Wallis棘突间固定结合改良小关节植骨术后的即刻稳定性生物力学评估  

Biomechanical Evaluation on Primary Stability of Wallis Interspinous Dynamic Stabilization Combined with Modified Facet Joints Bone Graft

作　　者：曾腾辉[1] 靳安民[1] 闫洪印[2] 陈扬[2] 李振宇[2] 欧阳均[3] 赵卫东[3] 

机构地区：[1]南方医科大学珠江医院骨科中心,广东省广州市510000 [2]深圳市第二人民医院 [3]南方医科大学生物力学教研室

出　　处：《中国骨与关节损伤杂志》2010年第7期598-601,共4页Chinese Journal of Bone and Joint Injury

基　　金：深圳市卫生局课题基金项目(200902057)

摘　　要：目的研究Wallis动态固定系统结合改良小关节植骨术的术后即刻稳定性,为临床应用提供生物力学依据。方法取7节新鲜小牛腰椎椎间节段,采用自身前后对照,标本完整状态设为完整组,标本单纯安装Wallis为单纯Wallis组,在Wallis组的基础上进行改良双侧小关节植骨术为Wallis植骨组。分别测试在前屈、后伸、左右侧屈、左右选转6种状态下的活动度(ROM),中性区(NZ)。结果在屈伸状态下Wallis组和Wallis植骨组的运动范围与中性区均较完整组减少,差异有统计学意义(P<0.05)。屈伸状态下,Wallis组与Wallis植骨组ROM没有统计学意义。中性区Wallis植骨组较Wallis组增大(P<0.05),与完整组无统计学差异。在侧屈和旋转状态下所有组间运动范围与中性区均无统计学差异。结论 Wallis结合改良小关节植骨术后的屈伸即刻稳定性增加,但是较单纯Wallis固定减少,患者术后应该佩戴支具。Objective To evaluate the biomechanics stabilization of lumbar interspinous dynamic stabilization device （the Wallis system） accompany with modified facet joint bone graft fusion in calf＇s lumbar specimen, stimulating postoperative immediately biomechanics conditions in clinical trial.Methods Seven vituline lumbar spines were instrumented across the L1-6 segment. The specimens were subjected to moments in flexion-extension, lateral bending, and axial rotation.The specimens were tested under the following conditions：intact interspinous dynamic stabilization device interspinous dynamic stabilization device （the wallis system） with bilateral facet joint fusion. The caudal end of the specimens was rigidly fled to a material testing system through a multicomponent load cell. The range of motion and neutral zone at operative and adjacent levels was calculated for the loading directions of flexion, extension, lateral bonding, and axial rotation.Resuits In flexion-extension directions of loading, both Wallis stabilization device group and wallis stabilization device with facet joint group significantly decreased neutral zone and range of motion compared with the intact group （P〈0.05）. Wallis stabilization device with facet fusion group significantly increased neutral zone compared with wallis stabilization device group （P〈0.05）. During lateral bending and axial rotation loading modes, there was no significantly difference among the three groups.Conclusion Wallis interspinous dynamic stabilization combined with modified bone graft fusion of bilateral facet joints is a simplified operation.The interspinous dynamic stabilization device （the Wallis system） accompany with facet joint fusion seems to provide stiffer fixation of the lumbar spine, compared to intact group. However, it provides less stability fixation after facet joint fusion. These data suggest that it would need external fixation after the lumbar interspinous dynamic stabilization device （the Wallis system） accompanied with facet

关 键 词：腰椎 WALLIS 小关节 生物力学 植骨 

分 类 号：R783.6[医药卫生—口腔医学]