胸腰段前、后纵韧带对Kaneda器械稳定性的影响  

The effects of the thoracolumbar anterior and posterior longitudinal ligaments on the stability of the Kaneda instrument

作　　者：张烽[1] 董士奎[1] 周小钢[1] 周海涛[1] 冯炜炜[1] 王以进[2] 

机构地区：[1]南通大学附属医院骨科,江苏南通226001 [2]上海大学生物力学研究所

出　　处：《中国临床解剖学杂志》2008年第4期440-442,共3页Chinese Journal of Clinical Anatomy

摘　　要：目的:用生物力学实验方式评价胸腰段脊柱椎管前方减压植骨+Kaneda内固定术中前、后纵韧带切除对其稳定性的影响。方法:采用7具新鲜小牛胸腰段脊柱标本,模拟临床手术行L1椎体切除椎管前方减压自体髂骨植骨+Kaneda内固定术,在WE-10A万能材料实验机上进行非破坏性生物力学测试。结果:在该术式中切除病变节段前纵韧带后胸腰椎的稳定性在旋转、轴压、前屈、后伸、侧弯各运动状态下有下降趋势,其中以后伸时最为明显,差异有统计学意义(P<0.05)。继续切除该节段后纵韧带,胸腰椎在屈伸、侧弯和旋转运动状态下稳定性下降显著,差异有统计学意义(P<0.05)。结论:在胸腰段脊柱椎管前方减压、植骨+Kaneda内固定术中局部切除前纵韧带将降低内固定后脊柱在后伸状态的即刻稳定性;前、后纵韧带均切除将明显降低Kaneda器械的固定效果。Objective： To determine the relative importance of the thoracolumbar anterior and posterior longitudinal ligaments resection by turn following anterior decompression and interbody iliac bone graft fixed with Kaneda instrument adopting biomechanical testing. Methods： A total of 7 fresh calf thoracolumbar spines （T13-L3） were performed L1 vertebra excision, anterior decompression and interbody iliac bone graft and internal fixation. Nondestructive biomechanical tests were performed on every group, including pure axis compression, flexion, extension, lateral bending and rotation. Results： When the ALL （anterior longitudinal ligament） was cut away, the stability of the specimen tended to decrease at rotation, axial compression, flexion, extension and lateral bending, and the decrease at extension was statistically significant. Error bars equaled one standard deviation and significance was indicated at P〈 0.05. After the resection of the relative segmental PLL （posterior longitudinal ligament）, the decrease of the specimen＇s stability at rotation, flexion, extension and lateral bending was statistically significant （P〈 0.05）. Conclusions： During the surgery of thoracolumbar anterior decompression and internal fixation, the resection of the ALL may lead to the instability of Kaneda fixed spine at extension, and the resection of both ALL and PLL would decrease the mechanical efficiency of Kaneda instrument.

关 键 词：胸腰段脊柱 纵韧带 生物力学 内固定 小牛 

分 类 号：R318.01[医药卫生—生物医学工程]