椎弓根螺钉内固定的生物力学强度影响因素的研究进展  

Research progress on factors affecting biomechanical strength of pedicle screw internal fixation

作　　者：房彦名 何达 范明星 张琦 田伟 Fang Yanming;He Da;Fan Mingxing;Zhang Qi;Tian Wei(Department of Spine Surgery,Beijing Jishuitan Hospital,Capital Medical University,Beijing 100035,China)

机构地区：[1]首都医科大学附属北京积水潭医院脊柱外科,北京100035

出　　处：《中华骨科杂志》2024年第3期193-198,共6页Chinese Journal of Orthopaedics

基　　金：中国医学科学院医学与健康科技创新工程(2021⁃I2M⁃5⁃007);国家自然科学基金(82302353)

摘　　要：椎弓根螺钉内固定系统在脊柱外科手术中扮演着关键角色,具有增加脊柱稳定性的优势,但存在内固定松动和螺钉拔出等潜在并发症。目前常采用轴向拔出力评估内固定的短期生物力学特性、疲劳试验评估内固定的长期生物力学特性、扭矩评估螺钉与脊椎骨质的相互作用。影响椎弓根螺钉生物力学特性的因素包括脊椎相关因素(骨密度)和螺钉相关因素(螺钉尺寸、螺钉设计和螺钉增强材料)。在高骨密度的骨骼中螺钉轴向拔出力可显著增加,而通过增加螺钉直径和长度、改进螺钉设计并使用螺钉增强材料也可以提高螺钉的固定强度。椎弓根螺钉内固定的生物力学研究为实现个体化和功能性最优通道选择提供了关键信息,设计具有最佳固定强度的螺钉通道有望降低螺钉松动的风险,减少手术并发症的发生,提高手术效果。The pedicle screw internal fixation system plays a crucial role in spinal surgery,with the advantage of enhancing spinal stability.However,potential complications such as internal fixation loosening and screw pullout still exist clinically.Currently,pullout of strength is commonly used to evaluate the short-term biomechanical properties of internal fixation,fatigue test is performed to evaluate the long-term biomechanical properties of internal fixation,and torque is used to evaluate the interaction between screws and spinal bone.Factors that influence the biomechanical properties of pedicle screws include spine-related factors(bone density)and screw-related factors(screw size,screw design,and screw augmentation materials).In bones with high bone density,pullout of strength is significantly increased,and fixation strength can also be improved by increasing screw diameter and length,improving screw design,and using screw augmentation materials.Biomechanical research on pedicle screw internal fixation provides key information for achieving individualized and functional optimal channel selection.Designing screw channels with optimal fixation strength is expected to reduce the risk of screw loosening and the occurrence of surgical complications,and improve surgical effects.

关 键 词：椎弓根钉 骨密度 生物力学 

分 类 号：R687.3[医药卫生—骨科学]