颈前路钢板置入内固定加椎间植骨治疗Ⅱ型Hangman骨折的生物力学评价  

Biomechanical evaluation of anterior cervical plate fixation combined with intervertebral bone graft for the treatment of Hangman's fracture

作　　者：黄阳亮[1] 刘少喻[1] 赵卫东[2] 李浩淼[1] 魏富鑫[1] 陈克冰[1] 

机构地区：[1]中山大学附属第一医院脊柱外科,广东省广州市510700 [2]南方医科大学生物力学实验室,广东省广州市510515

出　　处：《中国组织工程研究与临床康复》2010年第39期7251-7253,共3页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：广东省科技计划项目资助(2008B030301303);广州市黄埔区科技计划项目资助(0931)~~

摘　　要：背景:C2/3椎间盘切除,钢板置入内固定加椎间植骨是治疗Hangman骨折的常用术式。该术式在临床应用广泛,但目前尚缺乏相关实验评价钢板置入内固定治疗Hangman骨折的生物力学特点研究。目的:评价钢板置入内固定+椎间植骨治疗Ⅱ型Hangman骨折的生物力学稳定性。方法:6具正常成人新鲜冷冻颈椎,每一标本依次制作成以下3种状态组:即正常对照组、Ⅱ型Hangman骨折模型组、椎间植骨+钢板内固定组。按以上顺序应用脊柱三维运动试验机和三维激光扫描仪测试每一状态C2/3节段的三维运动范围。结果与结论:与正常对照组比较,Ⅱ型Hangman骨折模型组C2/3节段前屈、后伸、旋转及侧弯关节活动度均显著增大(P<0.05),钢板内固定+椎间植骨组旋转方向关节活动度显著增大(P<0.05);与Ⅱ型Hangman骨折模型组相比,钢板内固定+椎间植骨组C2/3节段前屈、后伸及侧弯关节活动度均显著减小(P<0.05)。结果提示钢板置入内固定能够在前屈、后伸及侧弯方向恢复Ⅱ型Hangman骨折的稳定性,然而在旋转方向缺乏稳定作用,术后需辅以外固定以确保融合。BACKGROUND：C2/3 discectomy,intervertebral autograft combined with plate fixation were commonly seen in surgical treatment of Hangman＇s fracture. This method was used widely in clinical practice,however,the investigation of its biomechanical feature was not sufficient. OBJECTIVE：To evaluate the biomechanical stabilities of intervertebral autograft combined with plate fixation in treatment of type Ⅱ Hangman＇s fracture. METHODS：Totally 6 fresh frozen human spine specimens were used,each of them was made into 3 conditions：intact condition （blank control group）,type Ⅱ Hangman＇s fracture condition （Hangman group） and plate fixation condition （plate fixation group）. On above sequences,three-dimensional laser scanner and three-dimensional motion testing machine were used to test range of motion （ROM） of C2/3 segment under each condition. RESULTS AND CONCLUSION：Compare with the blank control group,ROM of joint of the Hangman group was significantly larger on flexion,extension,axial rotation and lateral bending （P 0.05）; ROM of joint of the plate fixation group was significantly larger on direction of axial rotation （P 0.05）. Compare with Hangman group,ROM of joint of plate fixation group was significant smaller on direction of flexion,extension and lateral bending （P 0.05）. The results indicated that in treatment of type Ⅱ hangman＇s fracture,plate fixation is helpful in resuming stability on direction of flexion,extension and lateral bending,however,stability can not be achieved on direction of axial rotation,therefore,postoperative external fixation is recommended to secure fusion.

关 键 词：颈椎 HANGMAN骨折 生物力学 内固定 融合 医学植入物 

分 类 号：R318[医药卫生—生物医学工程]