脊柱病理学对后韧带复合体结构和功能的影响。

IF 2.9 2区 医学 Q1 ORTHOPEDICS Current Reviews in Musculoskeletal Medicine Pub Date : 2023-12-01 Epub Date: 2023-10-23 DOI:10.1007/s12178-023-09873-9
Bradley Anderson, Bahar Shahidi
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引用次数: 0

摘要

综述目的:脊柱韧带是脊柱减轻生物力学应力的重要组成部分。特别是后韧带复合体,它由黄韧带、棘间韧带和棘上韧带组成。然而,关于生物力学以及韧带健康在脊柱病理学和临床中的作用的研究却很少。本文对脊柱病理学对后韧带复合体的结构、功能和生物力学特性的影响进行了全面的综述。最近的发现:目前表征后韧带复合体生物力学特性的研究主要包括尸体研究和有限元建模,最近将患者特定解剖结构纳入有限元模型。目前研究的最终目标是了解这些韧带结构在健康和病理性脊柱中的相对贡献,以及保留韧带是否在脊柱外科技术中发挥重要作用。在基线时,后韧带复杂结构占脊柱稳定性的30-40%,这在很大程度上取决于每个韧带的内在生物力学特性。生物力学随着病理学和随后的刚性手术固定技术的不同而有很大差异,并且通常是不适应的。通常继发于脊柱病理学中的形态学变化,但韧带的形态学变化也可能是主要病理学。脊柱韧带的生物力学不适应会对脊柱的整体完整性产生不利影响,并最终导致手术失败和不良临床结果的风险增加。未来需要进行研究,特别是在活体受试者中,以更好地描述韧带的适应,从而为改善脊柱病理学的治疗提供靶点。
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The Impact of Spine Pathology on Posterior Ligamentous Complex Structure and Function.

Purpose of review: Spinal ligament is an important component of the spinal column in mitigating biomechanical stress. Particularly the posterior ligamentous complex, which is composed of the ligamentum flavum, interspinous, and supraspinous ligaments. However, research characterizing the biomechanics and role of ligament health in spinal pathology and clinical context are scarce. This article provides a comprehensive review of the implications of spinal pathology on the structure, function, and biomechanical properties of the posterior ligamentous complex.

Recent findings: Current research characterizing biomechanical properties of the posterior ligamentous complex is primarily composed of cadaveric studies and finite element modeling, and more recently incorporating patient-specific anatomy into finite element models. The ultimate goal of current research is to understand the relative contributions of these ligamentous structures in healthy and pathological spine, and whether preserving ligaments may play an important role in spinal surgical techniques. At baseline, posterior ligamentous complex structures account for 30-40% of spinal stability, which is highly dependent on the intrinsic biomechanical properties of each ligament. Biomechanics vary widely with pathology and following rigid surgical fixation techniques and are generally maladaptive. Often secondary to morphological changes in the setting of spinal pathology, but morphological changes in ligament may also serve as a primary pathology. Biomechanical maladaptations of the spinal ligament adversely influence overall spinal column integrity and ultimately predispose to increased risk for surgical failure and poor clinical outcomes. Future research is needed, particularly in living subjects, to better characterize adaptations in ligaments that can provide targets for improved treatment of spinal pathology.

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来源期刊
CiteScore
7.50
自引率
2.40%
发文量
64
期刊介绍: This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions. We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
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