不同骨质疏松程度下椎弓根螺钉强化固定的生物力学研究  

Biomechanical Analysis of Vertebral Pedicle Screws Fixation after Augmentation with Bone Cement on Different Grades of Vertebral Osteoporosis

作　　者：田吉光[1] 邱玉金[1] 高海波[1] 张春祥[1] 李攀[1] 

机构地区：[1]潍坊医学院外科学教研室,山东潍坊261053

出　　处：《潍坊医学院学报》2011年第1期43-45,共3页Acta Academiae Medicinae Weifang

摘　　要：目的 探讨在不同骨质疏松程度下多种脊柱固定方式对脊椎的固定效果.方法 取新鲜猪脊柱16具（共96节椎体）.用随机区组分为Ⅰ,Ⅱ,Ⅲ 3个区组,A,B,C,D 4个处理组.用EDTA-Na2脱钙处理2,3,4周后,A组：单纯行普通椎弓根钉固定;B组：钉道强化后普通椎弓根钉固定;C组：椎体强化后普通椎弓根钉固定;D组：空心椎弓根钉＋骨水泥固定.骨水泥凝固后行最大轴向拔出力和最大旋出力矩测试.结果 最大轴向拔出力和最大旋出力矩Ⅰ,Ⅱ组：B组高于A组;C组及D组高于B组;C组和D组比较差别无统计学意义.Ⅲ组：B,C,D组高于A组,B,C,D组之间差别无统计学意义.结论 椎弓根螺钉强化固定在一般骨质疏松脊柱上的效果明显,而在严重骨质疏松脊柱的效果下降.Objective To study the biomechanical effect of Vertebral Pedicle Screw Fixation ＇after several kinds of Fixation on different grades of vertebral osteoporosis. Methods Ninety-six fresh pig lumber vertehraes from 16 spines（96 vertebraes in total） ,which were classified into 3 blocks（ Block Ⅰ -Ⅲ ） and 4 groups（ Group A-D） by randomized block design,were decalcified by EDTA-Na2 for weeks. After bone mineral density was determined fimr fixation methods were applied. Common pedicle screws were implanted on vertebraes in Group A; Filled with PMMA in the pediele tracks,common pedicles screws then were implanted in Group B;Augmentation by injecting PMMA into vertebral body were applied on vertebraes in Group C ;Screws with hollow lateral holes enhanced by PMMA would be used in Group D. The maxi- mum axial pullout strength and rotational torque were recorded after PMMA completely solidified. Results Means of Fmax and rotational torque of Group C and D,both of which had no statistical difference,were significantly higher than that of Group A anti B in Block Ⅰ and Ⅱ. There were no difference in biomechanical test result between Group B,C, D in Block Ⅲ ,which were higher significantly than group A. Conclusion Effect of augmentation of vertebral pedicle screws was more significant in common osteoporosis than that in serious osteoporosis.

关 键 词：椎弓根螺钉 生物力学 骨密度 骨质疏松模型 

分 类 号：R68[医药卫生—骨科学]