中空锥槽椎弓根内固定系统联合PKP治疗胸腰椎压缩骨折的动力学性能研究  

Hollow pedicle screw system combined with PKP instead of traditional pedicle screw fixation for thoracolumbar compression fracture: a cadaver study

作　　者：成立[1] 陆文杰[1] 陈坚样[1] 王沛年[1] 童松林[1] 

机构地区：[1]浙江省慈溪市人民医院骨科,315300

出　　处：《中国矫形外科杂志》2016年第10期915-919,共5页Orthopedic Journal of China

摘　　要：[目的]探讨中空锥槽椎弓根内固定系统联合PKP治疗胸腰椎压缩骨折的动力学性能。[方法]采集新鲜人尸胸腰椎标本8具,分为A、B两组实验力学模型,一组为采用胸腰椎压缩骨折常规实心椎弓根内固定系统固定(A),另一组为采用中空锥槽椎弓根内固定系统联合PKP固定(B)。行生物力学冲击动力学试验。[结果]经试验得到胸腰椎冲击动力学性能有:(1)A、B两组胸腰椎各自的冲击动主应变响应;(2)A、B两组胸腰椎的动态力学性质以及胸腰椎的冲击能量阈值;(3)A、B两组冲击后胸腰椎伤椎的椎体高度和Cobb角的变化。结果显示A、B两组冲击动力学性能差异均有统计学意义(P<0.01),B组优于A组。[结论]胸腰椎压缩骨折采用中空锥槽椎弓根内固定系统联合PKP治疗,在生物力学性能方面优于常规实心椎弓根内固定系统,不但动态力学性能优越,而且中空锥槽椎弓根内固定系统微创、安全、可靠和有效。[Objective]To investigate the kinetic performance of internal fixation with a self- designed hollow pedicle screw system combined with PKP for treatment of thoracolumbar vertebral compression fracture. [ Method] Eight thoracolumbar vertebrae, without any known pathological defect, were collected from human corpses for this study. Specimens were divided into two groups according to different fixation methods,with 4 vertebrae segments in each. Conventinal internal fixation with pedicle screw system was used in group A and and internal fixation with hollow pedicle screw system combined with PKP, which was also strengthened with PMMA,was carried out in group B. All samples received biomechanical impact kinetic tests. [ Result] The re- sults from the dynamic test showed that：（ 1 ）The dynamic main strain in Group A was more than that in group B （P 〈 0.01 ） ; （2） The dynamic perfimance and the impact energy threshold in Group B was better and higher than that in group A （P 〈 0. 01 ） ; （3） The change of vertebral height and Cobb angle in group B was smaller than that in group A （P 〈 0.01 ）. [ Conclusion ] The kinetic performance of internal fixation with hollow pedicle screw system combined with PKP is better than internal fixation with traditional nedicle screw svstem. This new - designedfixation method is minimally invasive, safe and effective.

关 键 词：胸腰椎 压缩性骨折 中空锥槽椎弓根内固定系统 PKP 动态生物力学 

分 类 号：R683[医药卫生—骨科学]