Cervical intervertebral disc injury during simulated frontal impact.
Cervical intervertebral disc injury during simulated frontal impact.
复制标题
模拟正面碰撞时颈椎间盘损伤。
DOI：
10.1007/s00586-004-0783-4
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
Panjabi,ManoharM
中科院分区：
文献类型：
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作者：
Ito,S;Ivancic,PC;Pearson,AM;Tominaga,Y;Gimenez,SE;Rubin,W;Panjabi,ManoharM
在临床和生物力学研究中都观察到了由正面撞击引起的颈椎间盘损伤，但缺乏数据来阐明在这些碰撞过程中颈椎间盘损伤的机制。本研究的目的是确定在模拟整个人类颈椎模型正面撞击过程中，在T1椎体水平加速4g、6g、8g和10g时，肌力复制时的最大动态椎间盘环状组织应变和椎间盘剪切应变。这些数据与生理负荷期间获得的数据以及之前报道的后部碰撞数据进行了比较。在C2-C3椎间水平，正面撞击时的最大椎间盘剪切应变和最大环状组织应变超过(p<；0.05)相应的生理极限，分别从4微克和6微克开始。随后，它们以10克的速度扩散到整个颈椎，C4-C5除外。C5-C6椎间水平在正面和后方撞击时都有很高的受伤风险，而在正面撞击期间，除了C5-C6外，包括C2-C3在内的上椎间隙也可能发生亚失败损伤。与正面撞击相比，后部撞击时的撞击加速度较低，导致腰椎间盘损伤。在正面撞击过程中发生的颈椎间盘亚失效损伤可能会导致患者报告的慢性症状，如头颈部疼痛。
Cervical disc injury due to frontal impact has been observed in both clinical and biomechanical investigations; however, there is a lack of data that elucidate the mechanisms of disc injury during these collisions. The goals of the current study were to determine the peak dynamic disc annular tissue strain and disc shear strain during simulated frontal impact of the whole human cervical spine model with muscle force replication at 4 g, 6 g, 8 g and 10 g horizontal accelerations of the T1 vertebra. These data were compared with those obtained during physiological loading, and with previously reported rear impact data. Peak disc shear strain and peak annular tissue strain during frontal impact exceeded (p<0.05) corresponding physiological limits at the C2–C3 intervertebral level, beginning at 4 g and 6 g, respectively. These subsequently spread throughout the entire cervical spine at 10 g, with the exception of C4–C5. The C5–C6 intervertebral level was at high risk for injury during both frontal and rear impacts, while during frontal impact, in addition to C5–C6, subfailure injuries were likely at superior intervertebral levels, including C2–C3. The disc injuries occurred at lower impact accelerations during rear impact as compared with frontal impact. The subfailure injuries of the cervical intervertebral disc that occur during frontal impact may lead to the chronic symptoms reported by patients, such as head and neck pain.