Biomechanical Effects of Lateral Bending Position on Performing Cervical Spinal Manipulation for Cervical Disc Herniation: A Three-Dimensional Finite Element Analysis

被引：13

作者：

Huang, Xuecheng ^{[1
,2
]}

Ye, Linqiang ^{[2
]}

Wu, Zixian ^{[1
,2
]}

Liang, Lichang ^{[3
]}

Wang, Qianli ^{[2
]}

Yu, Weibo ^{[4
]}

Liang, De ^{[5
]}

Jiang, Xiaobing ^{[2
]}

机构：

[1] Guangzhou Univ Chinese Med, Sch Clin Med 1, Guangzhou 510405, Guangdong, Peoples R China

[2] Guangzhou Univ Chinese Med, Affiliated Hosp 1, Dept Spinal Surg, Guangzhou 510405, Guangdong, Peoples R China

[3] Guangzhou Univ Chinese Med, Shenzhen Hosp, Shenzhen 518034, Peoples R China

[4] Tongde Hosp Zhejiang Prov, Dept Orthopaed & Traumatol, Hangzhou 310012, Zhejiang, Peoples R China

[5] Guangzhou Univ Chinese Med, Lab Affiliated Natl Key Discipline Orthopaed & Tr, Guangzhou 510405, Guangdong, Peoples R China

来源：

EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE | 2018年 / 2018卷

基金：

中国国家自然科学基金;

关键词：

HIGH-VELOCITY; RADICULOPATHY; DEGENERATION; POSTERIOR; REPLACEMENT; ORIENTATION; ANTERIOR; MODERATE; THERAPY; LUMBAR;

D O I：

10.1155/2018/2798396

中图分类号：

R [医药、卫生];

学科分类号：

100218 [急诊医学];

摘要：

Background. Most studies report that the common position of cervical spinal manipulation (CSM) for treating symptomatic cervical disc herniation (CDH) is lateral bending to the herniated side. However, the rationality of lateral bending position on performing CSM for CDH is still unclear. Objective. The purpose of this study is to investigate the biomechanical effects of lateral bending position on performing CSM for CDH. Methods. A finite element (FE) model of CDH (herniated on the left side) was generated in C5-6 segment based on the normal FE model. The FE model performed CSM in left lateral bending position, neutral position, and right lateral bending position, respectively. Cervical disc displacement, annulus fiber stress, and facet joint stress were observed during the simulation of CSM. Results. The cervical disc displacement on herniated side moved forward during CSM, and the maximum forward displacements were 0.23, 0.36, and 0.45 mm in left lateral bending position, neutral position, and right lateral bending position, respectively. As the same trend of cervical disc displacement, the annulus fiber stresses on herniated side from small to large were 7.40, 16.39, and 22.75 MPa in left lateral bending position, neutral position, and right lateral bending position, respectively. However, the maximum facet stresses at left superior cartilage of C6 in left lateral bending position, neutral position, and right lateral bending position were 6.88, 3.60, and 0.12 MPa, respectively. Conclusion. Compared with neutral position and right lateral bending position, though the forward displacement of cervical disc on herniated side was smaller in left lateral bending position, the annulus fiber stress on herniated side was declined by sharing load on the left facet joint. The results suggested that lateral bending to the herniated side on performing CSM tends to protect the cervical disc on herniated side. Future clinical studies are needed to verify that.

引用

页数：8

共 41 条

[1]

[Anonymous], CLIN REHABILITATION

[2]

Bronfort Gert, 2004, Spine J, V4, P335, DOI 10.1016/j.spinee.2003.06.002

[3]

Creighton D, 2005, NEUROSURG FOCUS, V13, P10

[4]

Biomechanical comparison between fusion of two vertebrae and implantation of an artificial intervertebral disc [J].