腰椎峡部裂病理模型的建立和疲劳特性的研究张志王簕吕玉明张亮曾勉东(广州医学院第三附属医院骨科510150)【中图分类号】R683【文献标识码】A【文章编号】1672-5085(2011)46-0112-03【摘要】目的对比分析腰椎峡部内、外部分骨质的抗疲劳特性。方法12例成人新鲜腰L5椎标木模型，随机分为两组，每组6例，分别用咬骨钳咬除腰椎峡部外1/2或内1/2骨质，制作腰椎峡部外1/2缺损和内1/2缺损病理模型。采用游标卡尺对剩余腰椎峡部的宽度进行测量。对腰椎峡部外1/2缺损模型与腰椎峡部内1/2缺损模型的峡部缺损后宽度进行统计对比。将标木固定于脊柱三维运动试验机上，依次将腰椎峡部外1/2缺损和内1/2缺损病理模型标木置于生物材料力学试验机上，分别给予压缩负荷。记录断裂次数进行统计学分析。结果正常L5左侧腰椎峡部宽度为15.06±0.83,正常右侧腰椎峡部宽度为14.85±0.72,左右侧对比P=0.52。腰椎峡部外1/2缺损模型峡部宽度为5.24±0.41,腰椎峡部内1/2缺损模型峡部宽度为5.15±0.34,对比P=0.57o腰椎峡部外1/2缺损模型峡部断裂次数为25160±1019,腰椎峡部内1/2缺损模型峡部断裂次数为18782±3126,对比P=0.006。结论腰椎峡部外1/2缺损模型抗疲劳性优于腰椎峡部内1/2缺损模型，腰椎峡部内1/2承担了更多的腰椎负荷应力。同一应力下，腰椎峡部外1/2更容易疲劳骨折。【关键词】腰椎峡部生物力学AStudyonFatiguecharacteristicsoflumbarspondylolysisandstressdistributionofconductionZhangZhi,WangLe,LvYuming,ZhangLiang,Zengmingdong,(thethirdAffiliatedHospitalofGuangzhouMedicalCollege,GuangZhou510150)【Abstract】Objective:Tomakepathologicdefectmodelsofisthmusexternal1/2andinternal1/2,Tocompareandanalyzetheanti-fatiguefeaturesofthesetwomodels.Methods:Take12freshlumbarvertebraspecimens.Dividethese12specimensrandomlyinto2groups.Userongeurtoremoverespectivelytheexternal1/2isthmusandtheinternal1/2isthmusboneandthenmakepathologicaldefectmodels.Useelectricverniercalipertomeasurethewidthoftheremainingisthmus.Comparethewidthoftheexternal1/2isthmusdefectmodelandtheinternal1/2isthmusdefectmodel.Fixthespecimenonspine3Dmovementtestmachine,puttheexternal1/2isthmusdefectmodelandtheinternal1/2isthmusdefectmodelonmechanictestmachine.Recordthebreakagetimesandanalyzethem.Result:ThewidthofthenormalL5leftisthmusportionoflumbarvertebrais15.06±0.83,therightwidthis14.85±0.72.ThedifferencebetweentheleftwidthandtherightwidthisP=0.52.Theisthmuswidthoftheexternal1/2isthmusdefectmodelis5.24±0.41,theisthmuswidthoftheinternal1/2isthmusdefectmodelis5.15±0.34.ThedifferencebetweentheexternalandtheinternalisthmuswidthisP=0.57.Thebreakagetimesoftheexternal1/2isthmusdefectmodelare25160±1019,whiletheinternal1/2isthmusdefectmodelare18782±3126.ThedifferencebetweenthemisP=0.006.Conclusion:Theanti-fatiguefeaturesoftheexternal1/2lumbarvertebraisthmusdefectmodelisbetterthantheinternal1/2.Theinternal1/2bearsmoreloads.Theexternal1/2iseasiertobecomefatigueandfracture.【Keywords】isthmusportionoflumbarvertebrabiologydynamics椎弓峡部裂是一种常见的脊柱疾患，可引起一系列的腰腿痛症状。它是以腰椎椎弓峡部（关节突间部）的一侧或两侧缺损为主要病理特征，病变以L4-L5最为常见，约占95%，严重吋可发生椎体滑脱［1,2］。虽然奋学者报道急性外伤可引发峡部骨折，但大多数峡部裂患者并未奋明确的外伤史。Crawford用尸体腰椎材料经循环加载导致峡部骨折［3】，Ulibarri和Terai证实峡部冇明显的应力集中［4,5］，因此，峡部易发生疲劳性骨折。本研究将对峡部的奋关解剖学特征进行测量，并在成人新鲜标本上模拟腰椎峡部外1/2缺损和内1/2缺损病理模型，并对这两个病理模型进行疲劳试验，模拟腰椎椎弓峡部局部应力集中日积月累...