颈脊髓损伤前后路减压内固定术后稳定性研究  

Cervical Stability after Decompression by Combining Anterior and Posterior Approach for the Treatment of Cervical Spinal Cord Injury

作　　者：周栋[1] 徐南伟[1] 王以进[2] 农鲁明[1] 蒋西嘉[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院骨科,江苏省常州市213003 [2]上海大学上海生物力学工程研究所

出　　处：《中国骨与关节损伤杂志》2005年第6期364-366,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的研究一期前后路联合减压治疗颈脊髓损伤的颈椎稳定性问题,从生物力学角度验证本术式的可行性。方法采集新鲜人体颈椎标本6具,不同术式自身对照,采用实验应力分析方法,测定其颈椎的生物力学特性和颈椎稳定性问题。结果采用前后路联合减压钢板内固定,无论在颈椎的强度、刚度,抗扭转强度、刚度以及在颈椎稳定性、承载能力方面均比其他对照组强,均具有显著性差异(P<0·05),而颈椎前后路联合减压单纯前路Orion钢板+植骨融合术其生物力学的各项指标均比其他对照组差。结论颈椎一期前后路联合减压治疗颈脊髓损伤的颈椎生物力学实验证明,采用前后路联合钢板内固定,颈椎非常稳定、可靠、生物力学性能优越,疗效满意;而单纯行前路Orion钢板+植骨融合术,术后早期应辅以外固定。Objective To study the cervical stability after decompression by combining anterior and posterior approach for the treatment of cervical spinal cord injury ,and explore the clinical application feasibility of this operative procedure from biomechanical aspects. Methods Six spine specimens from fresh adult cadaver were used to t est the biomechanical p roperty and stability of cervical spine,which w ere treated by different operative procedures and studied by stress analysis. Results The group treated by primary anterior_posterior decompression and plate interna l fix ation was better than the matched control in cervical strength,rigid degree,anti_tor sion, cervical stability and loading ability.The difference in these aspects was sign ificant (P<0.05).The group treated with anterior_posterior decompress ion and anterior Orion plate fixation was worse in any aspect. Conclusion Primary decompression through anterion_posterion approach and anterion_posterion plate internal fixation is better than by anterion_posterion decompression and anterior Orion plate fixation in t he treatment of cervical spinal cord injury.When anterior Orion plate fixation is used, the external fixation must be guaranteed.

关 键 词：颈脊髓损伤 稳定性研究 内固定术后 后路减压 前路Orion钢板 颈椎前后路联合减压 钢板内固定 植骨融合术 人体颈椎标本 实验应力分析 生物力学特性 生物力学性能 减压治疗 颈椎稳定性 显著性差异 自身对照 扭转强度 承载能力 

分 类 号：R651.2[医药卫生—外科学] R942[医药卫生—临床医学]