中华创伤骨科杂志
中華創傷骨科雜誌
중화창상골과잡지
CHINESE JOURNAL OF ORTHOPAEDIC TRAUMA
2012年
3期
225-227
,共3页
李熙雷%车武%董健%马易群%王会仁%李娟%张东升
李熙雷%車武%董健%馬易群%王會仁%李娟%張東升
리희뢰%차무%동건%마역군%왕회인%리연%장동승
脊柱骨折%骨折固定术,内%骨钉%生物力学
脊柱骨摺%骨摺固定術,內%骨釘%生物力學
척주골절%골절고정술,내%골정%생물역학
Spinal fracture%Fracture fixation,internal%Bone nail%Biomechanics
目的 通过生物力学测试验证经伤椎单节段固定脊柱胸腰椎爆裂骨折(AO分型A3.1型)的稳定性. 方法 选取6具T10～L2的人脊柱标本,通过落锤实验机建立AO分型A3.1型T12爆裂骨折模型,在伤椎及其相邻椎体上置入椎弓根螺钉,建立单节段椎弓根螺钉固定(MSPI)模型,每具标本均进行完整、骨折及MSPI固定3种状态的生物力学测试,分析MSPI固定与完整标本的稳定性差异. 结果 MSPI固定组的前屈、后伸、左侧弯及右侧弯时的活动度平均分别为0.14°±0.02°、0.07°±0.02°、0.73°±0.22°和0.74°±0.13°明显小于骨折组0.84°±0.10°、1.94°±0.30°、2.33 °±0.56°和2.54°±0.44°及完整组0.46°±0.05°、1.01°±0 23°、1.34°±0.24°和1.30°±0.31°,差异均有统计学意义(P＜0.05).当扭转相同角度时,MPSI固定组所需的扭力(3103.00±213.11)N与完整组(2654.75±122.90)N相当,差异无统计学意义(P＞0.05),大于骨折组(1519.60±100.82)N,差异有统计学意义(P＜0.05). 结论 治疗AOA3.1型胸腰椎爆裂骨折时,MSPI能重建脊柱的稳定性.
目的 通過生物力學測試驗證經傷椎單節段固定脊柱胸腰椎爆裂骨摺(AO分型A3.1型)的穩定性. 方法 選取6具T10～L2的人脊柱標本,通過落錘實驗機建立AO分型A3.1型T12爆裂骨摺模型,在傷椎及其相鄰椎體上置入椎弓根螺釘,建立單節段椎弓根螺釘固定(MSPI)模型,每具標本均進行完整、骨摺及MSPI固定3種狀態的生物力學測試,分析MSPI固定與完整標本的穩定性差異. 結果 MSPI固定組的前屈、後伸、左側彎及右側彎時的活動度平均分彆為0.14°±0.02°、0.07°±0.02°、0.73°±0.22°和0.74°±0.13°明顯小于骨摺組0.84°±0.10°、1.94°±0.30°、2.33 °±0.56°和2.54°±0.44°及完整組0.46°±0.05°、1.01°±0 23°、1.34°±0.24°和1.30°±0.31°,差異均有統計學意義(P＜0.05).噹扭轉相同角度時,MPSI固定組所需的扭力(3103.00±213.11)N與完整組(2654.75±122.90)N相噹,差異無統計學意義(P＞0.05),大于骨摺組(1519.60±100.82)N,差異有統計學意義(P＜0.05). 結論 治療AOA3.1型胸腰椎爆裂骨摺時,MSPI能重建脊柱的穩定性.
목적 통과생물역학측시험증경상추단절단고정척주흉요추폭렬골절(AO분형A3.1형)적은정성. 방법 선취6구T10～L2적인척주표본,통과락추실험궤건립AO분형A3.1형T12폭렬골절모형,재상추급기상린추체상치입추궁근라정,건립단절단추궁근라정고정(MSPI)모형,매구표본균진행완정、골절급MSPI고정3충상태적생물역학측시,분석MSPI고정여완정표본적은정성차이. 결과 MSPI고정조적전굴、후신、좌측만급우측만시적활동도평균분별위0.14°±0.02°、0.07°±0.02°、0.73°±0.22°화0.74°±0.13°명현소우골절조0.84°±0.10°、1.94°±0.30°、2.33 °±0.56°화2.54°±0.44°급완정조0.46°±0.05°、1.01°±0 23°、1.34°±0.24°화1.30°±0.31°,차이균유통계학의의(P＜0.05).당뉴전상동각도시,MPSI고정조소수적뉴력(3103.00±213.11)N여완정조(2654.75±122.90)N상당,차이무통계학의의(P＞0.05),대우골절조(1519.60±100.82)N,차이유통계학의의(P＜0.05). 결론 치료AOA3.1형흉요추폭렬골절시,MSPI능중건척주적은정성.
Objective To test the biomechanical stability of fixation of thoracolumbar burst fractures (A 3.1 by AO classification) with monosegmental pedicle instrumentation (MSPI). Methods Six specimens of T10-L2 thoracolumbar spine segment were harvested from human donors ranging in age from 27 to 46 years (mean,39 years).Incomplete burst fractures (A3.1 by AO classification) were made at the level of T12 in the specimens using a mechanical dropping hammer.The fractures were fixated with MSPI in the specimens sequentially to restore spinal stability.The specimens in conditions of integrity,fracture and MSPI fixation were tested on the mechanical testing system for biomechanical assessment of the segmental stability.Range of motions (ROM) in flexion-extension and lateral bending were recorded by a 2-camera VICON motion measurement system.The rotational stability was tested by a computer torsional testing machine. Results The ROMs of MSPI specimens in flexion,extension,left and right lateral bending were respectively 0.14°± 0.02°,0.07° ± 0.02°,0.73 ° ± 0.22° and 0.74° ± 0.13°,significantly lower than those of fracture specimens (0.84° ± 0.10°,1.94° ± 0.30°,2.33° ± 0.56° and 2.54° ± 0.44° ) and those of intact specimens (0.46° ±0.05°,1.01° ±0.23°,1.34° ± 0.24° and 1.30° ± 0.31°) ( P ＜ 0.05).The torsional force needed in MSPI specimens was 3103.00 ± 213.11 N,which was not significantly different from that in intact specimens (2654.75 ± 122.90 N) ( P ＞ 0.05) but significantly higher than that in fracture specimens ( 1519.60 ± 100.82 N) ( P ＜ 0.05). Conclusion In the treatment of thoraeolumbar burst fractures (A3.1 by AO classification),MSPI can reconstruct the spinal stability.
