胸腰椎三柱同时损伤内固定方法的实验与临床初步观察  

Preliminary Observation on Clinical Application and Biomechanical Study of Spinal Internal Fixation Systems in Treating Thoracolumbar Three-columns Injury

作　　者：董健[1] 陈中伟[1] 陈统一[1] 陈长贤 洪水棕[3] 

机构地区：[1]上海医科大学附属中山医院骨科,200032 [2]福建泉州市人民医院骨科 [3]上海交通大学力学系生物力学研究室

出　　处：《骨与关节损伤杂志》1998年第3期142-144,共3页The Journal of Bone and Joint Injury

摘　　要：利用传感器及电测技术,采用新鲜人体胸腰段脊柱标本,评价后路短节段内固定器Steffee钢板、前路Kaneda器械、前路Kaneda与后路CD棒联合应用及后路节段性椎板下钢丝固定哈氏撑开棒四种手术在植骨状态下,治疗脊柱完全性三柱损伤提供的生物力学稳定能力。Steffee、Kaneda器械及节段性椎板下钢丝固定的哈氏撑开棒手术在这种严重损伤类型各有力学弱点,Steffee后伸、Kaneda前屈、节段性椎板下钢丝固定的哈氏撑开棒旋转明显失稳,前后路联合手术在轴压、前屈、后伸、侧弯、旋转五种运动方式皆能提供良好的稳定性。以此方法治疗1例腰椎半椎体切除与1例腰椎肿瘤全切除,随访1年,脊柱稳定,植骨融合满意。作者建议,在脊柱三柱损伤时宜采用前后路联合固定手术。The three-dimensional stability of the thoracolumbar three - columns injury treated respectively by four kinds of internal fixations was studied, using twelve intact fresh cadaveric thoracolumbar specimens. The operative techniques included: 1. the Steffee transpedicular screws and plates (Steffee); 2. the Kaneda anterior device with transverse fixa-tor (KT); 3. the Kaneda anterior device and posterior Cotrel - Dubousset transpedicular instrumentation (KT+CD); 4. Harrington distraction rod fixation supplemented with segmental sublaminal wires (s. Harrington), which all used with strut bone graft. KT+CD could provide good stability in five movement mode (compressive loading, flexion, extension, lateral bending and rotation). Steffee in extension, KT in flexion and s. Harrington in rotation were more unstable. This result was clinical applied in two patients. They have a good effect. Authors recommended KT + CD in treating spinal three-columns injury.

关 键 词：生物力学 内固定器 脊柱稳定性 脊柱损伤 

分 类 号：R683.205[医药卫生—骨科学] R681.505[医药卫生—外科学]