As one of the most important daily motor activities, human locomotion has been investigated intensively in recent decades. The locomotor functions and mechanics of human lower limbs have become relatively well underst...As one of the most important daily motor activities, human locomotion has been investigated intensively in recent decades. The locomotor functions and mechanics of human lower limbs have become relatively well understood. However, so far our understanding of the motions and functional contributions of the human spine during locomotion is still very poor and simultaneous in-vivo limb and spinal column motion data are scarce. The objective of this study is to investigate the delicate in-vivo kinematic coupling between different functional regions of the human spinal column during locomotion as a stepping stone to explore the locomotor function of the human spine complex. A novel infrared reflective marker cluster system was constrncted using stereophotogrammetry techniques to record the 3D in-vivo geometric shape of the spinal column and the segmental position and orientation of each functional spinal region simultaneously. Gait measurements of normal walking were conducted. The preliminary results show that the spinal column shape changes periodically in the frontal plane during locomotion. The segmental motions of different spinal functional regions appear to be strongly coupled, indicating some synergistic strategy may be employed by the human spinal column to facilitate locomotion. In contrast to traditional medical imaging-based methods, the proposed technique can be used to investigate the dynamic characteristics of the spinal column, hence providing more insight into the functional biomechanics of the human spine.展开更多
背景:Topping-off技术通过将腰椎融合和棘突间动态内固定系统(Coflex)结合,在实现充分减压的同时也能够对相邻节段予以保护。目前将Topping-off技术应用于腰骶区需要融合同时相邻节段存在退变的年轻患者的相关力学研究尚未见报道。目的...背景:Topping-off技术通过将腰椎融合和棘突间动态内固定系统(Coflex)结合,在实现充分减压的同时也能够对相邻节段予以保护。目前将Topping-off技术应用于腰骶区需要融合同时相邻节段存在退变的年轻患者的相关力学研究尚未见报道。目的:建立腰骶交界区Topping-off有限元模型,分析邻近节段生物力学及全腰椎活动度的变化趋势。方法:随机选择1名健康年轻男性志愿者,既往无腰部外伤史及腰痛病史,经签署志愿同意书后,行薄层CT扫描,获取影像学资料。将图像信息导入计算机,依次通过Mimics、Geomagic Studio 12.0、HyperMesh、Abaqus对图像信息进行分析建立全腰椎模型,即健康组模型。验证模型的有效性后,在健康组模型的基础上改变L4-S1椎间盘材料属性建立椎间盘中度退变模型,并在退变模型的基础上分别建立融合模型和Topping-off模型。然后分别计算4组模型在施加400 N的预载荷和10 N m的扭转力矩后L2-L5节段活动度变化趋势及L4/L5椎间盘、髓核以及关节突关节的应力变化。结果与结论:①Topping-off模型与融合模型腰椎活动度较退变模型减小,且Topping-off模型比融合模型减小更明显;②融合模型术后L4-L5活动度较退变模型显著增加,L2/L3、L3/L4节段活动度相比退变模型并无明显改变;Topping-off模型L4-L5活动度较退变模型减小,L2/L3、L3/L4节段活动度相比退变模型在前屈及后伸体位下均有一定程度增加;③相比退变模型,融合模型L4-L5节段在前屈、后伸、左旋、左侧弯4个体位下,椎间盘、髓核、关节突关节应力均增大,而Topping-off模型纤维应力在4个体位下均降低;④说明Topping-off技术不仅能够降低上位相邻节段椎间盘、髓核和关节突的关节应力,而且能够减少相邻节段过度活动,增加上位其他节段的活动度,进而在代偿腰椎活动度的同时延缓相邻节段退变。展开更多
基金supported by the Key Project of National Natural Science Foundation of China (No. 50635030)the National Basic Research Program ("973" Program) of China (No. 2007CB616913)+2 种基金was also supported by the China Scholarship Council (CSC)We also would like to thank Karin Jespers and Sharon Warner of the Structure and Motion Laboratory for their support of the experimental workJRH’s con-tributions were supported by research grants BB/C516844/1 and BB/F01169/1 from the BBSRC, whom we thank.
文摘As one of the most important daily motor activities, human locomotion has been investigated intensively in recent decades. The locomotor functions and mechanics of human lower limbs have become relatively well understood. However, so far our understanding of the motions and functional contributions of the human spine during locomotion is still very poor and simultaneous in-vivo limb and spinal column motion data are scarce. The objective of this study is to investigate the delicate in-vivo kinematic coupling between different functional regions of the human spinal column during locomotion as a stepping stone to explore the locomotor function of the human spine complex. A novel infrared reflective marker cluster system was constrncted using stereophotogrammetry techniques to record the 3D in-vivo geometric shape of the spinal column and the segmental position and orientation of each functional spinal region simultaneously. Gait measurements of normal walking were conducted. The preliminary results show that the spinal column shape changes periodically in the frontal plane during locomotion. The segmental motions of different spinal functional regions appear to be strongly coupled, indicating some synergistic strategy may be employed by the human spinal column to facilitate locomotion. In contrast to traditional medical imaging-based methods, the proposed technique can be used to investigate the dynamic characteristics of the spinal column, hence providing more insight into the functional biomechanics of the human spine.
文摘背景:Topping-off技术通过将腰椎融合和棘突间动态内固定系统(Coflex)结合,在实现充分减压的同时也能够对相邻节段予以保护。目前将Topping-off技术应用于腰骶区需要融合同时相邻节段存在退变的年轻患者的相关力学研究尚未见报道。目的:建立腰骶交界区Topping-off有限元模型,分析邻近节段生物力学及全腰椎活动度的变化趋势。方法:随机选择1名健康年轻男性志愿者,既往无腰部外伤史及腰痛病史,经签署志愿同意书后,行薄层CT扫描,获取影像学资料。将图像信息导入计算机,依次通过Mimics、Geomagic Studio 12.0、HyperMesh、Abaqus对图像信息进行分析建立全腰椎模型,即健康组模型。验证模型的有效性后,在健康组模型的基础上改变L4-S1椎间盘材料属性建立椎间盘中度退变模型,并在退变模型的基础上分别建立融合模型和Topping-off模型。然后分别计算4组模型在施加400 N的预载荷和10 N m的扭转力矩后L2-L5节段活动度变化趋势及L4/L5椎间盘、髓核以及关节突关节的应力变化。结果与结论:①Topping-off模型与融合模型腰椎活动度较退变模型减小,且Topping-off模型比融合模型减小更明显;②融合模型术后L4-L5活动度较退变模型显著增加,L2/L3、L3/L4节段活动度相比退变模型并无明显改变;Topping-off模型L4-L5活动度较退变模型减小,L2/L3、L3/L4节段活动度相比退变模型在前屈及后伸体位下均有一定程度增加;③相比退变模型,融合模型L4-L5节段在前屈、后伸、左旋、左侧弯4个体位下,椎间盘、髓核、关节突关节应力均增大,而Topping-off模型纤维应力在4个体位下均降低;④说明Topping-off技术不仅能够降低上位相邻节段椎间盘、髓核和关节突的关节应力,而且能够减少相邻节段过度活动,增加上位其他节段的活动度,进而在代偿腰椎活动度的同时延缓相邻节段退变。
