Dynamic intervertebral foramen narrowing during simulated rear impact
Dynamic intervertebral foramen narrowing during simulated rear impact
复制标题
DOI：
10.1097/01.brs.0000201243.81745.ba
复制
发表时间：
2006-03-01
期刊：
影响因子：
3
通讯作者：
Ito, S
中科院分区：
文献类型：
--
作者：
Panjabi, MM;Maak, TG;Ito, S
研究设计.模拟汽车后部撞击过程中椎间孔狭窄的生物力学研究。在模拟后部撞击过程中量化椎间孔的宽度、高度和面积变窄，并评估有和没有椎间孔椎关节强硬的个体发生神经根和神经节撞击的可能性。在挥鞭样损伤患者中记录的肌无力和感觉异常与颈椎椎间孔内的神经压迫有关。据我们所知，还没有研究全面检查孔尺寸的动态变化。有6个完整的颈椎标本（平均年龄70.8岁），肌肉力量复制和替代头部，在3.5，5，6.5和8 g的模拟后方冲击，无损伤的基线2 g加速度。在每次撞击过程中测定椎间孔宽度、高度和面积的峰值动态狭窄，并与基线狭窄进行统计学比较。从3.5 g撞击开始，在C5-C6处观察到平均峰值椎间孔宽度比基线窄显着增加（P < 0.05）。在3.5、5和6.5 g时，未观察到平均峰值椎间孔高度狭窄的显著增加，而C4-C5的平均峰值椎间孔面积显著窄于基线。外推目前的结果表明，神经节压迫损伤的最高可能性是在下颈椎，C5-C6和C6-C7。急性神经节压迫可能会对重复压迫产生致敏神经反应，导致后部撞击后的慢性神经根病。
Study Design. A biomechanical study of intervertebral foraminal narrowing during simulated automotive rear impacts.Objectives. To quantify foraminal width, height, and area narrowing during simulated rear impact, and evaluate the potential for nerve root and ganglion impingement in individuals with and without foraminal spondylosis.Summary of Background Data. Muscle weakness and paresthesias, documented in whiplash patients, have been associated with neural compression within the cervical intervertebral foramen. To our knowledge, no studies have comprehensively examined dynamic changes in foramen dimensions.Methods. There were 6 whole cervical spine specimens (average age 70.8 years) with muscle force replication and surrogate head that underwent simulated rear impact at 3.5, 5, 6.5, and 8 g, following noninjurious baseline 2 g acceleration. Peak dynamic narrowing of foraminal width, height, and area were determined during each impact and statistically compared to baseline narrowing.Results. Significant increases (P < 0.05) in average peak foraminal width narrowing above baseline were observed at C5-C6 beginning with 3.5 g impact. No significant increases in average peak foraminal height narrowing were observed, while average peak foraminal areas were significantly narrower than baseline at C4-C5 at 3.5, 5, and 6.5 g.Conclusions. Extrapolation of the present results indicated that the highest potential for ganglia compression injury was at the lower cervical spine, C5-C6 and C6-C7. Acute ganglia compression may produce a sensitized neural response to repeat compression, leading to chronic radiculopathy following rear impact.