胸椎钉棒系统置入方式的生物力学特征  

Biomechanical characteristics of placement methods of the thoracic pedicle screw system

作　　者：于德军[1] 刘丽晶[2] 金松[1] 田少华[1] 

机构地区：[1]齐齐哈尔医学院附属第三医院骨二科,黑龙江省齐齐哈尔市161042 [2]齐齐哈尔医学院附属第三医院妇产科,黑龙江省齐齐哈尔市161042

出　　处：《中国组织工程研究》2015年第22期3579-3583,共5页Chinese Journal of Tissue Engineering Research

基　　金：齐齐哈尔市基金项目(SFZD-2013092)~~

摘　　要：背景:有研究表明胸椎骨折椎弓根螺钉的置入方式、进针点、角度、长度已经有统一定论,单个螺钉的轴向拔出力及生物力学行为报道也很多,但关于3种螺钉置入并连接钉棒后的生物力学行为研究较少。目的:通过生物力学测试来进一步观察并比较3种胸椎螺钉置入并连接钉棒后的生物力学行为,从而了解胸椎置钉并连接钉棒后的强度,及其拔出后对胸椎置钉周围骨质的应力影响。方法:实验将新鲜冰冻胸椎标本随机分3组,经椎弓根固定组,经横突-椎体固定组,经改良肋横突法固定组,每组照标准胸椎置钉法分别置入胸椎钉棒系统,在力学仪器上测试,动态曲线描述拔出过程中钉棒系统及胸椎置钉周围骨质所承受力量,并进行统计学分析,比较3种置钉方法在胸椎上把持力的差异性。结果与结论:3种伤椎置钉方式中,经椎弓根固定组拔持力明显大于经横突-椎体法及经改良肋横突法组的把持力(P<0.01),经横突-椎体法及经改良肋横突法组的把持力差异无显著性意义。结果证实,经椎弓根固定法固定节段的胸椎置钉周围骨质所承受力稳定性明显优于经横突-椎体法及经改良肋横突法组。BACKGROUND： Studies have shown that placement, needling point, angle and length of pedicle screws for thoracic vertebral fractures have been unified. Many studies concerned axial pull-out force and biomechanical behavior of a single screw, but few reports addressed the biomechanical behavior after the replacement with three kinds of screw connecting to rods. OBJECTIVE： To further observe and compare biomechanical behavior after three kinds of thoracic screw placement connecting rod using biomechanical testing, to understand the strength of thoracic pedicle screw replacement connecting rods, and the effects of its pulling out on the stress of the bone surrounding the placement site. METHODS： The fresh frozen specimens of thoracic vertebra were divided into three groups at random： the pedicle fixation group, the transverse process-vertebral body fixation group, and modified rib transverse process fixation group. Thoracic pedicle screw system was inserted by the standard placement method in each group. The experiment was measured on the mechanical equipment. During pulling out, the strength that bone bore was described with dynamic curve, followed by statistical analysis. The difference in the gripping force on the thoracic vertebra among three kinds of screw placement method was compared. RESULTS AND CONCLUSION： Among three kinds of screw placement methods and among three kinds of screw placement methods on the injured vertebral body, the gripping force was significantly bigger in the pedicle fixation group than in the transverse process-vertebral body fixation group and modified rib transverse process fixation group（P〈0.01）. No significant difference in the gripping force was detected between the transverse process-vertebral body fixation group and modified rib transverse process fixation group. Results verified that the stability of loading ability was apparently better in the pedicle fixation group compared with the transverse process-vertebral body fixation group and modified rib transverse proc

关 键 词：组织工程 胸椎 骨折 生物力学 植入物 脊柱植入物 骨关节生物力学 胸椎骨折:经椎弓根固定:经横突-椎体固定:经改良肋横突法固定:螺钉拔出力:特征 

分 类 号：R318[医药卫生—生物医学工程]