颈椎小关节矢状位角的不对称性和椎体旋转的相关研究

Cervical disc replacement is a common treatment for cervical spondylosis and cervical disc herniation,but the prosthesis loosening and slippage is a severe complication in cervical disc replacement, one of the reasons for this complication is caused by vertebral instability,and vertebral rotation is one phenomenon of vertebral instability. Facet joints is an important structure to prevent rotation of the vertebral, and the relationship between facet tropism and vertebral rotation has been controversial. Question:1.What are the morphological differences between facet joint with facet tropism and without facet tropism under normal physiological conditions? 2.Is there direct relation between facet tropism and vertebral rotation? 3.Are the facet joint asymmetry angles corresponded to the vertebral rotation angles? On the basis of the preliminary studies, using fresh human specimens,our objective is:1.To observed the differences of facet tropism between 2D and 3D finite element model;2.To observed the differences of morphological anatomical differences between facet joint with facet tropism and without facet tropism;3.Using self-made vertebral rotation measuring instrument, to observe the facet joint asymmetry angles varying condition on 2D and 3D finite element model when the vertebral rotation 0o, clockwise and counterclockwise rotation of 3o,6o,9o, respectively.The study is expected to solve the controversy of the correlation between facet tropism and vertebral rotation fundamentally.

颈椎间盘置换术是颈椎病和颈椎间盘突出症常见的治疗方法，假体松动滑脱是颈椎间盘置换术严重的并发症，颈椎失稳是引起这个并发症的原因之一，椎体旋转是颈椎失稳的一种表现。小关节是防止椎体旋转的重要结构，而小关节矢状位角的不对称性和椎体旋转之间的关系却一直存在争议。目前的问题是：1.生理状态下矢状位角正常和异常小关节在实体和影像形态学上的差异？2.小关节矢状位角的不对称性是否由椎体旋转引起？3.小关节的不对称角度能否和椎体的旋转度数相对应？在前期研究的基础上我们计划：1.采用新鲜人体标本观察小关节的矢状位角度在2D和3D有限元模型下的表现；2.观察矢状位角正常和异常小关节在形态学上的解剖差异；3.通过自制的椎体旋转度角测量仪观察小关节矢状位不对称角度在椎体0度位以及顺时针或逆时针方向旋转3、6、9度时在2D和3D模型上的变化情况。本研究可望从根本上解决小关节矢状位不对称性和椎体旋转之间关系的相关争议