经半椎弓根螺钉固定与经椎弓根螺钉固定中上胸椎的拔出力比较  

Comparison of pull-out strength between middle-upper thoracic semi-pedicular screwing versus con-ventional pedicular screwing

作　　者：周纪平[1] 刘彬[1] 杨永军[1] 谭远超[1] 王增梅[2] 徐曼琼[2] 

机构地区：[1]山东省威海市,文登整骨医院,264400 [2]清华大学航空航天学院

出　　处：《中华创伤骨科杂志》2015年第10期892-894,共3页Chinese Journal of Orthopaedic Trauma

基　　金：基金项目：山东省科技发展计划项目（2012GGA10125）

摘　　要：目的通过比较经半椎弓根固定技术与传统经椎弓根固定技术固定中上胸椎的螺钉拔出强度，评价半椎弓根螺钉固定中上胸椎的生物力学效果。方法中上胸椎标本3具共24个椎体，分别采用传统经椎弓根螺钉固定（经椎弓根组）和经半椎弓根螺钉固定（经半椎弓根组）。根据所用螺钉规格不同将其分为3种不同测试条件：c1螺钉直径4．0mm，长度40mm；C2螺钉直径5．0mm，长度45mm；C3螺钉直径6．0mm，长度45mm。测试并比较两组螺钉的拔出力。结果c1条件下经椎弓根组的拔出力[（890．0±102．0）N]大于经半椎弓根组[（780．0±100．2）N]，差异有统计学意义（P〈0．05）；c2条件下经椎弓根组的拔出力[（940．2±116．3）N]与经半椎弓根组[（906．0±103．3）N]比较差异无统计学意义（P〉0．05）；C3条件下经椎弓根组拔出力[（899．3±119．2）N]与半经椎弓根组[（962．0±119．2）N]比较差异无统计学意义（P〉0．05）。结论当使用较细的螺钉（直径4．0mm）固定时，中上胸椎半椎弓根螺钉固定不如椎弓根螺钉固定坚强；但当使用较粗的螺钉（直径6．0mm）固定时，中上胸椎传统经椎弓根固定因椎弓根较细小，螺钉挤爆了椎弓根壁致使把持力明显下降，经半椎弓根螺钉固定拔出力与经椎弓根固定无显著差异，安全性明显优于经椎弓根固定。Objective To compare the pull-out strength between middle-upper thoracic se- mi-pedicular screwing versus conventional pedieular screwing. Methods Three specimens of mid- dle-upper thoracic vertebrae with 24 vertebral bodies were used in this experiment. The vertebral bodies were divided into 2 equal groups which were subjected to conventional fixation with transpedicular screws （group A） and fixation with trans-semi-pedicular screws （group B）, respectively. Each group were tested with screws of different specifications： C1 screws of 4.0 mm in diameter and 40 mm in length, C2 screws of 5.0 mm in diameter and 45 mm in length, C3 screws of 6.0 mm in diameter and 45 mm in length. The pull-out strengths of different screws were compared between the 2 groups. Results The pull-out strength of C1 in group A （890.0±102.0N） was signifieantly larger than in group B （780.0±100.2N） （P 〈0.05） . Thepnll-out strength of C2 in group A （940.2 ± 116. 3 N） was similar to that in group B （906. 0 ± 103.3 N） （ P 〉 0.05）. The pull-out strength of C3 in group A （899.3 ±119.2 N） was also similar to that in group B （962. 0 ± 119.2 N） （ P 〉0. 05）. Conclusions When a small screw is used, middle-upper thoracic semi-pedicular screwing is not as strong as conventional pedicular screwing. When a large screw is used, there is no significant dif- ference between middle-upper thoracic semi-pedicular screwing and conventional pedicular screwing in pull-out strength but the former may be superior in safety due to its more lateral approach.

关 键 词：胸椎 骨折固定术 骨钉 生物力学 

分 类 号：R687.3[医药卫生—骨科学]