Abstract
Clinical and experimental studies concerning intradiscal pressure have mainly been carried out using the lumbar spine. It has been shown that degenerative changes in the intervertebral disc and external loads can significantly influence intradiscal pressure. To see if these findings are also relevant for cervical discs, we carried out an in vitro study using human cervial spine specimens. The specimens were tested biomechanically under various conditions with simultaneous recording of intradiscal pressure in two cervical discs. We were able to confirm in vivo measurements of intradiscal pressure reported in the literature. Simulation of muscle force led to a marked increase in intradiscal pressure. Moreover, it was demonstrated that ventral cervical fusion has a significant influence on intradiscal pressure in both adjacent segments. In general, the results improve our understanding of the basic biomechanics of the cervical spine. The experiments with fused specimens could help to explain why degeneration is accelerated in adjacent motion segments after ventral cervical fusion.
Zusammenfassung
Sowohl klinische als auch experimentelle Arbeiten zur intradiskalen Druckmessung beschränken sich weitgehend auf Untersuchungen an der Lendenwirbelsäule. So konnte z.B. eine Abhängigkeit des intradiskalen Druckverhaltens vom Degenerationszustand der Bandscheibe v.a. aber von äußeren Lasteinwirkungen nachgewiesen werden. Um zu überprüfen, ob diese Befunde auch auf die Halswirbelsäule zutreffen, führten wir eine In-vitro-Studie mit humanen Präparaten durch. Diese wurden unter verschiedenen Bedingungen biomechanisch gesestet und simultan der intradiskale Druck in 2 Bandscheiben registriert. Wir konnten hierbei bei der Literatur in vivo erhobene Werte für den intradiskalen Druck in Neutralstellung experimentell bestätigen. Die Simulation von Muskelkräften führte zu einer eindrucksvollen Erhöhung des intradiskalen Drucks. Zudem konnte gezeigt werden, daß die Fusion eines zervikalen Bewegungssegments erheblichen Einfluß auf den intradiskalen Druck in den-beiden Nachbarsegmenten hat. Die Ergebnisse insgesamt erweitern unseren Kenntnisstand über das Verhalten intradiskaler Drücke in zervikalen Bandscheiben. Die Befunde an fusionierten Präparaten könnten dazu beitragen, ein lang bekanntes Phänomen zu erklären, und zwar die Beobachtung, daß die an ein blockiertes Segment unmittelbar angrenzenden Etagen langfristig einer vermehrten Degeneration unterliegen.
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Pospiech, J., Wilke, H.J., Claes, L.E. et al. Intradiskales Druckverhalten zervikaler Bandscheiben unter physiologischen und pathologischen Bedingungen In-vitro-Untersuchung. Langenbecks Arch Chir 381, 303–308 (1996). https://doi.org/10.1007/BF00191309
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DOI: https://doi.org/10.1007/BF00191309