目的 通过模拟颈椎间盘突出合并黄韧带病变所致的急性颈脊髓损伤,观察颈脊髓受压时前后方压应力的变化趋势,探讨前后方压应力与致压深度的关系.方法 采用10具新鲜成人尸体颈脊柱标本(C1 ~T1),通过前后方C4 ~ C5间骨窗伸入两根半球形测压杆,模拟颈椎间盘退变突出合并黄韧带病变时对颈脊髓前后方所形成的压迫.实验对颈脊髓前后方同时致压,致压深度最大和为椎管矢状径的60%,逐渐增加致压深度,分别测量不同致压深度下,颈脊髓脊膜前后方所受压应力的变化.结果 (1)前方致压深度一定,后方致压深度逐渐增加时,颈脊膜前方压应力无明显变化;颈脊膜后方压应力明显增大,其中致压深度为椎管中矢径的10% ~ 20%时各相邻致压深度间颈脊髓后方压应力两两比较差异无统计学意义(P>0.05);致压深度为椎管中矢径的30%~60%时各相邻致压深度间颈脊髓脊膜后方压应力两两比较差异有统计学意义(P<0.05);(2)后方致压深度一定,前方致压深度依次递增时,颈脊膜前方压应力明显增大,其中致压深度为椎管中矢径的10%~20%时各相邻致压深度间颈脊髓后方压应力两两比较差异无统计学意义(P>0.05);致压深度为椎管中矢径的30% ~ 60%时各相邻致压深度间颈脊髓脊膜后方压应力两两比较差异有统计学意义(P<0.05);颈脊膜后方压应力无明显变化.结论 颈脊髓脊膜前、后方所受压应力与致压深度呈非线性关系,所受压应力随致压深度增加而增大,前方或后方致压深度超过椎管中矢径的30%临界值后差异有统计学意义.
Objective To observe the anterior and posterior pressure change of the cervical spinal cord and to evaluate the relationship between the stress on cervical cord-meningeal complex (CCMC) compressed anteroposterior and the degree of canal occlusion by simulating cervical disc degeneration and cervical abnormal hgamentum flavum.Methods Specimens of 10 intact fresh cervical spine (C1-T1) from adult cadavers were collected in order to simulate cervical disc degeneration and abnormal ligamentumflavum by placing two hemispherical steel ball into the anterior and postierior side of the cervical spinal cordthrough the bone window of the C4-C5.The maximum depth of compression was 60% of the spine canal anteroposterior diameter.Results (1) Under the anterior depth of a certain pressure with the increase of posterior pressure depth,the stress on the anterior of the CCMC had no significant change,and the stress on the posterior of the CCMC increased greatly with the increase of the degree of canal