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[1]沈知彼,王輝昊,王寬,等.頸椎定位旋轉扳法對不同曲度頸椎內部結構應力的影響[J].中醫(yī)正骨,2018,30(03):8-12.
　SHEN Zhibi,WANG Huihao,WANG Kuan,et al.Effect of cervical fixed-position rotary pulling manipulation on internal structure stresses of cervical vertebrae with different curvature[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2018,30(03):8-12.
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頸椎定位旋轉扳法對不同曲度頸椎內部結構應力的影響()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數:
2018年03期
頁碼:
8-12
欄目:
頸椎疾患
出版日期:
2018-03-20

文章信息/Info

Title:
Effect of cervical fixed-position rotary pulling manipulation on internal structure stresses of cervical vertebrae with different curvature
作者:
沈知彼; 王輝昊; 王寬; 鄧真; 陳威燁; 詹紅生
上海中醫(yī)藥大學附屬曙光醫(yī)院,上海市中醫(yī)藥研究院骨傷科研究所,上海 201203
Author(s):
SHEN Zhibi; WANG Huihao; WANG Kuan; DENG Zhen; CHEN Weiye; ZHAN Hongsheng
Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,The Institute of Traumatology and Orthopedics Affiliated to Shanghai Academy of Traditional Chinese Medicine, Shanghai 201203,China
關鍵詞:
頸椎;  手法; 整骨;  扳法;  應力; 物理;  有限元分析
Keywords:
Keywords cervical vertebrae;  manipulation; osteopathic;  pulling manipulation;  stress; mechanical;  finite element analysis
摘要:
目的:觀察頸椎定位旋轉扳法對不同曲度頸椎內部結構應力的影響。方法:基于可靠的正常頸椎有限元模型(正常模型),結合1例頸椎曲度變直患者和1例頸椎反弓患者的頸椎CT圖像,建立曲度變直頸椎有限元模型(變直模型)和反弓頸椎有限元模型(反弓模型)。模擬右側頸椎定位旋轉扳法,分別加載于正常模型、變直模型和反弓模型,觀察3種模型椎間盤、韌帶、關節(jié)軟骨和終板的應力特征。結果:①頸椎椎間盤應力分布。正常模型椎間盤應力主要集中于C6～7和C7T1椎間盤右側纖維環(huán),變直模型椎間盤應力主要集中于C2～3椎間盤左側纖維環(huán),反弓模型椎間盤應力主要集中于C2～3、C3～4、C4～5椎間盤右側纖維環(huán); 3種模型椎間盤最高應力均集中于下段頸椎椎間盤纖維環(huán),其中正常模型最高應力集中于C6～C7右側鉤椎關節(jié)處,變直模型和反弓模型最高應力集中區(qū)域分別為C7～T1左側鉤椎關節(jié)處和C5～C6左側鉤椎關節(jié)處; 反弓模型椎間盤最高應力值最大,變直模型次之,正常模型最小。②頸椎主要韌帶應力分布。正常模型韌帶應力主要集中于C2～C3、C3～C4、C4～C5雙側關節(jié)囊韌帶及橫韌帶,最高應力集中于C3～C4右側關節(jié)囊韌帶; 變直模型韌帶應力主要集中于寰枕后韌帶、前縱韌帶(寰枕節(jié)段)、橫韌帶,最高應力集中于齒突尖韌帶; 反弓模型韌帶應力主要集中于下頸段右側關節(jié)囊韌帶、上頸段左側關節(jié)囊韌帶、橫韌帶,最高應力集中于寰枕后韌帶。③頸椎關節(jié)軟骨應力分布。3種模型關節(jié)軟骨應力均主要集中于寰枕關節(jié)兩側,最高應力均集中于寰樞關節(jié)軟骨,正常模型和反弓模型應力主要集中區(qū)域、最高應力集中區(qū)域位于右側,變直模型應力主要集中區(qū)域、最高應力集中區(qū)域位于左側; 反弓模型關節(jié)軟骨最高應力值最大,變直模型次之,正常模型最小。④頸椎終板應力分布。正常模型、變直模型、反弓模型終板應力主要集中部位分別為C2下終板、C3下終板和C4上終板; 正常模型終板最高應力集中于C3上終板左前部,變直模型和反弓模型終板最高應力均集中于C3上終板后部。結論:在頸椎定位旋轉扳法作用下,不同曲度頸椎內部結構應力集中部位及大小均不同。
Abstract:
ABSTRACT Objective:To observe the effect of cervical fixed-position rotatry pulling manipulation on internal structure stresses of cervical vertebrae with different curvature.Methods:A finite element model of cervical vertebrae with straightened physiological-curvature(straightened model)and a finite element model of cervical vertebrae with reversed physiological-curvature(reversed model)were created by using a reliable finite element model of normal cervical vertebrae(normal model)and the CT images of cervical vertebrae with straightened physiological-curvature and reversed physiological-curvature respectively.The loads,which simulated the cervical fixed-position rotatry pulling manipulation on the right side,were exerted on normal model,straightened model and reversed model.The stress characteristics of intervertebral disc,ligament,articular cartilage and endplate of the 3 kinds of models were observed.Results:The intervertebral disc stresses of normal model,straightened model and reversed model concentrated mainly on the right fibrous rings of C6/C7 and C7/T1 intervertebral discs,the left fibrous ring of C2/C3 intervertebral disc and the right fibrous rings of C2/C3,C3/C4 and C4/C5 intervertebral discs respectively.The highest stress of intervertebral discs of the 3 kinds of models concentrated on fibrous rings of intervertebral discs of lowe cervical vertebrae.The highest stress of intervertebral discs of normal model,straightened model and reversed model concentrated on right C6/C7 uncovertebral joint,left C7/T1 uncovertebral joint and left C5/C6 uncovertebral joint respectively.The intervertebral disc had high-to-low highest stress value in reversed model,straightened model and normal model in turn.The ligament stresses of normal model concentrated mainly on bilateral articular capsule ligaments and transverse ligaments at C2/C3,C3/C4 and C4/C5 segments,and the highest stress concentrated on right articular capsule ligament at C3/C4 segment.The ligament stresses of straightened model concentrated mainly on posterior occipitoatlantal ligament,occipitoatlantal anterior longitudinal ligament and transverse ligament,and the highest stress concentrated on apical dental ligament.The ligament stresses of reversed model concentrated mainly on right articular capsule ligament of lower cervical vertebrae,left articular capsule ligament of upper cervical vertebrae and transverse ligament,and the highest stress concentrated on posterior occipitoatlantal ligament.The articular cartilage stresses of the 3 kinds of models concentrated mainly on both sides of atlanto-occipital joint,and the highest stress concentrated on atlantoaxial articular cartilage.The stress concentration area and the highest stress concentration area of articular cartilage of normal model and reversed model were on the right,and those of straightened model were on the left.The articular cartilages had high-to-low highest stress value in reversed model,straightened model and normal model in turn.The endplate stresses of normal model,straightened model and reversed model concentrated mainly on lower endplates of C2 and C3 and upper endplate of C4 respectively.The highest stress of endplate of normal model concentrated on the left front of upper endplate of C3,and those of straightened model and reversed model concentrated on the back of upper endplate of C3.Conclusion:Both stress concentration position and stress concentration value are different in internal structure of cervical vertebrae with different curvature under the action of cervical fixed-position rotatry pulling manipulation.

參考文獻/References:

[1] 何劍波,蘇國義,林定坤.未成年人頸痛與頸椎曲度相關性的回顧分析[J].中華中醫(yī)藥雜志,2017,32(8):3812-3815.
[2] 張玉婷,王翔,詹紅生.頸椎曲度的測量方法及其臨床意義[J].中國骨傷,2014,27(12):1062-1064.
[3] 陳忻,朱立國,于杰,等.中醫(yī)綜合療法對神經根型頸椎病頸椎曲度變化的影響[J].北京中醫(yī)藥,2014,33(4):280-282.
[4] VARATHARAJAN S,FERGUSON B,CHROBAK K,et al.Are non-invasive interventions effective for the management of headaches associated with neck pain?An update of the Bone and Joint Decade Task Force on Neck Pain and Its Associated Disorders by the Ontario Protocol for Traffic Injury Management(OPTIMa)Collaboration[J].Eur Spine J,2016,25(7):1971-1999.
[5] CASSIDY JD,BRONFORT G,HARTVIGSEN J.Should we abandon cervical spine manipulation for mechanical neck pain? No[J].BMJ,2012,344:3680.
[6] KAWCHUK GN,JHANGRI GS,HURWITZ EL,et al.The relation between the spatial distribution of vertebral artery compromise and exposure to cervical manipulation[J].J Neurol,2008,255(3):371-377.
[7] 王輝昊,詹紅生,張明才,等.手法治療頸椎病意外事件分析與預防策略思考[J].中國骨傷,2012,25(9):730-736.
[8] 詹紅生,石印玉,張明才,等.基于“骨錯縫、筋出槽”病機認識的椎間盤病癥診治新觀點[J].上海中醫(yī)藥雜志,2007,41(9):4-6.
[9] 魏戌,朱立國,高景華,等.旋提手法對椎動脈型頸椎病患者經顱多普勒相關指標的影響[J].中醫(yī)雜志,2017,58(18):1573-1576.
[10] 王立童,詹紅生.以“骨錯縫,筋出槽”理論探討頸椎病的手法治療[J].中國運動醫(yī)學雜志,2009,28(6):703-705.
[11] 李義凱,李軍朋.與頸部手法治療相關的解剖學研究[J].中國臨床康復,2004,8(17):3348-3350.
[12] 姜宏,施杞.頸椎手法的生物力學研究與探索[J].中國中醫(yī)骨傷科雜志,1999,7(2):52.
[13] 紀雙泉,麥麗玲,陳建平,等.整脊手法結合神經松動術治療神經根型頸椎病療效觀察[J].中國康復醫(yī)學雜志,2017,32(5):582-584.
[14] 王輝昊,陳博,詹紅生.有限元分析技術在頸椎推拿手法生物力學研究中的應用[J].生物醫(yī)學工程學雜志,2013,30(5):1123-1126.
[15] 王輝昊,沈知彼,鄧真,等.人體全頸椎及椎動脈流固耦合模型的構建[J].浙江大學學報(醫(yī)學版),2015,44(2):131-137.
[16] WANG K,WANG H,DENG Z,et al.Cervical traction therapy with and without neck support:A finite element analysis[J].Musculoskelet Sci Pract,2017,28:1-9.
[17] KRISTJANSSON E,JONSSON H.Is the sagittal configuration of the cervical spine changed in women with chronic whiplash syndrome?A comparative computer-assisted radiographic assessment[J].J Manipulative Physiol Ther,2002,25(9):550-555.
[18] DENG Z,WANG K,WANG H,et al.A finite element study of traditional Chinese cervical manipulation[J].Eur Spine J,2017,26(7):1-10.
[19] YOGANANDAN N,KUMARESAN S,VOO L,et al.Finite element applications in human cervical spine modeling[J].Spine(Phila Pa 1976),1996,21(15):1824-1834.
[20] DEAN CL,GABRIEL JP,CASSINELLI EH,et al.Degenerative spondylolisthesis of the cervical spine:analysis of 58 patients treated with anterior cervical decompression and fusion[J].Spine J,2009,9(6):439-446.
[21] TEN HAVE HA,EULDERINK F.Degenerative changes in the cervical spine and their relationship to its mobility[J].J Pathol,1980,132(2):133-159.
[22] 魏威,葉楊,王以進.頸椎生理曲度變直的生物力學研究及臨床意義[J].浙江中西醫(yī)結合雜志,2011,21(9):610-613.
[23] 曾巖,黨耕町,馬慶軍.頸椎前路術后融合節(jié)段曲度變化與軸性癥狀和神經功能的相關性研究[J].中國脊柱脊髓雜志,2004,14(9):520-523.
[24] 賈連順,李家順.頸椎外科手術學[M].上海:上海遠東出版社,2001:139-141.

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備注/Memo

備注/Memo:
基金項目:國家自然科學基金項目(81473702,81503596,81202707,81001528); 上海市科學技術委員會科研計劃項目(14401970402,16401970102,15401934100); 上海市衛(wèi)生和計劃生育委員會項目(2017ZZ02024,20170242,ZXYXZ201703,ZYKC201602006,ZY3-LCPT-2-1005); 上海市市級醫(yī)院新興前沿技術聯(lián)合攻關項目(SHDC12014121); 詹紅生上海市名老中醫(yī)學術經驗研究工作室建設項目(SHGZS-2017025,SZYMZYGZS4013) 通訊作者:王輝昊 E-mail:[email protected]
更新日期/Last Update: 2018-08-02