The vertebral column
The vertebral column
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脊柱
DOI：
10.1002/9780470090121.ch15
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发表时间：
1997
期刊：
影响因子：
--
通讯作者：
S. Dietrich
中科院分区：
文献类型：
--
作者：
D. Rice;S. Dietrich
脊柱是脊椎动物的中心和特征性骨骼结构，整个亚门由此得名。脊柱取代脊索可以被认为是脊索动物进化过程中的一个突破。椎骨具有最佳的机械性能，可促进多种功能，包括运动和保护脊髓。鉴于脊柱的功能重要性，令人惊讶的是有多少脊柱缺陷与生命相容。缺陷的范围包括椎间盘畸形、椎体形态混乱或腰椎或骶椎过早终止（发育不全）（表 15.1）。由于轻微缺陷只能偶然发现，因此脊柱缺陷的频率很难估计。然而，随着产前诊断的进步，可以在早期软骨和骨形成过程中检测到脊柱缺陷。与脊柱裂相关的脊柱缺陷在新生儿中的发生率约为 1:1000，先天性脊柱侧弯（左右弯曲）和骶骨发育不全的发生率则较少（分别为 1:10,000 和 1:25,000；http://www.emedicine.com/orthoped/topic618.htm）。轻度脊柱缺陷可能会在后半生引起骨科问题，因此只有在出现问题时才需要就医。然而，严重的缺陷，特别是如果它们与复杂的综合征相关，或者如果它们具有严重的连锁反应，例如当脊髓不受保护时，则需要立即引起注意。因此，为了正确诊断和解释脊柱缺损，并选择合适的内侧入路，我们需要了解人体脊柱的正常和病理发育。自从组织形成脊柱以来，个体发育过程中导致脊柱建立的事件的表征一直在稳步进展
The vertebral column is the central, and characteristic, skeletal structure of vertebrates, giving the name to the entire subphylum. The replacement of the notochord by the vertebral column can be considered a breakthrough during chordate evolution. The vertebrae confer optimal mechanical properties which facilitate numerous functions including locomotion and protection of the spinal cord. Given the functional importance of the vertebral column, it is astonishing how many vertebral column defects are compatible with life. Defects can range from mishappen intervertebral disks to chaotic vertebral patterns or to premature termination (agenesis) of the lumbar or sacral vertebral column (Table 15.1). As mild defects may only be detected by chance, the frequency of vertebral column defects is difficult to estimate. However, with the advances in prenatal diagnostics, vertebral column defects can be detected during early cartilage and bone formation. Vertebral column defects associated with spina bifida occur with a frequency of about 1: 1000 newborns, the frequency of congenital scoliosis (side-to-side bending) and sacral agenesis are rarer (1: 10,000 and 1: 25,000, respectively; http://www. emedicine. com/orthoped/topic618. htm). Mild vertebral column defects may cause orthopaedic problems in the second half of life, and thus need medical attention only when problems arise. However, severe defects, in particular if they are associated with complex syndromes, or if they have serious knock-on effects, for instance when the spinal cord lies unprotected, require immediate attention. Thus, in order to diagnose and interpret vertebral column defects correctly, and to select the appropriate medial approach, we need to understand the normal and pathological development of the human vertebral column. The characterization of events during ontogeny that lead to the establishment of the vertebral column has progressed steadily since the tissue the vertebral column