【作者】 胡斌；

【导师】 李康华； 胡建中； 雷光华；

【作者基本信息】 中南大学 ， 外科学， 2007， 硕士

【摘要】 目的了解C_5／6椎间盘摘除、Bryan颈人工颈椎间盘置换对同节段关节突关节内压力的影响，探讨出现压力变化的原因，为临床上退行性颈椎间盘病变治疗方法的选择提供理论依据方法取11具新鲜青壮年尸体颈椎标本，包括C₃-T₁节段。将特制圆片状微型阻电式压力传感器置入C_5／6关节突关节内，在颈椎标本上施加轴向（0—150N）、侧弯（0—1.5Nm）、后伸（0—1.5Nm）、前屈（0—1.5Nm）分级载荷，分别测量C_5／6椎间盘完整组、C_5／6椎间盘摘除组和C_5／6Bryan颈人工椎间盘置换组，C_5／6关节突内的压力。比较各组的压力大小。实验数据采用SPSS11.0统计软件进行统计学分析，检验水准为a=0.05。结果1．在轴向、前屈、对侧弯、同侧弯四种工况相同载荷下，椎间盘摘除组C_5／6关节突关节的压力明显小于人工椎间盘组与椎间盘完整组，均有统计学差异（P＜0.05）。2．在后伸载荷下椎间盘摘除组C_5／6关节突关节内的压力明显大于人工椎间盘组与椎间盘完整组，均有统计学差异（P＞0.05）。3．人工椎间盘置换组C_5／6关节突关节内的压力在轴向、前屈、侧弯后伸四种工况下与椎间盘完整组比较无明显差异（P＞0.05）．结论1．颈人工椎间盘置换后同位关节突关节内压与椎间盘完整时相似。提示Bryan颈人工颈椎间盘能重建颈椎生物力学功能，减少远节椎间盘退变机率。2．颈椎间盘髓核摘除后同位关节突关节内压力的变化，提示颈椎间盘髓核摘除术后，有可能导致同位关节突关节出现退行性变，影响手术后疗效。更多还原

【Abstract】 Objective To explore the stress change in the same zygapophyseal joint after C_5/6 discectomy and artificial disc replacement, to provide theoretic evidences for the choose of the therapy of intervertebral disc disorders and the method of intervertebral disc functional reconstructionMethod Eleven healthy adult fresh-frozen multisegmental cervical spine segments （C₃ to T₁） were utilized in this investigation and biomechanically evaluated under the following C_5/6 conditions:（1）intact spine;（2）discectomy;（3）the Bryan Disc prosthesis implantation. The load（25N-150N） of neutrality and pure moments （0.25Nm-1.5Nm） of axial, flexion, extension, and lateral bending were applied on each group. The stress changes of the C_5/6 zygapophyseal joint was tested by modified cyclo-shaped miniature transducer .The data was analyzed by SPSS for windows 12.0, the statistic significance was set atα=0.05.Result 1. Under axial , anteflexion, and lateral bending loading, the disectomy indicated a significant decrease in the stress of the C_5/6 zygapophyseal joint compared to intac condition and CADR （P<0.05）.2. Under extension loading, the disectomy indicated a significant increase in the stress of the C_5/6 zygapophyseal joint compared to intac condition （P<0.05）. 3. There was no obvious diference between artificial disc replacement anddisc intact （P>0.05）.Conclusion 1. There was no difference between the C_5/6 ADR and intact spine group which revealed the prosthesis had the effect of disc functional reconstruction. 2.The discectomy of the C_5/6 can increased the stress of the C_5/6 zygapophyseal joint and maybe it can Induce the degeneration of the Same Zygapophyseal Joint.更多还原