目的:观察保留颈后方韧带复合体对单开门颈椎板成形术的生物力学特性的影响。方法:新鲜羊颈椎标本24具,分成三组,每组8具。A组,完整标本组,保留伸肌,切除前方结构;B组,在A组方法处理基础上行保留颈后方韧带复合体单开门颈椎板成形术;C组,在A组基础上行传统单开门颈椎板成形术。在电子万能试验机上行生物力学试验,测试项目包括三点折弯试验、轴向拉伸试验和压缩试验。分析比较三组间的差异性。结果:三点折弯试验标本变直时A、B两组位移无差异,C组与A、B两组比较均明显减小(P<0.05);在变直时A、B两组加载力无差异,C组则较A、B两组明显变小(P<0.05)。拉伸试验在变直时B组与A组比较加载力明显变小(P<0.05),C组与A组相比显著变小(P<0.01),同时C组与B组比较也明显变小(P<0.05);10N位移B、C两组与A组相比均明显增大(P<0.05)。压缩试验中在前方加压10N时B组与A组比较位移明显变大(P<0.05),C组显著大于A组(P<0.01),同时C组亦明显大于B组(P<0.05)。结论:在对抗导致颈椎变直和前屈的应力方面,保留颈后方韧带复合体完整性的单开门手术标本明显优于破坏了其完整性的传统单开门手术标本。
Objective:To study the biomechanical effects of reconstruction of the posterior cervical ligamentous complex on open-door laminoplasty in sheep cervical spine.Method:24 fresh cervical sipne specimens of sheep were separated into three groups with 8 specimens in each group.Group A,all anterior elements of the cervical spine removed,leaving the posterior muscles intact.Group B,based on the protocol of group A,open-door laminoplasty with reconstruction of posterior cervical ligamentous complex was performed.Group C,based on the protocol of group A,traditional expansive open-door laminoplasty was performed.Lateral bending axial extension and compression were performed respectively in each group under electric multipotential machine.Result:With deformation of the specimen in flexion experiment when it was straight,there was no significant difference between group B and group A,but the deformation of group C was significantly smaller than those of group B and group A(P<0.05).When loading stress made the specimen straight in flexion experiment,the difference between group B and group A was not significant,while that in group C was significantly lower than those in group A and group B(P<0.05).When loading stress made the specimen straight in axial extension experiment,group B was significantly lower than group A(P<0.05),group C was significantly lower than group A(P<0.01),group C was also significantly lower than group B(P<0.05).In anterior loading experiment when the loading value was 10N,group B was significantly higher than group A(P<0.05),the difference between group C and group A was significant(P<0.01),the difference between group C and group B was also statistical(P<0.05).Conclusion:With respect to anterior flexion and physical curve of cervical spine,the cervical laminoplasty plus reconstruction of posterior ligamentous complex is superior over traditional open-door laminoplasty alone.