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目的探讨颈椎前路融合术中植骨块的高度对邻近节段关节突压力及活动度的影响,为临床上选择适宜的植骨高度提供依据。方法采用8例新鲜成人尸体颈椎标本,对完整状态,C5/6节段椎间隙减压术后(100%M、120%M、140%M、160%M)5组,于BOSE机加载下行三维运动,并测量颈C4/5,C6/7关节突压力值及C4/5,C6/7三维运动范围;最后将结果行多重比较分析。结果中立位状态下,关节突压力值各组无显著差异,P>0.05;后伸状态下,关节突压力值增加最大,各组有显著差异,P<0.05,但植骨高度中以120%M时关节突压力值增加最小,左右侧屈及左右旋转时,各组植骨高度之间差异均有显著意义,P<0.05,但植高度为120%M时,关节突压力值增加最小。在前屈后伸、左右侧屈下:120%M与完整状态相比,上下临近节段活动度差异无显著差异,P>0.05;与其他各组差异均有显著差异,P<0.05;2)在左右旋转时各组差异无显著差异,P>0.05。结论下颈椎单间隙减压植骨,撑开植骨理想高度为平均高度的120%。
Objective To investigate the effect of the height of bone graft in adjacent anterior cervical fusion on the sudden pressure and mobility of the adjacent segments, and to provide a basis for selecting appropriate bone height in clinical practice. Methods: Eight adult fresh cervical cadaver specimens were used in the study. The intact, C5 / 6 segmental intervertebral space decompression (100% M, 120% M, 140% M, 160% M) Three-dimensional movement, and measurement of cervical C4 / 5, C6 / 7 articular pressure and C4 / 5, C6 / 7 three-dimensional range of motion; and finally the results of multiple comparisons. Results In the neutral position, there was no significant difference in the value of the articular process between each group (P> 0.05). Under the condition of posterior extension, the value of the articular process increased most significantly (P <0.05) There was significant difference between the two groups in bone height when left and right lateral flexion and left and right rotation when the knee joint pressure was increased minimally (P <0.05). However, when the height was 120% M, the increase of the knee joint pressure was the smallest. In the flexion and extension, left and right lateral flexion: 120% M compared with the intact state, there is no significant difference in the activities of upper and lower adjacent segments, P> 0.05; there are significant differences with other groups, P <0.05; 2 ) In the left and right rotation no significant difference between the groups, P> 0.05. Conclusion Under the cervical spine singular decompression bone graft, distraction open bone height of 120% of the average height.