骶骨部分切除对骶髂关节生物力学的影响  

Biomechanical effects of partial sacrectomy on the sacroiliac joint

作　　者：于滨生[1] 郑召民[1] 陈辉[1] 庄新明[1] 梁春祥[1] 韩国伟[1] 张旭华[1] 

机构地区：[1]中山大学附属第一医院脊柱外科,广州市510700

出　　处：《中国脊柱脊髓杂志》2008年第9期673-676,共4页Chinese Journal of Spine and Spinal Cord

基　　金：广东省卫生厅科研资助项目(编号:200810401029)

摘　　要：目的:评价骶骨部分切除对骶髂关节生物力学的影响,明确骶骨切除范围与稳定重建的关系。方法:7具成人尸体L5-骨盆标本,分别在完整状态、S2以下切除(A组)、1/2S2以下切除(B组)、S1以下切除(C组)、1/2S1以下切除(D组)、右侧骶髂关节切除(E组)等情况下通过858型MTS材料实验机给标本施加800N轴向压缩和7Nm轴向扭转载荷,记录完整状态及残留骶髂关节刚度,比较各组间的差异。结果:轴向压缩时,A组～E组残留骶髂关节刚度分别是完整状态组的98.7%、97.1%、94.4%、82.9%和55.2%;完整状态组、A组、B组和C组间的压缩刚度无显著性差异,D组和E组的轴向压缩刚度显著低于完整状态组。轴向旋转时,A组～E组残留骶髂关节刚度分别为完整状态刚度的90.7%、88.5%、81.9%、71.9%和44.5%;完整状态组、A组和B组间的旋转刚度值无显著性差异,C组、D组和E组的轴向旋转刚度显著低于完整状态组和A组。结论:骶骨切除范围与骶髂关节稳定性相关,骶骨向上切除至S1将导致骶髂关节旋转失稳,切除至1/2S1将进一步引起残留骶髂关节的轴向压缩失稳。骶骨切除超过上述范围时应考虑局部稳定性重建。Objective：To examine the biomechanical effects of partial transverse sacrectomy on the sacroiliac joint,and determine the relationship of extent of the sacrectomy and requirement of the reconstruction. Method：Seven L5-pelvis specimens of adult human cadaver were used in this study.The segmental transverse sacrectomies were divided into followings：partial sacrectomy below S2 （group A）,partial sacrectomy below 1/2 of S2（group B）,partial sacrectomy below S1 （group C）,partial sacrectomy below 1/2 of S1（group D）,resection of sacroiliac joint on right side （group E）.Biomechanical test of those specimens under the stages of intact or various partial sacrectomies was performed by using MTS machine under 800N compression and 7Nm torsion loading modes.Rigidity of the residual sacroiliac joints was analyzed.Result：Under compression loading,group A-group E preserved 98.7%,97.1%,94.4%,82.9% and 55.2% of the initial rigidity of sacroiliac joint respectively.No significant differences were detected among the intact,group A,group B,and group C.However,the compressive rigidity of group D and group E was markedly lower than that of the intact.Under torsion load- ing,group A-group E preserved 90.7%,88.5%,81.9%,71.9% and 44.5% of the initial sacroiliac joint rigidity respectively.No significant differences were demonstrated among the intact,group A,and group B.However,the torsive rigidity of group C and group D was less than that of the intact and group A.Conclusion：The extent of partial sacrectomy is related to the stability of sacroiliac joint.Transverse partial sacrectomy involving S1 can result in rotational instability,and the resection level beyond 1/2 of S1 will further lead to compressive instability.When the sacrectomy is at or above the 1/2 S1 level,local reconstruction should be considered.

关 键 词：骨盆 骶骨切除 生物力学 重建 

分 类 号：R318.01[医药卫生—生物医学工程] R687.3[医药卫生—基础医学]