新型上颈椎前路钩状钛板治疗寰枢椎不稳的生物力学测试  

Biomechanical testing of neotype retropharyngeal cervical hook-plate for atlantoaxial instability

作　　者：蔡斌[1] 晏怡果[1] 王文军[1] 赵延胜[1] 王麓山[1] 宋西正[1] 林海英[1] 

机构地区：[1]南华大学附属第一医院脊柱外科,湖南衡阳421001

出　　处：《中国矫形外科杂志》2010年第5期412-415,共4页Orthopedic Journal of China

基　　金：湖南省卫生厅科技计划项目(编号:B2009055)

摘　　要：[目的]测试研究新型上颈椎前路钩状钛板治疗寰枢椎不稳的生物力学稳定性。[方法]采用上颈椎新鲜尸体标本6例依次参加5组试验:正常状态组、寰枢椎不稳组、新型上颈椎钩状钛板固定组、前路经寰枢关节螺钉固定组及后路Brooks钢丝固定组,利用SPSS13.0软件包进行重复测量的方差分析,组间两两比较采用SNK检验法,差异标准置于0.05。[结果]前屈稳定性上,新型上颈椎钩状钛板组和Brooks组差异无显著性(P=0.525),但两者不如前路经寰枢关节螺钉组(P<0.05)。后伸稳定性上,新型上颈椎钩状钛板组和前路经寰枢关节螺钉组差异无显著性(P=0.372),且两者稳定性明显强于Brooks组(P<0.05)。侧屈上,前路经寰枢关节螺钉组与新型上颈椎钩状钛板组差异无显著性(P=0.216),且两者稳定性明显强于Brooks组。旋转稳定性上,前路经寰枢关节螺钉组优于新型上颈椎钩状钛板组,而后者又较Brooks组稳定性强(P<0.05)。[结论]新型上颈椎前路钩状钛板具有一定的生物力学强度,其对于寰枢椎的稳定性弱于前路经寰枢关节螺钉,但明显强于Brooks,能够为寰枢椎不稳的病例提供可靠的固定强度。[Objective] To analyze the mechanics of neotype retropharyngeal cervical hook-plate（RCHP）for atlantoaxial instability with biomechanical testing.[Methods]Six fresh adult craniocervical specimens（C0～3）used for testing the biomechanical instability were all putted into following five test courses：intact,instability（Type ⅡOdontoid fracture）,RCHP,Anterior C1、2 transarticular screw fixation,brooks.Repeated statistical analysis of the data was performed using the SPSS 13.0 software package.Measures were performed with SNK testing method to determine whether significant differences existed,P=0.05.[Results]Biomechanical testing showed that,compared with the controlled group and the injured group,each fixation course significantly decreased ROM in all test modes.In the ROM of flexion,there was no significant difference between RCHP and Brooks（P=0.525）,but both of them was higher than anterior C1、2 transarticular screw fixation（P0.05）.There was no significant difference between RCHP and anterior C1、2 transarticular screw fixation（P=0.372）in the ROM of extension and later bending,both of them had a significantly better stability than Brooks.In the ROM of rotation,the differences were significant（P0.05）.The rotation stability of anterior C1、2 transarticular screw fixation was higher than that of RCHP and the latter was higher than that of Brooks.[Conclusion]According to the results of this biomechanical testing,RCHP can provide an outstanding character of biomechanical stability for atlantoaxial instability.The mechanics of RCHP is inferior than anterior C1、2 transarticular screw,but is significantly better than Brooks.

关 键 词：寰枢椎不稳 生物力学 钛板 上颈椎 内固定 

分 类 号：R687.3[医药卫生—骨科学]