腰椎棘突钉-钩-板静态固定装置的生物力学研究  

Biomechanical study of the spinous screw-hook-laminar static system

作　　者：张红军[1] 邵高海[1] 李敬花[1] 张涛[1] 李波[1] 余雨[1] 王群波[1] 

机构地区：[1]重庆医科大学附属永川医院骨科,重庆400016

出　　处：《重庆医科大学学报》2016年第2期113-117,共5页Journal of Chongqing Medical University

基　　金：重庆市科技计划攻关项目(编号:CSTC2011AC5199)

摘　　要：目的：探讨腰椎棘突钉-钩-板静态固定装置固定后对固定及邻近节段椎间盘、关节突载荷的影响。方法：采用10具新鲜成人脊柱标本（L1～S1）,采用自身前后对照,分为完整组（N组）;损伤组（I组）;棘突钉-钩-板组（L组）;置入Wallis系统（W组）;椎弓根螺钉固定组（P组）,每组2具标本。用WDW-4100电子万能试验机,分别重复测试中立位（AC）、前屈后伸（Flex/Ext）、左右侧弯（LB）、旋转运动加载模式下,完整标本、损伤标本和各种固定方式之间的稳定性的差异,以及固定后对邻近节段椎间盘及关节突力学载荷影响。结果：力学稳定性,L组固定节段标本的生物学稳定性与I组相比有显著差异[垂直位移：AC（3.17±0.43）mm,Flex（3.13±0.34）mm,Ext（5.52±0.63）mm,LB（5.62±0.53）mm;水平位移：AC（0.72±0.06）mm,FLex（0.57±0.06）mm,Ext（0.72±0.06）mm,LB（0.67±0.06）mm,P〈0.05],与N组及W组比较无显著性差异（P〉0.05）。即L组稳定性与N组和W组相仿。L组与P组比较,稳定性有差异（P〈0.05）。即L组稳定性较P组稳定性差。对邻近节段椎间盘、关节突应力载荷的影响。L、W组在相同力学载荷下,对邻近节段椎间盘、关节突力学载荷影响比较无统计学差异[垂直位移：AC（3.12±0.43）mm,Flex（2.72±0.36）mm,Ext（4.32±0.36）mm,LB（4.82±0.55）mm;水平位移：AC（0.67±0.01）mm,Flex（0.54±0.04）mm,Ext（0.70±0.04）mm,LB（0.78±0.05）mm,P〉0.05];L组与P组在相同力学载荷下,对固定邻近节段椎间盘、关节突力学载荷影响比较有统计学差异[垂直位移：AC（2.91±0.53）mm,Flex（4.22±0.59）mm,Ext（5.22±0.56）mm,LB（5.42±0.49）mm;水平位移：AC（0.92±0.06）mm,Flex（0.62±0.06）mm,Ext（0.98±0.09）mm,LB（0.99±0.09）mm,P〈0.05],即L组固定对邻近节段椎间盘、关节突载荷的影响小于P组。结论：腰椎棘突钉-钩-板静态稳定装置生物力学性能优良,刚度适Objective：To investigate the biomechanical effects and stability of the spinous screw-hook-laminar static system on fixed and adjacent segment. Methods：Ten fresh adult human cadaveric lumbar spine specimens（L1～S1）were divided into intact group（N）,instable mode group（I）,spinous process screw-hook- laminar static system implantation group（L）,pedicle screw implantation group（P）and Wallis system implantation group（W）. Each group had two specimens. In five groups,the stability of lumbar spine and the stress changes of adjacent segment under flexion extension,lateral bending and axial motion were examined repeatedly on the WDW-4100 electronic universal testing machine. Results：Mechanical stability：The stability of the damaged section was notably increased in L group than in I group[vertical displacement：AC（3.17±0.43）mm,Flex（3.13±0.34）mm,Ext（5.52±0.63）mm,LB（5.62±0.53）mm;lateral displacement：AC（0.72±0.06）mm,Flex（0.57±0.06）mm,Ext（0.72±0.06）mm,LB（0.67±0.06）mm,P〈0.05]. The stability of fixed segments was equally increased in L group than in N group and W group（P〈0.05）. The stability of L group was inferior to pedicle screw-rod fixation（P）group（P〈0.05）. Biomechanical effects to adjacent segment disc and zygapophysial joints：under the same mechanical load,there was no significant difference between L group and W group in the stress changes of adjacent segment（vertical displacement：AC（3.12±0.43）mm,Flex（2.72±0.36）mm,Ext（4.32 ±0.36） mm,LB（4.82 ±0.55） mm;lateral displacement：AC（0.67 ±0.01） mm,Flex（0.54 ±0.04） mm,Ext（0.70±0.04）mm,LB（0.78±0.05）mm,P〈0.05）. L group had low impact on adjacent segment disc and zygapophysial joints than P group [vertical displacement：AC（2.91±0.53）mm,Flex（4.22±0.59）mm,Ext（5.22±0.56）mm,LB（5.42±0.49）mm;lateral displacement：AC（0.92±0.06）mm,Flex（0.62±0.06）mm,Ext（0.98±0.09）mm,LB（0.99±0.09）mm,P〈0.05]. Conclusions：With

关 键 词：腰椎 棘突 静态固定装置 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程]