ISOBAR TTL半坚强动态固定系统对腰椎固定节段关节突关节载荷的影响  

The experimental study of ISOBAR TTL dynamic stabilization system： the effect on lumbar segmental zygapophysial joint stress

作　　者：唐恒涛[1] 赵卫东[2] 吴学建[1] 

机构地区：[1]郑州大学第一附属医院骨科,450052 [2]南方医科大学解剖教研室

出　　处：《中华实验外科杂志》2015年第3期593-595,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 观察ISOBAR TTL动态固定系统对腰椎固定节段关节突关节载荷的影响.方法 采用6具新鲜尸体腰椎标本,压敏片插入脊柱标本L3-L4两侧关节突关节间隙内,L3-L4节段在椎间盘正常及摘除状态,分别进行TTL系统固定;依次使标本处于中立位、前屈10°、后伸10°,左弯10°、左旋10°,MTS-858材料机施加400 N轴向负荷,保持最大载荷1 min后卸载,压敏片图像扫描到计算机中存储、分析、处理.结果 L3-L4节段在无固定组与TTL固定组关节突关节压力在直立、前屈、后伸、侧屈、侧旋等状态结果差异有统计学意义（P＜0.05）,固定组较无固定组关节突关节压力显著降低.TTL固定组在直立、前屈、后伸、侧屈和侧旋等状态时关节突关节压力分别减少为垂直载荷（400 N）的4.01％、0.74％、3.78％、3.45％和19.6％,关节突关节负荷也分别减少为正常的关节突关节负荷的24.99％、17.23％、17.0％、18.40％和35.99％;椎间盘摘除状态,关节突关节压力在直立、后伸、侧屈和侧旋等状态较正常明显增加,但前屈状态则明显减小,差异有统计学意义（P＜0.05）.结论 TTL半坚强动态固定系统能够起到明显缓解腰椎固定节段关节突关节载荷的作用.Objective To study the effect of the TTL dynamic stabilization （DS） system on the zygapophysial joint stress （ZJS） of the lumbar motive segment.Methods Six fresh adult lumbar samples were tested.The L3-L4 segment,being studied in normal and disectomy state,was stabilized by TTL system.Insert pressure sensitive film （PSF） into the zygapophysial joint space,in the position of flexion 10°,extension 10°,left bending 10°,left rotation 10°,MTS provided 400 N axial load,then unloaded after maintaining the utmost load for about 1 min,pick out the PSF.Repeated testing for 3 times,then took the mean as the pressure value of that state.The image will be input in the computer to analyse.Results After stabilization,the ZJS decreased obviously in every state.In the TTL group,the ZJS in erection,flexion,extension and rotation state decreased to 4.01%,0.74%,3.78%,3.45%,19.6% of the axial load （400 N）,and 24.99%,17.23%,17.0%,18.40%,35.99% of the normal state respectively.There existed statistical significence（P 〈0.05）.After the disc was removed,the ZJS increased manifestly,but decreased obviously in flexion state.Conclusion TTL system can alleviate the ZJS of the fixed segment obviously.

关 键 词：腰椎 运动保留 生物力学 关节突关节 

分 类 号：R687.3[医药卫生—骨科学]