经口咽前路寰枢椎复位钢板系统的研制与初步临床应用  

Design and preliminary clinical application of transoralpharyngeal atlantoaxial reduction plate

作　　者：尹庆水[1] 艾福志[1] 章凯[1] 夏虹[1] 吴增晖[1] 昌耘冰[1] 麦小红[1] 刘景发[1] 

机构地区：[1]广州军区广州总医院骨科,510010

出　　处：《中华外科杂志》2004年第6期325-329,共5页Chinese Journal of Surgery

基　　金：广东省自然科学基金资助项目 ( 2 0 0 2 3 0 1) ;广东省医学科研基金资助项目 (A2 0 0 2 5 13 ) ;广东省重点攻关项目 ( 99B0 670 3G)

摘　　要：目的　研制经口咽前路寰枢椎复位钢板系统 (TARP) ,评价其生物力学性能 ,并进行初步的临床应用观察。方法　研制设计一种新型的经口咽前路寰枢椎复位钢板系统 ,该系统包括蝶形钛合金钢板、自锁螺钉和寰枢椎复位器等配套安装器械。将此系统在 12具枕骨～C3 新鲜标本上分别进行了三维运动测试 (n =6 )和拔出力实验 (n =12 ) ,比较其生物力学性能 ,并初步临床应用 3例。结果　TARP系统设计有巧妙的即时复位机制。TARP、Brooks钢丝、Magerl经关节螺钉、前路螺钉以及Brooks钢丝 +Magerl经关节螺钉等 5组在屈伸方向的平均活动范围分别为 4 0、6 2、5 1、6 6、3 7度 ;在侧屈方向的平均活动范围分别为 2 3、3 6、2 7、4 2、1 8度 ;平均旋转活动范围分别为 7 4、8 9、8 6、10 7、6 0度。结果显示TARP的生物力学性能与Brooks钢丝 +Magerl经关节螺钉固定等效 ,较其他 3种方法具有更坚强的固定作用。临床应用术后随访平均 8 3个月 ,3例寰椎完全复位 ,伤口愈合良好 ,无感染 ,四肢麻痹消失 ,肌力恢复 ,病理反射消失。钢板螺钉未松动。结论　TARP设计新颖独到 ,具有良好的生物力学性能 ,手术操作简便易行 ,能达到即时复位 ,固定效果好 。Objective To design transoralpharyngeal atlantoaxial reduction plate(TARP), evaluate its biomechanical performance and observe its preliminary clinical effect Methods A brand new TARP system was designed, including butterfly titanium alloy plate, self locking screws, atlantoaxial reductor and other operation instruments Twelve fresh occipital bone C 3 specimen were designed for biomechanical test including range of motion(ROM)( n =6) and screw pull out strength( n =12) Preliminary clinical application of TARP was reported Results The reduction mechanism of the TARP system was designed cleverly TARP had equal effect with Magerl+Brooks and it was more stable than the other three clinically widely used atlantoaxial fixators: Magerl, Brooks and anterior transarticular screw fixation through C 2 vertebral body TARP′s C 1 and C 2 screws were strong enough for atlantoaxial arthrodesis and their antipull out performance was excellent Clinical application on irreducible atlantoaxial dislocation proved that TARP had the function of instant reduction, the operation was feasible and the operation effect was significant Conclusion TARP′s design is novel and it has excellent biomechanical performance The operation procedure is simple and reasonable Furthermore, instant reduction could be completed during the operation and the fixation is strong Above all, TARP is creative and will have excellent prospect

关 键 词：经口咽前路寰枢椎复位钢板系统 研制 临床应用 生物力学性能 评价 自锁螺钉 寰枢椎复位器 

分 类 号：R687.1[医药卫生—骨科学]