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經(jīng)傷椎單側(cè)椎弓根螺釘內(nèi)固定術(shù)治療急性脊柱創(chuàng)傷中的生物力學(xué)評(píng)價(jià) Biomechanical evaluation of unilateral pedicle screw fixation through injured vertebrae in the treatment of acute spinal trauma |
| 作者： 周政 李良文 成俊 黃強(qiáng) 石國佳 邢叔星 |
| 單位：成都市第五人民醫(yī)院骨科（成都 611130）;成都中醫(yī)藥大學(xué)解剖教研室（成都 610075） |
| 關(guān)鍵詞： 脊柱骨折; 椎弓根螺釘; 內(nèi)固定; 生物力學(xué) |
| 分類號(hào)：R318 |
| 出版年·卷·期（頁碼）：2020·39·5（529-534） |
| 摘要： |
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目的 通過生物力學(xué)評(píng)價(jià)的方法比較不同內(nèi)固定術(shù)式治療急性脊柱創(chuàng)傷的穩(wěn)定性。方法 選取成都中醫(yī)藥大學(xué)醫(yī)學(xué)院解剖教研室提供的成人尸體胸腰段標(biāo)本(T11-L3)共 10 具,經(jīng)鋸條橫斷其2/3椎體后制備成胸腰段椎體骨折標(biāo)本.將標(biāo)本隨機(jī)等分為經(jīng)傷椎單側(cè)固定組和跨傷椎固定組各 5 具? 前組行經(jīng)傷椎單側(cè)椎弓根固定聯(lián)合四釘固定臨近椎體,后組給予跨傷椎四釘固定臨近椎體,觀察并比較 兩組標(biāo)本的強(qiáng)度、扭轉(zhuǎn)力、拔出力、軸向剛度、載荷與應(yīng)變及位移的關(guān)系。結(jié)果 500 N 作用力下,經(jīng)傷椎 單側(cè)固定組應(yīng)變及位移均小于跨傷椎固定組(p<0.05) ;以 L1椎體為例,在 500 N 作用力下,經(jīng)傷椎單側(cè)固定組強(qiáng)度、軸向剛度、扭轉(zhuǎn)強(qiáng)度和扭轉(zhuǎn)剛度均高于跨傷椎固定組(p<0.05) 在拔出力方面兩組無顯著(p>0.05) 結(jié)論 經(jīng)傷椎單側(cè)椎弓根螺釘內(nèi)固定在治療急性脊柱損傷時(shí)較跨傷椎內(nèi)固定體現(xiàn)出更 穩(wěn)定的生物力學(xué)特性,值得臨床推廣. |
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Objective To compare the stability of different internal fixation methods in the treatment of acute spinal trauma by biomechanical evaluationMethods A total of 10 fresh adult cadaveric thoracolumbar specimens ( T11 - L3 ) provided by the Department of Anatomy, Chengdu University of Traditional Chinese Medicine were selected to prepare thoracolumbar vertebral fracture specimens after 2 / 3 vertebral bodies were transected by saw blade group and cross injury fixation group, 5 in each unilateral pedicle fixation combined with four screws, while in the latter group, the adjacent vertebrae were fixed by four screws torsion force, pull?out force, axial stiffness, load, strain and displacement was observed and compared between the two groupsResults Under the action of 500 N, the strain and displacement of the unilateral fixation through injured vertebrae group were less than that of the cross injury fixation group ( P < 01 as an example, under the action of 500 N, the strength, axial stiffness, torsional strength and torsional stiffness of the unilateral fixation through injured vertebrae group were higher than those of the cross injury fixation group (P< 0P>0Conclusion Compared with the traditional cross injury internal fixation, the unilateral fixation through injured vertebrae has more stable biomechanical characteristics in the treatment of acute spinal injury, and the operation is more convenient,which is worthy of clinical promotion |
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地址：北京安定門外安貞醫(yī)院內(nèi)北京生物醫(yī)學(xué)工程編輯部 電話：010-64456508 傳真：010-64456661 電子郵箱：[email protected] |