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Biomechanical Effect of One-Level or Two-Level Minimally Invasive Posterior Cervical Foraminotomies

机译:一水平或两水平微创后路颈椎切开术的生物力学效应

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The option to treat unilateral cervical radiculopathy with minimal posterior cervical foraminotomy (PCF) surgery over the traditional anterior approach raises concerns due to the unknown changes that occur to the structural properties of the spine. The objective of this study was to determine the biomechanical stability of unilateral minimally invasive PCF performed at one or two levels in a human cadaveric cervical spine model. Five fresh human sub-axial (C2-T1) cadaveric cervical spines were biomechanical tested under a combined compressive force and flexion or extension bending moment.   Three spine conditions were studied: harvested, one-level C5-C6 foraminotomy, and two level C5-C6 and C6-C7 foraminotomies.  Measurements included global and individual motion segment unit (MSU)  rotations and analyzed at an end load limit of 3Nm. Individual MSU contributions relative to global motion were statistically compared using a one-way repeated measures ANOVA and Student-Newman-Keuls test (P=0.05). No significant differences occurred in the total rotation or the segment rotational contributions between the three spine conditions in flexion testing or extension.  From a biomechanical perspective, a one-level or two-level PCF is appropriate surgical option for treating cervical radiculopathy.
机译:由于脊柱结构特性发生未知变化,因此与传统的前路入路相比,采用最小限度的后颈椎间孔切开术(PCF)手术来治疗单侧颈椎神经根病的选择引起了人们的关注。这项研究的目的是确定在人体尸体颈椎模型中在一到两个水平上进行的单方面微创PCF的生物力学稳定性。在组合的压缩力和屈曲或伸展弯曲力矩的作用下,对五只新鲜的人类亚轴(C2-T1)尸体颈椎进行了生物力学测试。研究了三种脊柱条件:收获,一级C5-C6椎间孔切开术和二级C5-C6和C6-C7椎间孔切开术。测量包括全局和单个运动段单位(MSU)的旋转,并在3Nm的极限载荷极限下进行分析。使用单向重复测量方差分析和Student-Newman-Keuls检验,对MSU相对于整体运动的贡献进行统计比较(P = 0.05)。在屈曲测试或伸展过程中,三个脊柱条件之间的总旋转或节段旋转贡献没有显着差异。从生物力学的角度来看,一级或二级PCF是治疗颈椎神经根病的合适手术方法。

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