双头和单头螺纹中空加压螺钉治疗齿突骨折的生物力学比较研究  

Biomechanical study on internal fixations with a single cannulated one-threaded or double-threaded screw for the treatment of Type II odontoid fractures

作　　者：韩国伟[1] 刘少喻[1] 赵卫东[2] 于滨生[1] 梁春祥[1] 陈柏龄[1] 李浩淼 魏福鑫[1] 

机构地区：[1]中山大学附属第一医院黄埔院区脊柱外科,广州510700 [2]南方医科大学生物力学实验室,广州510515

出　　处：《中国临床解剖学杂志》2007年第3期335-336,340,共3页Chinese Journal of Clinical Anatomy

基　　金：广东省科技计划重点项目资助(2003C30202)

摘　　要：目的:比较双头螺纹和单头螺纹中空加压螺钉的生物力学特性,为临床治疗齿突骨折提供科学依据。方法:选择20具枢椎骨标本,制成齿突Ⅱ型骨折模型,分别用双头螺纹和单头螺纹中空加压螺钉固定骨折,测试两种螺钉的剪切刚度和最大拔出力,作统计分析。结果:双头螺纹中空加压螺钉治疗组的剪切刚度显著高于单头螺纹中空加压螺钉治疗组(P<0.01),最大拔出力两者无显著差异(P>0.05)。结论:双头螺纹中空加压螺钉治疗齿突骨折具有更强的生物力学稳定性;对于骨质梳松者和手术操作引起钉道扩大的患者,应首选双头螺纹中空加压螺钉。Objectives： To compare the biomechanical properties of a single cannulated one-threaded screw and a single cannulated double-threaded screw with an intention to provide scientific basis for the clinical treatment of Type Ⅱ odontoid fractures. Methoda： Totally 20 Chinese axis specimens were collected, followed by the preparation of Type Ⅱ odontoid fracture models. The fracture was then repaired using internal screw fixation with a single cannulated one-threaded screw and a single cannulated double-threaded screw respectively. The shear stiffness and the maximum resistance of the two kinds of screw were tested for statistic analysis. Results： The shear stiffness of the double-threaded screw treatment group was significantly higher than that of the one-threaded screw treatment group （P〈0.01）, while the maximum resistance had no significant difference between two groups （P〉0.05）. Conclusions： Internal screw fixation with a single cannulated double-threaded screw for the treatment of Type Ⅱ odontoid fracture has more favorable biomechanical stability. The first choice of the internal fixation should be a single cannulated double-threaded screw for patients with osteoporosis or those who is susceptible to expanded screw pathway during surgical procedures.

关 键 词：枢椎齿突骨折 内固定 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]