CLINICAL BIOMECHANICS OF CERVICAL SPINE

创伤、类风湿性关节炎和退化是主要的 上颈椎问题（枕骨-C1-C2关节复合体）。 它们导致疼痛、畸形和神经功能障碍。 一个 重要且临床上公认的实体是脊柱不稳定。 它将脊柱的主要问题与临床结果联系起来。 由于创伤、关节炎或退化而导致脊柱不好 等等，手术重建用于稳定不稳定的 脊椎 有几个问题仍然没有答案。 上颈椎不稳的原因是什么？ 是什么 不同类型的不稳定性及其测量方法 什么 是这个区域的损伤机制吗 每个角色扮演什么角色 在提供稳定性方面发挥作用吗 什么类型和 不稳定的程度导致椎动脉功能不全？ 椎骨、神经、脊椎骨和脊椎骨之间的正常解剖关系是什么 神经根脊髓和椎动脉 鉴于不稳定的 上颈椎，有什么相对优势， 不同手术方式的优缺点 据推测，一套综合的研究，适用于 现代生物力学研究方法，需要解决 上述临床和基础科学问题。 该提案， 包括五项研究，提供了一个全面的方法， 上颈椎的研究。 对于这个地区，我们 建议使用新鲜人体尸体和尸体 标本，如下：（1）解剖。 详细说明和量化 三维解剖学，使用计算机制图;计算机 图形学（2）生物力学。 正常的三维运动 （3）不稳定性。 测定 失稳阈值和韧带在稳定性中的作用;（4） 外伤 高速创伤及损伤机制;（5）外科手术。 脊柱不稳定损伤和创伤的外科重建。 这项工作在多个领域具有临床意义。 为 第一次，椎骨，韧带， 将对脊髓、神经根和椎动脉进行量化 并在视觉上显示，从而提供更全面的 了解这种联合复合体的功能。 生物力学和不稳定性研究将记录正常和 上颈椎的异常运动，这将有助于 确定临床使用的不稳定阈值。 实验创伤将确定常见损伤的机制： 脱臼，骨折和颈部扭伤，再次帮助提供了一个 了解脊柱损伤，这可能会导致改善 治疗方法 最后，生物力学评价目前 用于稳定受伤和关节炎的现有外科手术 脊柱将导致目前的改进建议- 天的方法，以及新的外科手术的发展， 程序.

Trauma, rheumatoid arthritis, and degeneration are the major problems in the upper cervical spine (occiput-C1-C2 joint complex). They result in pain, deformity and neurological dysfunction. An important and clinically recognized entity is spinal instability. It relates the major problems of the spine to the clinical results. Given an unsable spine, due to trauma, arrthritis, or deeneration etc., surgical reconstruction is used to stabilized the unsable spine. Several questions remain unanswered. What constitutes instability in the upper cervical spine? What are the different types of instabilities and their measurements? What are the mechanisms of injuries in this region? What roles doe each of the spinal ligaments play in providing stability? What type and magnitude of instability leads to vertebral artery insufficiency? What are the normal anatomic relationship between vertebrae, nerve roots, the spinal cord and vertebral artery? Given an unstable upper cervical spine, what are the relative advantages and disadvantages of different surgical procedures? It is hypothesized that an integrated set of studies, which applies modern methods of biomechanical investigation, is needed to address the above clinical and basic science questions. The proposal, which consists of five studies, provides a comprehensive approach to the study of the upper cervical spine. For this region, we propose to determine, using fresh human cadavers and cadaveric specimens, the following: (1) Anatomy. Detaialed and quantified three-dimensional anatomy, using computer graphics; computer graphics (2) Biomechanics. Normal three-dimensional movements andphysical properties; (3) Instability. Determination of Instability thresholds and the role od ligaments in stability; (4) Trauma. High speed trauma and mechanisms of injury; (5) Surgery. Surgical reconstruction of unstable injured and traumatized spines. The proposed work has clinical sugnificance in several areas. For the first time, spatial relationships between vertebrae, ligaments, spinal cord, nerve roots and vertebral arteries will be quantified and visually displayed, thereby providing a more thorough understanding of the way in which this joint complex functions. The biomechanical and instability studies will document normal and abnormal motions of the upper cervical spine, which will help determine the instability thresholds for clinical use. Experimental trauma will determined mechanisms of common injuries: dislocations, fractures and whiplash, again helping to provide an understanding of spinal injuries, which may lead to improved treatment methods. Finally, biomechanical evaluations of presently available surgical procedures for stabilizing injured and arthritic spines will lead to recommendations for improvements of present- day methods, as well as to the development of new surgical procedures.