CAJ | 학술논문

目的评价椎弓根钉道局部强化技术及其结合膨胀式椎弓根螺钉提高椎弓根螺钉固定强度的效果.方法通过自行设计及加工的钉道局部强化装置,向钉道周壁点状注入CaSO4骨水泥以强化椎弓根钉道.5具新鲜冻存人体脊柱标本,每具随机选取4个腰椎共20个腰椎标本,采用随机区组设计方法分为10个区组.设计四种固定方法:A组(普通椎弓根螺钉)、B组(普通椎弓根螺钉+钉道局部强化)、C组(膨胀式椎弓根螺钉+钉道局部强化)、D组(普通椎弓根螺钉+钉道内灌注CaSO4骨水泥),随机应用在每个区组的2个椎体共4个椎弓根钉道.分别测试每个椎弓根螺钉的最大轴向拔出力及能量吸收值.从剩余腰椎标本中任意取两个腰椎,应用钉道局部强化技术后利用Micro-CT观察钉道周壁微观结构变化.结果 C、D两组的最大轴向拔出力均值及能量吸收值均值高于A组(P＜0.01)及B组(P＜0.05),B组最大轴向拔出力均值及能量吸收值均值高于A组(P＜0.01),C、D两组之间的差异无统计学意义(P＞0.05).结论钉道局部强化技术可显著提高椎弓根螺钉的固定强度,结合使用膨胀式椎弓根螺钉可进一步提高螺钉的固定强度.
목적 평개추궁근정도국부강화기술급기결합팽창식추궁근라정제고추궁근라정고정강도적효과.방법 통과자행설계급가공적정도국부강화장치,향정도주벽점상주입CaSO4골수니이강화추궁근정도.5구신선동존인체척주표본,매구수궤선취4개요추공20개요추표본,채용수궤구조설계방법분위10개구조.설계사충고정방법:A조(보통추궁근라정)、B조(보통추궁근라정+정도국부강화)、C조(팽창식추궁근라정+정도국부강화)、D조(보통추궁근라정+정도내관주CaSO4골수니),수궤응용재매개구조적2개추체공4개추궁근정도.분별측시매개추궁근라정적최대축향발출력급능량흡수치.종잉여요추표본중임의취량개요추,응용정도국부강화기술후이용Micro-CT관찰정도주벽미관결구변화.결과 C、D량조적최대축향발출력균치급능량흡수치균치고우A조(P＜0.01)급B조(P＜0.05),B조최대축향발출력균치급능량흡수치균치고우A조(P＜0.01),C、D량조지간적차이무통계학의의(P＞0.05).결론 정도국부강화기술가현저제고추궁근라정적고정강도,결합사용팽창식추궁근라정가진일보제고라정적고정강도.
Objective To evaluate the improvement of pedicle screw fixation with the application of local screw tunnel augmentation technique and expansive pediele screws.Methods Injecting CaSO4 bone cement into the perine of pediele screw tunnel by new design instruments in order to augment the screw tunnel.Twenty lumbar vertebrae from five frozen human spine specimens were divided into 10 blocks by randomized block design.Four fixation methods were applied:group A(common pedicle screws),group B(common pedicle screws+local screw tunnel augmentation technique),group C(expansive pedicle screws+local screw tunnel augmentation technique),group D(common pedicle screws+CaSO4 bone cement filled into pedicle screw tunnels).Four fixation methods were performed in four screw tunnels of each two blocks at random.And then the maximum axial pullout strength(Fmax)and energy absorbed were measured for comparison.Results Mean values of the Fmax and energy absorbed of group C or D were statistically significantly greater than those of group A(P＜0.01)and group B(P＜0.05).Mean values of the Fmax and energy absorbed of group B were also statistically significantly greater than those of group A(P＜0.01).There was no statistical significant difference between group C and group D(P＞0.05).Conclusion The pedicle screw fixation might be improved with the application of local screw tunnel augmentation technique and it might be even finner if combined with expansive pedicle screws.