The occipitoatlantal capsular ligaments are the primary stabilizers of the occipitoatlantal joint in the craniocervical junction: a finite element analysis
The occipitoatlantal capsular ligaments are the primary stabilizers of the occipitoatlantal joint in the craniocervical junction: a finite element analysis
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DOI：
10.3171/2018.10.spine181102
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发表时间：
2019-05-01
影响因子：
2.8
通讯作者：
Brookmeyer, Douglas L.
中科院分区：
文献类型：
--
作者：
Phuntsok, Rinchen;Ellis, Benjamin J.;Brookmeyer, Douglas L.
目的关于枕椎关节的关键稳定韧带的相对贡献，存在相互矛盾的证据。身体研究受到损伤的性质和数量的限制，可以用来鉴定OA稳定韧带的损伤情况。有限元分析可以克服这些限制，为这一领域提供有价值的数据。作者完成了5个特定对象颅颈关节(CCJ)模型的有限元分析，以研究OA关节的生物力学，并确定稳定所必需的韧带结构。方法模拟5个CCJ FE模型在生理载荷下的单独和联合损伤情景，以评估关键韧带结构对OA关节稳定性的相对作用。每个模型都在不同的损伤情况下进行了屈伸、轴向旋转和横向弯曲测试。单独的韧带损伤方案包括降低OA关节囊韧带(OACL)的僵硬或完全去除横韧带(TL)、覆盖膜(TM)或翼状韧带(ALS)的组合方案。结果与其他单独的损伤相比，单独的OACL损伤导致了OA关节所有运动范围(ROM)的最大百分比增加。屈曲、伸展、侧弯和轴向旋转分别增加12.4%±7.4%、11.1%±10.3%、83.6%±14.4%和81.9%±9.4%(P
OBJECTIVE There is contradictory evidence regarding the relative contribution of the key stabilizing ligaments of the occipitoatlantal (OA) joint. Cadaveric studies are limited by the nature and the number of injury scenarios that can be tested to identify OA stabilizing ligaments. Finite element (FE) analysis can overcome these limitations and provide valuable data in this area. The authors completed an FE analysis of 5 subject-specific craniocervical junction (CCJ) models to investigate the biomechanics of the OA joint and identify the ligamentous structures essential for stability.METHODS Isolated and combined injury scenarios were simulated under physiological loads for 5 validated CCJ FE models to assess the relative role of key ligamentous structures on OA joint stability. Each model was tested in flexion-extension, axial rotation, and lateral bending in various injury scenarios. Isolated ligamentous injury scenarios consisted of either decreasing the stiffness of the OA capsular ligaments (OACLs) or completely removing the transverse ligament (TL), tectorial membrane (TM), or alar ligaments (ALs) Combination scenarios were also evaluated.RESULTS An isolated OACL injury resulted in the largest percentage increase in all ranges of motion (ROMs) at the OA joint compared with the other isolated injuries. Flexion, extension, lateral bending, and axial rotation significantly increased by 12.4 % +/- 7.4%, 11.1% +/- 10.3%, 83.6% +/- 14.4%, and 81.9% +/- 9.4%, respectively (p