in strength are key factors for the prevalence of cervical spondylosis.
Fang M, Jiang SY, Hong SZ, Yan JT, Sun WQ, Liu YC, Zuo YZ. Role of cervical extensor muscles in pressure alterations of intervertebral disc and facet joints.Zhongguo Zuzhi Gongcheng Yanjiu yu Linchuang Kangfu 2008;12(15):2847-2850(China)
[www.zglckf.com/zglckf/ejournal/upfiles/08-15/15k-2847(ps).pdf]
1Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China; 2Department of Engineering Mechanics, Shanghai Jiao Tong University, Shanghai 200030, China; 3Department of Massage, First People's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai 200080, China
Fang Min☆, Doctor, Chief physician, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
lhr_tcm@126.com
Supported by: the National Natural Science Foundation of China, No. 30472247*; Shanghai Leading Academic Discipline Project, No. T0302*
Received: 2008-01-15 Accepted: 2008-02-16��
Advertisement |
 |