可吸收陶瓷改善椎弓根螺钉稳定性的体外生物力学试验  

Augmentation of absorbable calcium phosphate cement for the enhancement of pedicle screw fixation: an in vitro biomechanical study

作　　者：邵景范[1] MR Sarkar LE Claes L Kinzl 罗永湘[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院矫形外科,武汉430030 [2]德国Ulm大学创伤外科和生物力学研究所

出　　处：《中华骨科杂志》2001年第10期619-621,共3页Chinese Journal of Orthopaedics

摘　　要：目的探讨在椎弓根螺钉置入时添加可吸收陶瓷Biobon对椎弓根螺钉稳定性的影响。方法采用28个L3～L5椎体标本,将椎弓根螺钉按标准操作分别置入两侧椎弓根,随机在其中一侧加Biobon。对其中16个椎体测试螺钉最大轴向拔出力F-max和螺钉拔出过程中达到最大轴向拔出力时的能量吸收值E-F-max及螺钉拔出一个螺距2.0mm时的能量吸收值E-2mm。另外12个椎体作梯增负荷的周期抗屈试验。结果同未加Biobon组比较,加入Biobon组的F-max增加了79.7%。E-F-max和E-2mm也分别增加了83.1%和68.2%,两组差异有非常显著性意义Wilcoxon检验,P<0.01。周期抗屈试验中,添加Biobon可使螺钉耐受更强的负荷或在同等负荷下仅产生较小的位移。结论在椎弓根螺钉置入时添加Biobon能显著提高其初始稳定性。Objective To ascertain whether an augmentation of absorbable calcium phosphate cement can enhance pedicle screw fixation in the osteoporotic lumbar spine. Methods Twenty eight specimens of cadaveric lumbar vertebral bodies (L3-L5) were instrumented with USS pedicle screws (5 mm×45 mm) using the standard procedure bilaterally and Biobon was randomly inserted unilaterally. In 16 of these specimens, the maximum axial pull out strength and energy absorption(E-F-max) and the energy absorption value (E-2 mm)during pulling out of the screw for one pitch were determined. In the remaining 12 specimens, the screws were loaded in the superior inferior direction with increasing forces of 25 to 200 N for 800 cycles. Results The pull out strength of the augmented pedicles averaged 79.7% greater than that of the control side. The energy absorption to failure was increased by 83.1% by Biobon augmentation. The E-2 mm was 68.2% greater in the augmented specimens than in the control group (Wilcoxon test,P< 0.01). In cyclic load tests, augmented screws were found to withstand a greater number of cycles or greater loading before loosening. Conclusion The data suggest that augmentation with calcium phosphate cement can enhance immediate screw fixation in osteoporotic human vertebrae both for pull out and cyclic loading.

关 键 词：脊柱 骨螺丝 可吸收性植入物 生物力学 

分 类 号：R68[医药卫生—骨科学]