选用5具新鲜成人尸体脊柱T4/5,T7/8及T11/12脊柱功能单位(FSU),分别切除T4/5,T7/8,T11/12节段的右侧关节突,分别造成3种实验模型(正常脊柱结构、右侧关节突切除外侧1/2,全切除),运用脊柱三维运动实验机测试各模型的稳定性.结果示下胸椎单侧关节突全部切除对脊柱旋转产生影响(P=0.000 755).在胸椎减压手术过程中手术需要保留下胸椎的关节突,如果需要切除时可以辅以内固定系统.
[1] 丁文元, 李宝俊, 申勇, 张为, 董玉昌. 经后外侧入路治疗胸椎间盘突出症38例报告 [J]. 中华骨科杂志 2006.doi:10.3760/j.issn:0253-2352.2006.01.009
[2] Polikeit A, Nolte LP, Ferguson SJ. The effect of cement augmentation on the load transfer in an osteoporotic functional spinal unit: finite-element analysis. [J]. Spine 2003, 10(10).
[3] ZYROMSKI N J, PURTILL M A. Large caliber bullet trapped in the thoracic spinal column [J]. the Journal of trauma:Injury Infection and Critical Care 2006, 60(02).
[4] WTATKINS I V R, WATKINS III R, WILLIAMS L. Stability provided by the sternum and rib cge In the Thoracic Spine [J]. Spine 2005, 30(11).
[5] 崔京浩, 徐凡力. 骨骼生物力学 [J]. 工程力学 1996.
[6] KUKLO T R, LEHMAN Jr RA. Effect of various tapping diameters on insertion of thoracic pedicle screws:a biomechanical analysis [J]. Spine 2003, 28(18).
[7] PAGE P. Spinal kinematics [J]. Spine 2006, 31(17).
[8] VAN DILLEN L R, SAHRMANN S A, NORTON B J. The effect of modifying patient-preferred spinal movement and alignment during symptom testing in patients with low back pain:a preliminary report [J]. Archives of Physical Medicine and Rehabilitation 2003, 84(03).
[9] DICKMAN C A, ROSENTHAL D, REGAN J J. Reoperation for herniated thoracic discs [J]. Neurosurgical Focus 1999, 6(05).
[10] ODA I, ABUMI K, CUNNINGHAM B W. An in vitro human cadaveric study investigating the biomechanical properties of the thoracic spine [J]. Spine 2002, 27(03).
