CLINICAL BIOMECHANICS OF CERVICAL SPINE

创伤、类风湿性关节炎和退行性变是主要的 上颈椎(枕骨-C1-C2关节复合体)的问题。 它们会导致疼痛、畸形和神经功能障碍。一个 重要的和临床公认的实体是脊柱不稳。 它将脊柱的主要问题与临床结果联系起来。 由于创伤、关节炎或退化而失去坚韧的脊椎的 等，手术重建是用来固定不稳定 脊椎。有几个问题仍未得到回答。 什么构成了上颈椎的不稳定？何谓 不同类型的不稳定性及其测量？什么 这一地区的损伤机制是什么？每个人都扮演什么角色 脊椎韧带在提供稳定性方面起到了什么作用？什么类型和 不稳定程度会导致椎动脉供血不足吗？ 椎骨、神经之间的正常解剖关系是什么 根、脊髓和椎动脉？给出了一个不稳定的 上颈椎，有哪些相对优势和 不同外科手术的缺点是什么？ 假设一套综合的研究，适用于 生物力学研究的现代方法，需要解决 上述临床和基础科学问题。这项提议， 由五项研究组成，提供了一个全面的方法 对上颈椎的研究。对于这一地区，我们 建议使用新鲜的人类身体和身体来确定 标本如下：(1)解剖学。细化和量化 使用计算机图形学的三维解剖学；计算机 图形(2)生物力学。正常的三维运动 和物理性质；(3)不稳定性。的决定 不稳定阈值和韧带在稳定性中的作用；(4) 精神创伤。高速创伤及损伤机制；(5)手术治疗。 不稳定、损伤和创伤脊柱的外科重建。 这项拟议的工作在几个领域具有临床意义。为 第一次，椎骨、韧带、 脊髓、神经根和椎动脉将被量化 并直观地显示，从而提供了更全面的 了解这个联合复合体的运作方式。 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性阈值。 实验性创伤将决定常见损伤的机制： 脱位、骨折和鞭打，再次帮助提供 对脊柱损伤的了解，这可能会导致改进 治疗方法。最后，对Present进行了生物力学评价。 可用于稳定受伤和关节炎的外科手术 脊椎将导致对目前的改进建议- 日方法，以及新外科手术的发展 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.