枕骨板联合C2双侧椎板螺钉交叉棒固定稳定性的生物力学研究  

Biomechanical stability evaluation of the fixation technique for crossed rods consisting of occipital plate and C2 bilateral lamina screws

作　　者：邱锋 许喜林[1] 马向阳 江伟城 刘耿超 方周群 林泽江 QIU Feng;XU Xilin;MA Xiangyang;JIANG Weicheng;LIU Gengchao;FANG Zhouqun;LIN Zejiang(Department of Orthopaedics,Puning Overseas Chinese Hospital,Puning Guangdong,515300,P.R.China;Department of Spinal Surgery,Orthopaedics Hospital,General Hospital of Southern Theatre Command,Guangzhou Guangdong,510010,P.R.China)

机构地区：[1]普宁华侨医院骨科,广东普宁515300 [2]中国人民解放军南部战区总医院骨科医院脊柱外科,广州510010

出　　处：《中国修复重建外科杂志》2020年第12期1545-1549,共5页Chinese Journal of Reparative and Reconstructive Surgery

摘　　要：目的采用生物力学测试评价枕骨板联合C2双侧椎板螺钉交叉棒固定寰枢椎的稳定性。方法取6具新鲜尸体标本制备寰枢椎失稳模型,植入枕骨板及C2双侧椎板螺钉后,分别行平行棒固定及交叉棒固定。按照失稳模型(失稳组)、平行棒固定后(平行固定组)、交叉棒固定后(交叉固定组)顺序,采用生物力学三维测试仪测量寰枢椎前屈、后伸、左侧屈、右侧屈、左旋转、右旋转6个方向的活动度。测试后X线片观察内固定物位置。结果生物力学测试显示,交叉固定组及平行固定组在各方向活动度均明显小于失稳组,差异有统计学意义(P<0.05)。在前屈、后伸以及左、右侧屈方向,交叉固定组及平行固定组间差异均无统计学意义(P>0.05);在左、右旋转方向,交叉固定组活动度明显小于平行固定组,差异均有统计学意义(P<0.05)。测试完成后X线片检查示内固定物位置均良好。结论应用枕骨板联合C2双侧椎板螺钉固定时,采用交叉棒固定方式可进一步增强枕颈融合的轴向旋转稳定性。Objective To evaluate the stability of the fixation technique for the crossed rods consisting of occipital plate and C2 bilateral lamina screws by biomechanical test.Methods Six fresh cervical specimens were harvested and established an atlantoaxial instability model.The models were fixed with parallel rods and crossed rods after occipital plate and C2 bilateral laminae screws were implanted.The specimens were tested in the following sequence:atlantoaxial instability model(unstable model group),under parallel rods fixation(parallel fixation group),and under crossed rods fixation(cross fixation group).The range of motion(ROM)of the C0-2 segments were measured in flexion-extension,left/right lateral bending,and left/right axial rotation.After the test,X-ray film was taken to observe the internal fixator position.Results The biomechanical test results showed that the ROMs in flexion-extension,left/right lateral bending,and left/right axial rotation were significantly lower in the cross fixation group and the parallel fixation group than in the unstable model group(P<0.05).There was no significant difference between the cross fixation group and the parallel fixation group in flexion-extension and left/right lateral bending(P>0.05).In the left/right axial rotation,the ROMs of the cross fixation group were significantly lower than those of the parallel fixation group(P<0.05).After the test,the X-ray film showed the good internal fixator position.Conclusion The axial rotational stability of occipitocervical fusion can be further improved by crossed rods fixation when the occipital plate and C2 bilateral lamina screws are used.

关 键 词：枕颈固定 交叉棒 生物力学 寰枢椎不稳 

分 类 号：R687.3[医药卫生—骨科学]