颈椎后纵韧带骨化椎板成形术后对颈髓和神经根的生物力学影响:开放式和双门式椎板成形术的有限元分析比较。

PubMed ID
G H
发表日期 2018年07月

原始出处 生物力学工程杂志
Journal of biomechanical engineering
作者 Khuyagbaatar  Batbayar  Kim  Kyungsoo  Purevsuren  Tserenchimed  Lee  Sang-Hun  Kim  Yoon Hyuk 

文献标题 颈椎后纵韧带骨化椎板成形术后对颈髓和神经根的生物力学影响:开放式和双门式椎板成形术的有限元分析比较。
Biomechanical Effects on Cervical Spinal Cord and Nerve Root Following Laminoplasty for Ossification of the Posterior Longitudinal Ligament in the Cervical Spine: A Comparison Between Open-Door and Double-Door Laminoplasty Using Finite Element Analysis.
Biomechanical Effects on Cervical Spinal Cord and Nerve Root Following Laminoplasty for Ossification of the Posterior Longitudinal Ligament in the Cervical Spine: A Comparison Between Open-Door and Double-Door Laminoplasty Using Finite Element Analysis.

文献摘要

许多临床病例报道了C5麻痹的易感因素,并对两种椎板成形术进行了比较。然而,对于椎板成形术后颈脊髓和神经根的生物力学研究尚未见报道。本研究旨在探讨颈椎后纵韧带骨化症两种最常见的椎板成形术后脊髓和神经根的生物力学变化。建立了具有神经根复合结构的颈椎和脊髓的有限元模型。采用两种颈椎椎管成形术模型,分析椎管占位程度和OPLL形状的变化,分析脊髓和神经根的应力变化、脊髓后移和颈神经根移位。与椎板成形术类型相比,OPLL引起的脊髓压迫的形态和程度对应力变化、脊髓后移和神经根移位的影响更大。外侧型OPLL导致神经根受力不平衡,神经根位移最高。椎板成形术的类型和OPLL引起的脊髓压迫的形态和程度影响颈髓和神经根的应力和后移。侧方型OPLL可能是椎板成形术后神经根应力和张力不平衡的结果。


Many clinical case series have reported the predisposing factors for C5 palsy and have presented comparisons of the two types of laminoplasty. However, there have been no biomechanical studies focusing on cervical spinal cord and nerve root following laminoplasty. The purpose of this study is to investigate biomechanical changes in the spinal cord and nerve roots following the two most common types of laminoplasty, open-door and double-door laminoplasty, for cervical ossification of the posterior longitudinal ligament (OPLL). A finite element (FE) model of the cervical spine and spinal cord with nerve root complex structures was developed. Stress changes in the spinal cord and nerve roots, posterior shift of the spinal cord, and displacement of the cervical nerve roots were analyzed with two types of cervical laminoplasty models for variations in the degree of canal occupying ratio and shape of the OPLL. The shape and degree of spinal cord compression caused by the OPLL had more influence on the changes in stress, posterior shift of the spinal cord, and displacement of the nerve root than the type of laminoplasty. The lateral-type OPLL resulted in imbalanced stress on the nerve roots and the highest nerve root displacement. Type of laminoplasty and shape and degree of spinal cord compression caused by OPLL were found to influence the changes in stress and posterior displacement of the cervical spinal cord and nerve roots. Lateral-type OPLL might contribute to the development of C5 palsy due to the imbalanced stress and tension on the nerve roots after laminoplasty.

Many clinical case series have reported the predisposing factors for C5 palsy and have presented comparisons of the two types of laminoplasty. However, there have been no biomechanical studies focusing on cervical spinal cord and nerve root following laminoplasty. The purpose of this study is to investigate biomechanical changes in the spinal cord and nerve roots following the two most common types of laminoplasty, open-door and double-door laminoplasty, for cervical ossification of the posterior longitudinal ligament (OPLL). A finite element (FE) model of the cervical spine and spinal cord with nerve root complex structures was developed. Stress changes in the spinal cord and nerve roots, posterior shift of the spinal cord, and displacement of the cervical nerve roots were analyzed with two types of cervical laminoplasty models for variations in the degree of canal occupying ratio and shape of the OPLL. The shape and degree of spinal cord compression caused by the OPLL had more influence on the changes in stress, posterior shift of the spinal cord, and displacement of the nerve root than the type of laminoplasty. The lateral-type OPLL resulted in imbalanced stress on the nerve roots and the highest nerve root displacement. Type of laminoplasty and shape and degree of spinal cord compression caused by OPLL were found to influence the changes in stress and posterior displacement of the cervical spinal cord and nerve roots. Lateral-type OPLL might contribute to the development of C5 palsy due to the imbalanced stress and tension on the nerve roots after laminoplasty.


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