寰枢椎前路可动固定系统的研制及生物力学研究  

Biomechanical evaluation of a novel motion-preserving atlanto-odontoid joint system: an in vitro human cadaveric study

作　　者：蔡璇[1] 王杰 李浩鹏[1] 贺西京[1] CAI Xuan;WANG Jie;LI Haopeng;HE Xijing(Department of Orthopaedic Surgery, Second Affiliated Hospital of Xi＇ an Jiaotong University , Xi＇ an710004, China)

机构地区：[1]西安交通大学第二附属医院骨二科,西安710004

出　　处：《山西医科大学学报》2018年第4期422-425,共4页Journal of Shanxi Medical University

基　　金：国家自然科学基金青年基金资助项目(81601955)

摘　　要：目的依据解剖学参数设计并制造寰枢椎前路可动固定系统,采用新鲜尸体标本进行生物力学测试,评价可动固定术后寰枢椎的稳定性和运动功能。方法采用60套干燥寰枢椎标本进行解剖学观测,依据解剖学参数设计并制造寰枢椎前路可动固定系统,将12具新鲜的成人头颈部标本制备成生物力学实验模型,分别测定其完整状态、寰椎前弓与齿状突切除减压术后、可动固定术后以及Harms钢板内固定术后四种状态下的运动范围和中性区。结果寰枢椎前路可动固定系统术后,寰枢椎在屈伸、侧屈下的运动范围和中性区与完整状态相似,差异无统计学意义(P>0.05),轴向旋转运动与完整状态相比有显著增加,差异具有统计学意义(P<0.05);同时,与完整状态、减压术后及假体置换术后相比,Harms钢板内固定术后寰枢椎在各个方向运动下的运动范围与中性区均减小,差异具有统计学意义(P<0.05)。结论寰枢椎前路可动固定系统能够从结构和功能上对寰枢椎进行仿生模拟,达到了兼顾寰枢椎稳定性和运动功能的双重目的,为寰枢椎疾患的手术治疗提供了一种全新的选择。Objective To design a novel motion-preserving atlanto-odontoid joint system according to anatomical parameters and determine the initial stability and function of this device in human cadaveric cervical spine models. Methods Flexibility tests were conducted on 12 human cadaveric craniocervical specimens in the intact state,after dissection of the atlantoaxial ligaments and odontoidectomy,after the motion-preserving atlanto-odontoid joint system implantation,and after Harms rigid fixation,respectively. Rotational angles of the C1-C2 segment were measured to study the immediate stability and function of the artificial atlanto-odontoid joint implantation. Results Compared with that in the intact state,the range of motion and neutral zone showed no significant difference in flexion,extension,and lateral bending after the motion-preserving atlanto-odontoid joint system implantation,but the range increased significantly in axial rotation（ P〈0. 05）. Compared with that in the intact state,after dissection of the atlantoaxial ligaments and odontoidectomy,or after the motion-preserving atlanto-odontoid joint system implantation,the range of motion and neutral zone in all directions decreased after Harms rigid fixation（ P〈0. 05）. Conclusion The motion-preserving atlanto-odontoid joint system may correct the atlantoaxial instability arising from C1-C2 anterior decompression procedures,and can be a new choice for atlanto-axial surgery.

关 键 词：寰枢椎 生物力学 可动固定系统 尸体 

分 类 号：R681.5[医药卫生—骨科学]