CAJ | 학술논문

目的通过生物力学实验评估单椎节经椎弓根钉棒固定方法(STSR)治疗不伴椎体滑脱的腰椎椎弓峡部裂的力学特性.方法取人体下腰椎标本6具,在L4下关节突、L5上下关节突、S1上关节突分别贴应变片,在正常状态、L5双侧椎弓峡部裂状态、植入STSR内固定状态3种力学形态下分别测量应变片在力学加载时的应变量变化.结果前屈时L5下关节突竖形应变量内固定状态与峡部裂状态比较减少27%;后伸时L4 下关节突竖形片、L5下关节突横形片、L5下关节突竖形片应变量内固定状态与峡部裂状态比较分别减少23%、21%和51%,以上差异均有统计学意义(P＜0.05).侧屈时L5下关节突竖形片内固定状态与峡部裂状态比较减少59%;旋转时L4下关节突竖形片应变量内固定状态与峡部裂比较减少57%,以上差异有统计学意义(P＜0.01).结论 STSR系统能恢复峡部裂造成的不稳定,与峡部裂状态比较在下腰椎前屈、后伸、侧屈、旋转运动时增加了相应关节突的稳定.
목적 통과생물역학실험평고단추절경추궁근정봉고정방법(STSR)치료불반추체활탈적요추추궁협부렬적역학특성.방법 취인체하요추표본6구,재L4하관절돌、L5상하관절돌、S1상관절돌분별첩응변편,재정상상태、L5쌍측추궁협부렬상태、식입STSR내고정상태3충역학형태하분별측량응변편재역학가재시적응변량변화.결과 전굴시L5하관절돌수형응변량내고정상태여협부렬상태비교감소27%;후신시L4 하관절돌수형편、L5하관절돌횡형편、L5하관절돌수형편응변량내고정상태여협부렬상태비교분별감소23%、21%화51%,이상차이균유통계학의의(P＜0.05).측굴시L5하관절돌수형편내고정상태여협부렬상태비교감소59%;선전시L4하관절돌수형편응변량내고정상태여협부렬비교감소57%,이상차이유통계학의의(P＜0.01).결론 STSR계통능회복협부렬조성적불은정,여협부렬상태비교재하요추전굴、후신、측굴、선전운동시증가료상응관절돌적은정.
Objective To evaluate the biomechanical characteristics of single-segment trans-pedicle screws and rod(STSR)which can be used to treat spondylolysis without slip through experiments in vitro.Methods A total of 6 fresh human cadareric Iumbar spines were used in this investigation.The Micro-Strain Gages were stuck at the surface of zygapophyseal joint of L4 inferior,L5 superior and inferior,S1 superior in cross-shaped.The values of MSG were measured under three phases including normal condition(NC),spondylolysis with artificial cut condition(SC),and intra-segmental trans-pedicle screws and rod fixation condition(IFC).Results The results of measure at 15 inferior vertical strain gages had significant difference under flexion Ioading between IFC and SC.in which IFC was decreased by about 27%.The significant differece under extension Was observed at L4 inferior vertical gages.L5 inferior transverse gages,L5 inferior vertical gages between IFC and SC,in which IFC Was decreased by about 23%,21%,and 51% respectively(P＜0.05).The significant difference under lateral bending Was seen at 15 inferior vertical gages between IFC and SC.and the former Was less in 59% than the latter.When loading with torsion,the IFC Was less in 57%than SC at L4 inferior vertical gages(P＜0.01).Conclusion STSR could stabilize the lumbar spine with spondylolysis.In Comparison to SC.STSR restored the stabilization of zygapophyseal ioint under flexion,extension,lateral bending,and torsion loading.