| 研究生: |
陳舒品 Chen, Sue-Ping |
|---|---|
| 論文名稱: |
退化性羊頸椎之運動學評估:骨植入物對鄰近椎節間運動之影響 Kinematic Evaluation of Degenerative Cervical Spine Model in Sheep: the Influence of Bone Grafting on the Adjacent Segmental Motion |
| 指導教授: |
張冠諒
Chang, Guan-Liang 李宜堅 Lee, E-Jian |
| 學位類別: |
碩士 Master |
| 系所名稱: |
工學院 - 醫學工程研究所 Institute of Biomedical Engineering |
| 論文出版年: | 2006 |
| 畢業學年度: | 94 |
| 語文別: | 中文 |
| 論文頁數: | 63 |
| 中文關鍵詞: | 運動學評估 、骨融合 、退化性頸椎 |
| 外文關鍵詞: | degenerative cervical spine, kinematic evaluation, bone fusion |
| 相關次數: | 點閱:72 下載:1 |
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頸椎是由七節頸脊骨連接而成,向上與顱骨、向下與胸椎相連,包含八對神經,是脊柱中非常重要的部份。頸椎常因椎間盤的老化、彈性疲乏、磨損而產生脊椎退化性病變。在頸椎退化性椎間盤病的治療中,頸椎融合手術是最常見的的外科治療方法。
本研究以羊的頸椎為實驗試件,經過外科手術,評估在退化性頸椎中經椎間盤去除後有無植入骨植入物的效果。實驗前先將黑肚綿羊施以頸椎手術:頸椎第二節(C2)和第三節(C3)間的椎間盤破壞且頸椎第三節(C3)和第四節(C4)間的椎間盤施行假手術(sham)組(假手術:實行與C2-C3相同的手術操作, 但是不破壞椎間盤)、C2-C3椎間盤破壞且C3-C4椎間盤去除組、C2-C3椎間盤破壞且C3-C4椎間盤去除加骨移植組和控制組,手術後經過六個月的飼養以達到延遲性的目的,六個月後取下第一至第四節頸椎為實驗試件,將試件置於靜態測試架上,利用動態量測分析系統:Vicon 460,紀錄頸椎在空間中的運動情況,並利用Matlab程式轉換得到力矩與角度變化的關係;本實驗進行前屈、後彎、左右側彎、左右旋轉共六個過程。
結果發現退化性頸椎其各方向的運動範圍相較於控制組都明顯降低。而在退化性頸椎中,椎間盤去除組的各方向運動範圍相較於sham組皆有明顯降低,而椎間盤去除加骨移植組除了在左右旋轉相較於sham組稍微有增加外,其它各方向皆稍微降低,雖然如此,但椎間盤去除加骨移植組的各方向運動範圍相較於椎間盤去除組皆有增加,且與sham組有較相似的活動範圍。從X-ray的觀察上,所有經過手術的試件皆長出了白色的結痂組織。
The cervical spine is the most important part in the spine. The cervical degenerative diseases are often observed with aging disc. The descectomy with bone fusion surgical operation is the most often used to treat cervical disc degenerative disease.
Thirty Barbods Black Belly Sheep’s second to fourth cervical spine which have been surgical operation were used in this study to evaluate the influence of bone grafting on the adjacent motion segment of the degenerative cervical spine. Four groups were classified according to various surgical planning that are control group, C2-C3 disc injury and C3-C4 sham, C2-C3 disc injury and C3-C4 descectomy only, C2-C3 disc injury and C3-C4 descectomy with born grafting. Each study sheep was fed for six months postoperatively before the kinematical tests. Kinematics tests which measured in six modes of motion included flexion, extension, left-right lateral bending, and left-right axial rotation, use motion analysis system (Vicon 460) to record the three-dimensional motion of the specimen.
The results indicated that the degenerative cervical displayed smaller motion ranges of the six motion ranges. The data provided the results implied severe disc disease of the degenerative cervical spine could decrease the all motion ranges, and therefore restrict to neck motion profile. At the descectomy functional unit, the results indicated that descectomy segment of the degenerative cervical spine actually induced smaller motion ranges of all testing modes that did sham-operated group. The descectomy with bone grafting segment of the degenerative cervical spine displayed smaller motion ranges in flexion, extension, left and right lateral bending, but higher motion ranges in left and right axial rotation that did sham-operated group, however, it displayed higher motion ranges in all testing modes than did descectomy only. Therefore, the bone grafting group was more stable than the descectomy only in the degenerative cervical spine. In X-ray examination, the white scar tissue were observed in all of the operation segment.
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