单枚椎间融合器并对侧经皮椎弓根螺钉固定的生物力学研究  

An biomecanical study on single cage insertion combined with contralside pedicle screw and single rod fixation

作　　者：王建华[1] 夏虹[1] 吴增晖[1] 廖穗祥[1] 尹庆水[1] 

机构地区：[1]广州华博博士后工作站广州军区广州总医院骨科,广东广州510010

出　　处：《临床骨科杂志》2007年第2期180-182,共3页Journal of Clinical Orthopaedics

基　　金：广州市科技计划基金项目(编号:2004Z3-E0211)

摘　　要：目的对单枚融合器联合单侧钉棒系统固定的生物力学性能进行评价。方法5具新鲜小牛腰椎标本,建立以下力学模型:A组:双侧开窗+双枚融合器置入+双侧椎弓根钉棒固定;B组:单侧小关节切除+单枚融合器斜向置入+同侧椎弓根钉棒固定;C组:单侧开窗+单枚融合器置入+同侧椎弓根钉棒固定;D组:单侧开窗+单枚融合器置入+对侧椎弓根钉棒固定。在生物力学平台上测试各试验组在不同工况下的ROM值。结果A组的固定最稳固,各工况下ROM值最低。B组的前后抗弯ROM值与A组差异无显著性,其左右侧弯和旋转方向的稳定性较A组有所降低。与B组比较,D组的前后弯曲性能与B组差异无显著性,其左右侧弯方向的ROM低与B组。两组的抗旋转ROM值差异无显著性。C组的左右抗弯及抗旋转性能均差于B、D组。结论单枚椎间融合器联合对侧椎弓根钉棒固定是一种力学性能较为优良组合,可以替代单侧斜向融合器并同侧椎弓根钉棒技术用于下腰椎微创手术。Objective To evaluate the biomechanical property of a new operation method in lumbar spine：single cage insertion combined with contraside pedicle screw and single rod fixation. Methods 5 calf lumbar specimen were divided into 4 groups ： Group A ： double cages with double side pedicle screw-rod system ; Group B ： single cage insertion inclinely combined with same side pedicle screw - rod system fixation ; GroupC ： single cage insertion combined with the same side single pedicle screw-rod ;Group D：single cage insertion combined with contraside single pedicle screwrod system. ROMs were checked under different motion states ： anterior and posterior bending , left and right bending , left and right rotation. Results （1） In 4 groups , the ROM of group A was smallest in all states. Compared with group A. the group B had a higher ROM in the left and right bending and roatation states. But there was no difference in the ROM in anterior and posterior bending states. （2） Compared with group B, the group D had a lower ROM in the left and right bending;while the ROM in rotation states was alike. Group C had higher ROM in right bending and roatation states than group B and D. Conclusions Single cage insertion combined with contraside single pedicle screw-rod fixation is a good method with good biomechanical property,which could be used in minimally invasive surgery in the lower lumbar disorders.

关 键 词：椎弓根螺钉 椎间融合器 外科手术 微创性 生物力学 

分 类 号：R687.32[医药卫生—骨科学] R681.5[医药卫生—外科学]