新型低弹性模量脊柱椎弓根螺钉的研制及生物力学特性  

Design and biomechanical properties of a novel low elastic modulus spine pedicle screw

作　　者：阮智[1] 阿鲁缇 

机构地区：[1]石河子大学医学院第一附属医院,新疆维吾尔自治区石河子市832000 [2]新疆医科大学附属第一医院,新疆维吾尔自治区乌鲁木齐市830054

出　　处：《中国组织工程研究》2016年第53期7959-7965,共7页Chinese Journal of Tissue Engineering Research

基　　金：新疆自然科学基金(2013211A082)~~

摘　　要：背景:常用的骨水泥强化椎弓跟螺钉能提高螺钉固定能力,但是骨水泥渗漏、螺钉取出困难等问题一直未得到有效的解决。目的:探讨新型低弹性模量脊柱椎弓根螺钉的研制方法及生物力学特性。方法:将人完整脊柱标本椎体取一侧椎弓根植入新型低弹性模量脊柱椎弓根螺钉,采用骨水泥推杆、灌注筒在X射线下向椎体内灌注2 mL骨水泥,对侧植入常规螺钉对照。所有椎体分别进行3点弯曲实验、最大轴向拔出力、最大旋出力矩及周期抗屈实验。结果与结论:(1)生物力学特性:新型低弹性模量螺钉与常规螺钉在屈服载荷上差异无显著性意义(P>0.05),与常规螺钉相比,新型低弹性模量螺钉屈服位移增加,最大拔出力,最大旋出力矩,最大载荷均高于常规螺钉(P<0.05),位移则显著降低(P<0.05);(2)结果提示:新型设计的低弹性模量脊柱椎弓跟螺钉结合骨水泥推杆、灌注筒使用操作简单,避免了骨水泥的渗漏,能提高骨质疏松椎体内的稳定型及生物力学性能,保持脊柱刚度和稳定性,促进脊椎融合。BACKGROUND： Bone cement is commonly used to strengthen pedicle screws that can improve the ability of screw fixation, but the bone cement leakage and difficulty of screw out remain to be resolved. OBJECTIVE： To investigate the development and biomechanical characteristics of a novel low elastic modulus pedicle screw.METHODS： The novel low elastic modulus pedicle screw was implanted into one side of vertebral pedicle removed from a human complete spine, followed by 2 m L bone cement perfusion using bone cement pusher and infusion tube under X-ray, while the conventional screw was implanted into the contralateral side as control. All vertebrae underwent the three-point bending test, maximum axial pullout force, maximum torque and cyclic bending resistance test. RESULTS AND CONCLUSION：（1） The novel low elastic modulus screw and conventional screw had no significant difference in the yield load（P〈0.05）. The yield displacement, maximum pullout force, maximum torque and maximum loading of the novel low elastic modulus screw were all significantly higher than those of the conventional screw（P〈0.05）, while it showed significant reduction in displacement（P〈0.05）.（2） These results indicate that the novel low elastic modulus pedicle screw is easy to operate, avoids the bone cement leakage, and can improve the biomechanical properties and stability of osteoporotic vertebrae and keep the spine stiffness and stability, which is beneficial for spinal fusion.

关 键 词：组织工程 脊柱 生物力学 骨科植入物 脊柱植入物 低弹性模量 脊柱椎弓根螺钉 常规螺钉 生物力学特性 骨水泥推杆 灌注筒 最大轴向拔出力 最大旋出力矩 周期抗屈实验 新疆维吾尔自治区自然科学基金 

分 类 号：R318[医药卫生—生物医学工程]