短节段DRFS脊柱内固定术后即刻刚度的变化及其意义  

Biomechanical evaluation of stiffness of short-segment instrumented spine

作　　者：李禾[1] 叶启彬[2] 白建鹏[1] 高春华[1] 汪爱媛[3] 

机构地区：[1]武警总医院骨科,北京100039 [2]中国医学科学院中国协和医科大学北京协和医院骨科,北京100730 [3]解放军总医院骨科研究所,北京100853

出　　处：《颈腰痛杂志》2008年第1期10-12,共3页The Journal of Cervicodynia and Lumbodynia

基　　金：武警部队科研资助(WJ200502)

摘　　要：目的测试短节段猪脊柱标本在完整、失稳后及内固定后的刚度变化。方法选择12节段猪脊柱标本12具,测定其前屈、后伸、侧屈及旋转时的刚度;切除椎间盘、小关节及前后纵韧带松解脊柱,测定其各项运动刚度;用DRFS脊柱内固定系统进行短节段内固定后重复测试各项运动刚度。结果与完整脊柱的刚度(前屈、后伸、侧屈及旋转的刚度分别为0.389±0.305,1.090±0.355,1.012±0.301,1.232±0.441,1.103±0.414,1.013±0.402)相比,失稳后脊柱各项运动的刚度(前屈、后伸、侧屈及旋转的刚度分别为0.216±0.218,0.278±0.204,0.255±0.124,0.409±0.169,0.633±0.218,0.626±0.216)均明显减少(P<0.05),而内固定后脊柱各项运动的刚度(前屈、后伸、侧屈及旋转的刚度分别为(0.568±0.351,0.679±0.151,0.759±0.314,0.729±0.311,1.006±0.304,0.975±0.218)均明显高于失稳后脊柱,与完整脊柱前屈、侧屈及旋转运动无明显差异,后伸运动的刚度明显高于完整脊柱(P<0.01)。结论短节段脊柱内固定后各项运动的刚度明显高于脊柱失稳后,与完整标本相比除后伸运动的刚度明显增高外,其余各方向的运动刚度相近。Objective To test the change of the stiffness of the intact,released,and instrumented spines in an in vitro porcine model. Methods Twelve porcine spines （12 segments each）were prepared for the biomechanical test with Material Test System. The Stiffness during forward-bending,backward-bending,lateral-bending and axial rotation were recorded;then established the specimen of spine as unstable status by destroying the intervertebral discsand the facet joints,followed by repeating the stiffness test;and DRFS were applied for internal fixation to the unstable spine and stiffness tests were repeated again. Results The stiffness in unstable porcine spine were significantly lower than those either in intact-porcine spine or in the short-instrumented porcine one （P〈0.05）,but they were similar between the two latter during forward-bending,lateral-bending and axial rotation except that it was higher during backward-bending in the short-instrumented porcine （P〈0.05）. Conclusion The stiffness in short-instrumented porcine is markedly increased than in unstable porcine spine,except during backward-bending,which is comparable with that in intact porcine spine.

关 键 词：脊柱 短节段 刚度 内固定 

分 类 号：R687.32[医药卫生—骨科学]