雑誌文献を検索します。書籍を検索する際には「書籍検索」を選択してください。

Rinsho Seikei Geka Volume 38, Issue 4 （April 2003）

臨床整形外科 38巻4号（2003年4月発行）

Japanese English

特集脊椎脊髄病学最近の進歩 2003（第31回日本脊椎脊髄病学会より）

腰椎椎間板変性と運動力学特性の関連 The Relationship between Disc Degeneration and Flexibility of the Lumbar Spine 田中信弘 ¹ , Howard S. An ² , Tae-Hong Lim ² , 藤原淳 ² , 藤本吉範 ¹ , 越智光夫 ¹ Nobuhiro Tanaka ¹ , Howard S. An ² , Tae-Hong Lim ² , Atsushi Fujiwara ² , Yoshinori Fujimoto ¹ , Mitsuo Ochi ¹ ¹広島大学大学院医歯薬学総合研究科展開医科学専攻病態制御医科学講座整形外科学 ²ラッシュ医科大学整形外科 ¹Department of Orthopaedic Surgery, Programs for Applied Biomedicine, Division of Clinical Medical Science, Graduate School of Biomedical Sciences, Hiroshima University ²Department of Orthopaedic Surgery, Rush-Presbyterian-St. Luke's Medical Center キーワード： lumbar spine , 腰椎 , intervertebral disc , 椎間板 , biomechanics , 生体力学 Keyword: lumbar spine , 腰椎 , intervertebral disc , 椎間板 , biomechanics , 生体力学 pp.453-461

発行日 2003年4月1日 Published Date 2003/4/1

DOI https://doi.org/10.11477/mf.1408100681

PDF(1264KB)

有料閲覧

Abstract 文献概要
1ページ目 Look Inside

　抄録：本研究は，椎間板変性度の違いによる三次元的生体力学特性を比較検討することを目的とした．47新鮮遺体（死亡時年齢39～87歳，平均68歳）より採取した114椎間を対象とした．椎間板変性度は，MR画像とcryomicrotomeによる肉眼的形態を用い，Thompson分類に従いⅠ度からⅤ度に分類した．生体力学検査は，重錘を使用し純モーメントを上位椎体に加え，屈曲，伸展，左右回旋，左右側屈の各6方向のrotational angleおよびtranslationを求めた．T12-L1からL3-4椎間までの上位腰椎では，回旋，屈曲運動はⅣ度で増大し，Ⅴ度で減少し，側屈運動はⅢ度で増大していた．一方，L4-5，L5-S1の下位腰椎では，回旋，側屈運動はⅢ度で増大していた．腰椎運動力学特性は椎間板変性により影響され，特に回旋運動では椎間板変性による影響が大きく，Ⅲ度，Ⅳ度の椎間板変性は腰椎不安定性に大きく関与していることが示唆された．

　The purpose of this study was to investigate the relationship between grade of degeneration of intervertebral discs and 3-dimensional biomechanical characteristics of the motion segment under multidirectional loading conditions. The material used in this study consisted of 114 lumbar motion segments from T12-L1 to L5-S1 retrieved from 47 fresh cadaver spines (average age at death, 68 years；range, 39 to 87 years).The severity of degeneration (gradesⅠ to Ⅴ according to Thomson's system) was determined by examining magnetic resonance (MR) images and cryomicrotome sections. Pure unconstrained moments with dead weights were applied to the motion segments in 6 load steps. The directions of loading included flexion, extension, right and left axial rotation, and right and left lateral bending. Segments from the upper lumbar levels (T12-L1 to L3-4) tended to have greater rotational movement in flexion, extension, and axial rotation with disc degeneration up to gradeⅣ,but the motion decreased when the disc degeneration reached grade Ⅴ. In the lower lumbar spine, motion in axial rotation and lateral bending at L4-5 and L5-S1 was increased in grade Ⅲ. These results suggest that kinematic properties of the lumbar spine are related to disc degeneration. D isc degeneration, particularly in grades Ⅲ and Ⅳ, in which radial tears of the anulus fibrosus are found, was generally associated with greater motion. Disc space collapse and osteophyte formation, as found in grade Ⅴ, resulted in stabilization of the motion segments.