前路不同术式对胸腰椎爆裂骨折稳定性的生物力学试验  

作　　者：耿红 费骏[2] 

机构地区：[1]浙江省医疗器械研究所,310009 [2]杭州市红十字会医院,310003

出　　处：《浙江临床医学》2014年第10期1549-1551,共3页Zhejiang Clinical Medical Journal

摘　　要：目的：探讨经前路不同的手术方法对胸腰段爆裂性骨折力学稳定性的影响。方法采集国人新鲜尸体胸腰椎标本，建立Denis B型胸腰椎爆裂性骨折损伤模型，用实验应力分析方法和压敏片法，比较不同术式的生物力学变化。结果采用4种不同的前路减压及固定方法，以切除部分L1椎体及相应T12-L1椎间盘＋植骨融合＋钢板单节段固定T12-L1（A组）最优，其次是扩大切除L1椎体及相应上下相邻椎间盘＋钛网融合＋钢板固定T12-L2（D组）和切除部分L1椎体及相应T12-L1椎间盘＋植骨融合＋钢板双节段固定T12-L2（B组），扩大切除L1椎体及相应上下相邻椎间盘＋植骨融合＋钢板固定T12-L2（C组）的力学性能相对较差。结论（1）四种术式的力学强度均低于正常脊柱的力学强度。（2）钛网融合组能够获得较好的生物力学性能，不但强度大、承载能力强，而且刚度高、即时稳定性好，优于自体髂骨植骨组。（3）单节段前路钢板固定的力学性能优于双节段固定。Objective To explore the biomechanical testing on the effect of different anterior approach on the stability of the thoracolumbar burst fracture. Methods The samples of fresh thoracolumbar burst fracture from Chinese corpse and Denis B type model of thoracolumbar burst fracture was established, the experimental stress analysis and pressure-sensitive method were applied to compare the biomechanical changes of different types of operation. Results 4 different types of anterior depression and fixation were applied.Among them, resecting part of the L1 vertebral and according T12-L1 disc＋bone graft and fusion＋steel plate single segmental fixation T12-L1（group A）;the second was to extended resection of L1 vertebral and according adjacent disc＋Titanium mesh fusion＋steel plate fixation of T12-L2（group D）and partial esection of the L1 vertebral and according T12-L1 disc＋bone graft and fusion＋steel plate segmental fixation T12-L2（B group）, the extended resection of L1 disc and adjacent dics＋bone graft and fusion＋steel plate fixation of T12-L2（C group） had the relative weak biomechanical feature. Conclusions （1） the biomechanical powers of all the 4 types of operation were weaker than the normal spine. （2） the titanium mesh group has a relative better biomechanical feature, which not only has strength and supporting power , but high stiffness and instant stability, which is superior to autologous bone grafts. （3） single segmental anterior steel plate fixation is biomechanically superior than the double segmental fixation.

关 键 词：前入路 生物力学特性 固定 骨折 

分 类 号：R683.2[医药卫生—骨科学]