头下斜肌切断术治疗枕大神经痛的解剖学研究

目的:探讨枕大神经的走行及其与头下斜肌的关系,为枕大神经痛的诊断和治疗提供解剖学依据.方法:对15例成人尸体标本进行解剖,观察枕大神经的走行,分别测量头下斜肌切断前后颈部中立位、后伸30°位、前屈30°位、前屈60°位时枕大神经长度的变化,并进行统计学处理.结果:颈部处中立位时,枕大神经的张力适中;后伸30°位时,枕大神经相对松弛,张力下降;前屈30°位和前屈60°位时,枕大神经的第2段的长度分别为(5.63±0.05)mm和(6.03±0.06)mm.头下斜肌切断后,颈椎中立位,枕大神经的第1弯曲无明显上移;后伸30°位时,枕大神经的第1弯曲也无上移;前屈30°位及60°位时,枕大神经的第1弯曲分别上移(0.21±0.02)mm和(0.31±0.02)mm.结论:切断头下斜肌可使枕大神经第2段长度增加,第一弯曲上移,颈椎前屈时枕大神经移动度增大并松弛,避免了头下斜肌对枕大神经的压迫刺激.     

上颈椎C0-C3节段不同载荷作用下生物力学特性的有限元分析

研究上颈椎C0-C3活动节段在不同载荷作用下前屈、后伸、侧屈和旋转时椎体应力、关节活动度(range of motion,ROM)及椎间盘的应力分布情况,探讨载荷改变对上颈椎生物力学特性的影响。基于CT图像数据建立人体上颈椎有限元模型,模型包括皮质骨、松质骨、纤维环、髓核、关节软骨、终板及韧带等结构,根据解剖特征赋予不同部位的材料属性,计算分析上颈椎C0-C3各节段在不同力矩作用下屈伸旋转时颈椎ROM、椎体应力和椎间盘最大应力变化趋势,与前人离体试验和有限元结果进行对比验证。人体上颈椎C0-C3节段在40 N和1.5 N·m载荷作用下,前屈时ROM最小,C0-C1、 C1-C2、C2-C3各节段ROM分别为1.88°、2.16°和1.59°;后伸时ROM大于前屈,最大相差幅度为2.32°;侧屈时ROM大于前屈,增幅分别为2.57°、2.41°和0.49°;轴向旋转时ROM最大,相对于侧屈ROM分别增加了247.64%、282.71%和-43.27%。当施加40 N预载荷和1.0、1.5、2.0、2.5 N·m力矩时,随着力矩等值增大,上颈椎C0-C3节段整体ROM呈非线性增加,变化特征为前屈时最小,旋转时最大;椎间盘最大应力值呈非线性增加(前屈和侧屈)和减少(后伸和旋转),ROM和应力分布趋势和前人研究结果一致。上颈椎三维有限元模型在不同载荷下数值分析的结果符合正常人体颈椎生理活动范围和生物力学特性,为临床颈椎病理和生理的生物力学研究提供理论依据。     

空军飞行员颈肌强度的研究

目的 研究空军飞行员颈部各肌群的强度及其在航空动力环境中的意义。方法 采用CME-1飞行员颈肌训练器对149名空军飞行员颈部前、后、左、右肌群进行等长测试。每一个方向测量10次,10次中最大峰值作为该侧肌群的强度;计算每侧10次测试的峰值均值与肌群强度比值,反映飞行员的耐力。结果 空军飞行员前、后、左、右各肌群的强度分别为（132．0±42.2）N、（205.2±82.2）N、（174.3±76.4）N和（191.2±78.3）N,前屈和后伸肌群分别与其他肌群比较有显著性差异（P<0.001）,左、右侧屈肌群之间的比较亦有显著性差异（P＜0.001）,前屈肌群强度最小,后伸肌群强度最大,左右侧肌群强度居中,且右侧肌强度大于左侧。前、后、左、右各肌群反复测试10次的各次最大肌力均值与肌强度之比分别为74.24%、72.86%、72.75%和68.72%。结论 为了充分发挥高性能战斗机的机动性能,最大限度地减少加速度导致的飞行员颈部损伤,应鼓励空军飞行员在地面进行颈肌强度训练,并掌握好飞行过程中头部控制技术。     

横韧带损伤上颈椎C0-C3不稳定节段的三维有限元分析

目的建立寰椎横韧带损伤上颈椎C0-C3不稳定节段的三维有限元模型,探究横韧带损伤对上颈椎关节活动度ROM(the range of motion)和椎骨应力分布的影响。方法基于CT图像数据结合临床寰椎横韧带损伤特征,建立人体寰椎横韧带损伤上颈椎不稳定的三维有限元模型,比较分析横韧带损伤后上颈椎在不同工况下的关节活动度及椎骨应力分布情况。结果横韧带损伤后上颈椎寰枢关节在前屈、后伸、侧弯和轴向旋转等工况下的关节活动度均比正常组有不同程度的增大,增值分别为:3.5°、 4.8°、 1.1°和4.7°;屈伸时横韧带损伤后模型最大应力均比无损模型的大。结论寰椎横韧带损伤后上颈椎模型相比正常模型稳定性差,符合横韧带损伤后的真实情况,建立的有限元模型可用于上颈椎生物力学特性的分析。     

快速制动条件下颈部肌肉主动力特性研究EI北大核心

本文研究了快速制动条件下颈部肌肉的主动力特性,可为减少舰载机拦阻着舰时飞行员颈部损伤提供理论支撑。通过开展模拟快速制动条件下的静态加载和实车制动实验,采集受试者头颈部运动状态和颈部肌肉肌电信号,分析颈部肌肉主动力响应特点。结果发现颈部肌肉预紧时头颈部前屈时间推迟、幅度减小;颈部在极限位置持续时间减少,向座椅方向恢复更快;斜方肌比胸锁乳突肌肌电信号更高,可能发挥了更大作用。上述结果提示飞行员在实际制动飞行中可通过预紧颈部肌肉以降低颈部损伤,可以考虑设计颈部肌肉预紧相关装具。     

中,下部颈椎的三维运动

在5例新鲜颈椎(C3～T1)上,通过施加最大载荷为2.34N.m 的纯扭矩,使颈椎产生前屈、后伸、右/左侧弯、左/右旋转等运动。每一种运动均进行3次加载/卸载循环,在第3次分级加载时测量椎体的运动。得到的主要参数有:中性区 NZ(Neutral zone);弹性区 EZ(Elastic zone);脊椎运动范围 ROM(Rangeof motion)。分析结果表明:中、下部颈椎各节段的前屈运动和侧弯运动的幅度都从上至下依次减小,其中前屈运动为8.4°～4.0°,侧弯运动为6.4°～3.0°;C3～C7各节段后伸运动幅度较接近,为3.7°～3.2°,而 C7～T1为2.1°;各节段的旋转运动幅度也很接近,为7.4°～6.7°。     

山羊颈椎能成为人类颈椎的良好模型吗?

目的比较山羊与人颈椎的体外三维生物力学特征.方法取新鲜成年人尸体与崇明山羊颈椎标本(C0～T1)各8具,在脊柱三维运动测试仪上检测两者屈曲、后伸、左右侧屈、左右轴向旋转等模式下的运动范围和中性区.结果在前屈运动方式下,山羊和人C1-2的ROM分别为16.9°±5.1°和14.3°±3.2°,超过其它节段.在后伸运动方式下,山羊与人C1-2的ROM分别为20.6°±4.8°和18.7°±3.7° C0-1的ROM分别为19.3°±4.7°和18.4°±4.3°,超过其它节段.在轴向旋转运动模式下,山羊与人C1-2的ROM分别为48.60±8.6°和56.3°±8.9°.除山羊C4-7左右侧屈的NZ与人相比有统计学差异(P＜0.05)外,其它节段前屈、后伸、轴向旋转及左右侧屈的ROM和NZ与人相比无统计学差异(P＞0.05).结论崇明山羊与人颈椎在前屈、后伸、左右侧屈和轴向旋转等运动模式下的ROM及NZ相近,可作为颈椎研究的良好动物模型.     

6岁儿童全颈有限元模型的构建及验证

目的利用6岁儿童颈部有限元模型预测不同载荷下颈部损伤的力学响应。方法基于CT图像构建具有真实肌肉的6岁儿童颈部有限元模型,应用该模型通过分别重构儿童颈椎不同节段的动态拉伸实验、全颈椎拉伸实验和儿童志愿者低速碰撞实验验证其有效性。结果不同椎段拉伸仿真试验和全颈椎拉伸仿真试验中的力-位移曲线能够较好吻合实验曲线;儿童志愿者仿真试验的头部角速度-时间历程曲线位于实验数据通道内,吻合较好。结论该模型有效性得到验证,可用于研究儿童颈部不同载荷条件下的生物力学响应及损伤机制。     

颈部肌肉作用下颈椎牵引的生物力学特性

目的建立C1~7全颈椎三维有限元模型,研究其在颈部肌肉作用下颈椎牵引的生物力学特性,为临床颈椎牵引的治疗提供参考。方法建立正常颈椎的三维非线性有限元模型,在此基础上结合临床颈椎牵引的方法,利用生物力学分析软件进行建模仿真,在牵引重量一定的情况下,用后伸0°、10°、20°、30°、40°进行牵引,获得关节力和肌肉力,筛选合适的关节力和肌肉力对颈椎模型进行有限元分析。结果颈椎后伸牵引过程中,在肌肉力的作用下,颈椎椎体、椎间盘、钩椎关节的平均最大等效应力分别增加4.86、1.79、0.69 MPa,颈椎椎体的平均最大相对位移在矢状轴、垂直轴方向上分别增加5.53、0.63 mm。颈椎后伸牵引的生物力学特性与文献中的有限元分析结果相近。结论颈部肌肉对颈椎各椎体、椎间盘以及钩椎关节应力及位移的增加具有较大的促进作用。临床上行颈椎后伸牵引时,应考虑到颈部肌肉的作用,牵引角度不宜过大,推荐0°~20°是颈椎牵引初期相对安全的角度范围。     

后纵韧带硬化对颈椎力学影响的三维有限元分析

目的利用三维有限元分析探讨后纵韧带(posterior longitudinal ligament,PLL)硬化后对颈椎生物力学的影响,分析探讨其可能引起的颈部稳定性改变。方法对1位健康成年男性进行颈部CT及MR扫描,获取C1—C7节段的断层图片,采用MIMICS(Version 12)软件对颈椎图像进行三维重建,用HYPERMESH 10.0软件对三维几何进行网格划分,后处理计算软件为LS-DYNA3D 971。模型开发和模拟计算在Dell Power Edge 12G M420刀片式服务器上进行,并固定C7,对C1进行前屈、仰伸及轴向旋转运动,加载力矩为3 N·m。比较在前屈、仰伸及旋转运动下,正常以及PLL硬化后颈椎有限元模型的生物力学改变对颈部稳定性的影响。结果颈椎前屈运动中,PLL硬化后椎间盘纤维环最大应力减小6%。颈椎仰伸运动中,PLL硬化后髓核最大应力降低约11%,椎小关节最大应力增大约15.7%。颈椎旋转运动中,PLL硬化椎间盘纤维环最大应力降低24%,最大应力集中在C4/5纤维环旋转方向侧;髓核最大应力降低25%,且最大应力位置由C2/3髓核上方下移至C6/7髓核下方;椎小关节最大应力下降10%。结论 PLL硬化后,前屈及旋转运动使PLL承载更多的力,可能加重已有病变或引起继发损伤;仰伸运动会使最大受力部位转移到椎小关节,导致继发性椎小关节损伤的可能性增加。     

Changes in saccadic reaction time while maintaining neck flexion in men and women

We investigated changes in saccadic reaction time in relation to the degree of increase in activity of neck extensor muscles when neck flexion occurred, and assessed the reliability of the measurements. Saccadic reaction time was measured firstly, during neck flexion angles set at 5° increments from 0° (resting position) to 25°, with the chin either resting on a stand or not, and secondly, during shoulder girdle elevator muscles providing a relative muscle force of 30%, with the neck flexion angle maintained at 0° by having the subjects rest their chins on a stand. Saccadic reaction time was evaluated by the latency to the beginning of eye movement toward the lateral target, which was moved at random intervals in 20° amplitude jumps. Muscle activity in the trapezius muscle was evaluated using the mean amplitude of electromyogram recordings. Very high coefficients of reliability in muscle activity and saccadic reaction time were observed between the two sets of tests at 1-h intervals and also among the three trials with a 1-min rest. When their necks were flexed and the subjects rested their chins on a stand, muscle activity increased slightly in accordance with the enlargement of this angle, with no significant change in saccadic reaction time. With the chin not resting on the stand, muscle activity increased gradually, while the saccadic reaction time decreased to that obtained at an average neck flexion angle of 20°. However, the angle where the shortest reaction time was obtained showed considerable individual variation (5–25°). Activity in the trapezius muscle at a 20° neck flexion angle, with the chin not resting on the stand, was far less than that for 30% maximal voluntary contraction in shoulder girdle elevator muscles. Nevertheless, the saccadic reaction times were roughly equivalent under the two different sets of conditions. No sex differences were observed in terms of saccadic reaction time under any set of conditions. Accepted: 27 September 1999     

飞行员机动飞行过程中颈椎动力学响应仿真及损伤预测

目的 采用有限元方法针对典型机动飞行动作过程中飞行员颈椎动力学响应进行仿真,并采用冲击损伤及疲劳损伤模型对飞行员颈椎组织损伤失效进行分析预测。方法 构建具有较高生物仿真度的颈部有限元模型,结合实例对模型的有效性进行验证。加载离心训练机不同模式下的过载曲线进行数值仿真,并采用通用颈椎损伤判定准则和生物组织疲劳损伤模型对组织的冲击损伤及疲劳损伤进行预测分析。结果 机动飞行动作下,过载冲击产生的椎骨、椎间盘最大应力分别为66.53、58.63 MPa,根据Nij损伤准则计算得到最大Nij为0.096,低于损伤耐受阈值1,不会对颈椎骨组织造成直接的急性损伤;引用生物组织疲劳损伤模型得知,松质骨在不间断重复加载超过40 000次的情况下发生疲劳失效破坏,考虑到飞行员有限的飞行生涯,椎骨骨组织不会因疲劳损伤积累而导致破坏。结论 研究结果在一定程度上有助于制定飞行员训练和飞行方案,也为其防护装备开发提供数据支持。     

水平负向加速度对不同座椅靠背角假人模型颈部损伤的差异

目的 基于假人模型,研究水平负向加速度(-G_x)作用下不同靠背角与颈部损伤的关系。方法 将假人模型面朝轨道方向,固定在加速度平台底座上,设置靠背角为17°、22°、30°3个实验组,每个实验组按照相同的加速度曲线分别进行10次重复试验,比较相同-G_x条件下颈椎上、下部加速度差异,通过曲线拟合计算并比较颈部损伤指数(neck injury criteria, NIC)。结果 颈椎上、下部在前后向、垂直向的加速度变化曲线形态一致,存在峰值差异;在前后向(X轴),靠背角22°实验组的加速度峰值稍高于17°、30°靠背角实验组的加速度峰值;在垂直向(Z轴),靠背角22°实验组的加速度峰值低于17°、30°靠背角实验组的加速度峰值;在前后向及垂直向,靠背角22°实验组测得的NIC_max较小,靠背角30°实验组测得的NIC_max次之,靠背角17°实验组测得的NIC_max较大。结论 靠背角度与颈部损伤之间呈非线性关系。本实验中在-G_x作用下,靠背角为22°时假人模型的颈...     

基于脊柱矢状面曲线建立腰椎 L4 ~ 5 力学简化模型及其有效性验证

目的 根据人体脊柱矢状面曲线建立腰椎 L4~ 5 活动节段力学简化模型,对该模型结构进行有效性验证与分 析。 方法 采用基于飞行时间测距原理的体外测量装置获取人体脊柱矢状面曲线,基于该曲线构建腰椎 L4 ~ 5 机 械简化模型,并从关节活动度(range of motion, ROM)、椎间盘应力( intervertebral disc pressure, IDP)分布及小关节 力(facet joint force,FJF)方面对模型有效性进行验证。 结果 在 0. 2、0. 4、0. 6、0. 8、1 kN 随动载荷( follower load, FL)下模型最大 IDP 分别为 0. 23、0. 46、0. 69、0. 92、1. 15 MPa,纯扭矩下模型屈曲、后伸、侧屈及轴向扭转时 ROM 分 别为 6. 61°、4. 03°、3. 30°、2. 03°,在 FL 和扭矩共同作用下屈曲、后伸、侧屈及轴向扭转时 IDP 分别为 1. 80、1. 00、 1. 36、0. 80 MPa,后伸、侧屈及轴向旋转时 FJF 分别为 79. 60、29. 49、94. 64 N。 结论 基于人体脊柱矢状面曲线构建 的力学简化模型可用于脊柱矢状面曲线变化的脊柱力学分析。     

A mathematical modelling study investigating the influence of knee joint flexion angle and extension moment on patellofemoral joint reaction force and stress

BackgroundPatellofemoral pain (PFP) is the most common orthopaedic condition among runners. Individuals with PFP exhibit greater patellofemoral joint (PFJ) reaction force and stress when compared with pain-free controls. However, it is not clear whether PFJ reaction force and stress are the highest (or lowest) when knee joint flexion angle and extension moment are in which combinations. We aimed to investigate the influence of knee joint flexion angle and extension moment on PFJ reaction force and stress.MethodsA PFJ sagittal model was used to quantify PFJ reaction force and stress. Based on the public dataset of the previous study, peak knee joint flexion angle and extension moment at various running speeds was calculated. Based on the calculated peak value, simulation ranges were set to knee joint flexion angle of 10–45° and extension moment of 0–240 Nm. The quadriceps force, effective lever arm length at quadriceps muscle, and PFJ contact area were determined as a function of the knee joint flexion angle and extension moment, and finally PFJ forces and stress were estimated.ResultsPFJ reaction force increased as the knee flexion angle and extension moment increased. Although PFJ stress also increased as the knee extension moment increased, it was at the highest and lowest at 10° and about 30° knee joint flexion angles, respectively.ConclusionsIncorporating knee flexion posture (approximately 30°) during running may help in reducing PFJ stress, which would be useful in the prevention of pain and act as an optimal treatment program for PFP.     

Prediction of Three Dimensional Maximum Isometric Neck Strength

We measured maximum isometric neck strength under combinations of flexion/extension, lateral bending and axial rotation to determine whether neck strength in three dimensions (3D) can be predicted from principal axes strength. This would allow biomechanical modelers to validate their neck models across many directions using only principal axis strength data. Maximum isometric neck moments were measured in 9 male volunteers (29 ± 9 years) for 17 directions. The 3D moments were normalized by the principal axis moments, and compared to unity for all directions tested. Finally, each subject’s maximum principal axis moments were used to predict their resultant moment in the off-axis directions. Maximum moments were 30 ± 6 N m in flexion, 32 ± 9 N m in lateral bending, 51 ± 11 N m in extension, and 13 ± 5 N m in axial rotation. The normalized 3D moments were not significantly different from unity (95% confidence interval contained one), except for three directions that combined ipsilateral axial rotation and lateral bending; in these directions the normalized moments exceeded one. Predicted resultant moments compared well to the actual measured values (r ² = 0.88). Despite exceeding unity, the normalized moments were consistent across subjects to allow prediction of maximum 3D neck strength using principal axes neck strength.     

Hand digit control in children: age-related changes in hand digit force interactions during maximum flexion and extension force production tasks

We studied the finger interactions during maximum voluntary force (MVF) production in flexion and extension in children and adults. The goal of this study was to investigate the age-related changes and flexion–extension differences of MVF and finger interaction indices, such as finger inter-dependency (force enslaving (FE): unintended finger forces produced by non-instructed fingers during force production of an instructed finger), force sharing (FS; percent contributions of individual finger forces to the total force at four-finger MVF), and force deficit (FD; force difference between single-finger MVF and the force of the same finger at four-finger MVF). Twenty-five right-handed children of 6–10 years of age and 25 adults of 20–24 years of age participated as subjects in this study (five subjects at each age). During the experiments, the subjects had their forearms secured in armrests. The subjects inserted the distal phalanges of the right hand into C-shaped aluminum thimbles affixed to small force sensors with 20° of flexion about the metacarpophalangeal (MCP) joint. The subjects were instructed to produce their maximum isometric force with a single finger or all four fingers in flexion or extension. In order to examine the effects of muscle–force relationship on MVF and other digit interaction indices, six subjects were randomly selected from the group of 25 adult subjects and asked to perform the same experimental protocol described above. However, the MCP joint was at 80° of flexion. The results from the 20° of MCP joint flexion showed that (1) MVF increased and finger inter-dependency decreased with children’s age, (2) the increasing and decreasing absolute slopes (N/year) from regression analysis were steeper in flexion than extension while the relative slopes (%/year) with respect to adults’ maximum finger forces were higher in extension than flexion, (3) the larger MVF, FE, and FD were found in flexion than in extension, (4) the finger FS was very similar in children and adults, (5) the FS pattern of individual fingers was different for flexion and extension, and (6) the differences between flexion and extension found at 20° MCP joint conditions were also valid at 80° MCP joint conditions. We conclude that (a) the finger strength and independency increase from 6 to 10 years of age, and the increasing trends are more evident in flexion than in extension as indexed by the absolute slopes, (b) the finger strength and finger independency is greater in flexion than in extension, and (c) the sharing pattern in children appears to develop before 6 years of age or it is an inherent property of the hand neuromusculoskletal system. One noteworthy observation, which requires further investigation, was that FE was slightly smaller in the 80° condition than in the 20° condition for flexion, but larger for extension for all subjects. This may be interpreted as a greater FE when flexor or extensor muscles are stretched.     

In-situ forces in the human posterior cruciate ligament in response to posterior tibial loading

Although some investigators have referred to the human posterior cruciate ligament (PCL) as the center of the knee, it has received less attention than the more frequently injured anterior cruciate ligament (ACL) and medial collateral ligament (MCL). Therefore, our understanding of the function of the PCL is limited. Our laboratory has developed a method of measuring thein-situ forces in a ligament without contacting that ligament by using a universal force-moment sensor (UFS). In this study, we attached a USF to the tibia and measuredin-situ forces of the human PCL as a function of knee flexion in response to tibial loading. At a 50-N posterior tibial load, the force in the PCL increased from 25±11 N (mean±SD) at 30° of knee flexion to 48±12 N at 90° of knee flexion. At 100 N, the corresponding increases were to 50±17 N and 95±17 N, respectively. Of note, at 30° knee flexion, approximately 45% of the resistance to posterior tibial loading was caused by contact between the tibia and the femoral condyles, whereas, at 90° of knee flexion, no resistance was caused by such contact. For direction of thein-situ force, the elevation angle from the tibial plateau was greater at 30° of knee flexion than at 90° of knee flexion. The data gathered on the magnitude and direction of thein-situ force of the PCL should help in our understanding of the dependence of knee flexion angle of the forces within the PCL.     

Load-Based Lower Neck Injury Criteria for Females from Rear Impact from Cadaver Experiments

The objectives of this study were to derive lower neck injury metrics/criteria and injury risk curves for the force, moment, and interaction criterion in rear impacts for females. Biomechanical data were obtained from previous intact and isolated post mortem human subjects and head–neck complexes subjected to posteroanterior accelerative loading. Censored data were used in the survival analysis model. The primary shear force, sagittal bending moment, and interaction (lower neck injury criterion, LN_ic) metrics were significant predictors of injury. The most optimal distribution was selected (Weibulll, log normal, or log logistic) using the Akaike information criterion according to the latest ISO recommendations for deriving risk curves. The Kolmogorov–Smirnov test was used to quantify robustness of the assumed parametric model. The intercepts for the interaction index were extracted from the primary risk curves. Normalized confidence interval sizes (NCIS) were reported at discrete probability levels, along with the risk curves and 95% confidence intervals. The mean force of 214 N, moment of 54 Nm, and 0.89 LN_ic were associated with a five percent probability of injury. The NCIS for these metrics were 0.90, 0.95, and 0.85. These preliminary results can be used as a first step in the definition of lower neck injury criteria for women under posteroanterior accelerative loading in crashworthiness evaluations.     

椎间盘不对称切除对小关节压力及腰椎稳定性的影响

目的探讨腰椎间盘不对称切除对小关节压力及腰椎稳定性的影响。方法采用7具人体脊柱标本(L2~3),制备完整椎间盘组、1/4椎间盘切除组、1/2椎间盘切除组,对标本施加7.5 N·m的屈伸、侧弯和轴向旋转方向的纯力偶矩,记录腰椎运动范围(range of motion,ROM)和小关节压力。结果后伸方向,1/4椎间盘切除状态下非切除侧小关节压力显著性增大;侧弯方向,1/2椎间盘切除状态下的两侧小关节压力均有显著性增大;轴向旋转方向,1/2椎间盘切除状态下仅切除侧小关节压力显著性增大。1/4椎间盘切除、1/2椎间盘切除状态下的ROM均大于完整椎间盘,但前屈方向各组间ROM无差别,各组间侧弯和轴向旋转的ROM在左、右侧无差别。结论腰椎间盘不对称切除导致腰椎除前屈方向外稳定性下降和小关节压力不对称性增大,提示腰椎间盘不对称退变引起腰椎不稳和小关节压力增大可产生腰痛。