潍坊医学院学报
濰坊醫學院學報
유방의학원학보
JOURNAL OF WEIFANG MEDICAL COLLEGE
2013年
4期
265-267
,共3页
骨折%颈椎前路融合%内固定
骨摺%頸椎前路融閤%內固定
골절%경추전로융합%내고정
Fracture%ACDF%Internal fixation
目的通过比较多种颈椎内固定方式以寻找颈椎后路治疗颈椎单侧小关节骨折的标准的手术方式。方法对6具新鲜的人体颈椎标本（C3～T1）的C3椎体从0Nm到2．0Nm以0．5Nm的增量进行运动。每个标本顺次进行以下8步处理：①完整状态；②C5/6平面不稳定；③C5～6双侧侧块内固定；④不稳定的右侧C5侧块骨折；⑤C5～6单侧侧块内固定；⑥辅以棘突间缆线的C5～6单侧侧块内固定；⑦C4～6双侧侧块内固定；⑧C5～6 ACDF。结果相对于完整状态，平均活动范围C5～6双侧侧块内固定减少到33．3％，C5～6单侧侧块内固定上升到113．6％，辅以棘突间缆线的C5～6单侧侧块内固定减少到90．3％，C4～6双侧侧块内固定减少到44．2％，ACDF减少到66．9％．结论辅以棘突间缆线的单侧侧块内固定应该被视为颈椎后路手术的方式之一。
目的通過比較多種頸椎內固定方式以尋找頸椎後路治療頸椎單側小關節骨摺的標準的手術方式。方法對6具新鮮的人體頸椎標本（C3～T1）的C3椎體從0Nm到2．0Nm以0．5Nm的增量進行運動。每箇標本順次進行以下8步處理：①完整狀態；②C5/6平麵不穩定；③C5～6雙側側塊內固定；④不穩定的右側C5側塊骨摺；⑤C5～6單側側塊內固定；⑥輔以棘突間纜線的C5～6單側側塊內固定；⑦C4～6雙側側塊內固定；⑧C5～6 ACDF。結果相對于完整狀態，平均活動範圍C5～6雙側側塊內固定減少到33．3％，C5～6單側側塊內固定上升到113．6％，輔以棘突間纜線的C5～6單側側塊內固定減少到90．3％，C4～6雙側側塊內固定減少到44．2％，ACDF減少到66．9％．結論輔以棘突間纜線的單側側塊內固定應該被視為頸椎後路手術的方式之一。
목적통과비교다충경추내고정방식이심조경추후로치료경추단측소관절골절적표준적수술방식。방법대6구신선적인체경추표본（C3～T1）적C3추체종0Nm도2．0Nm이0．5Nm적증량진행운동。매개표본순차진행이하8보처리：①완정상태；②C5/6평면불은정；③C5～6쌍측측괴내고정；④불은정적우측C5측괴골절；⑤C5～6단측측괴내고정；⑥보이극돌간람선적C5～6단측측괴내고정；⑦C4～6쌍측측괴내고정；⑧C5～6 ACDF。결과상대우완정상태，평균활동범위C5～6쌍측측괴내고정감소도33．3％，C5～6단측측괴내고정상승도113．6％，보이극돌간람선적C5～6단측측괴내고정감소도90．3％，C4～6쌍측측괴내고정감소도44．2％，ACDF감소도66．9％．결론보이극돌간람선적단측측괴내고정응해피시위경추후로수술적방식지일。
Objective To find a gild standard dorsal approach by comparing several fixation methods .Meth-ods Six fresh human cervical spine specimens (C3 ~T1) were tested by applying pure moments to the C 3 vertebral body in increments of 0.5 Nm from 0 Nm to 2.0 Nm.Each specimen was tested in the following 8 conditions:①intact;②after destabilization via injury to the C5~6 facet;③with bilateral C5~6 lateral mass screws and rods;④after further destabilization by creating a right unilateral lateral mass fracture of C 5;⑤with unilateral left C5~6 lateral mass screws and rod;⑥with unilateral C5~6 lateral mass screws and rod supplemented with an interspinous cable;⑦with a bilateral multilevel dorsal construct C4~6;and⑧after a C5~6 anterior cervical discectomy and fusion (ACDF) procedure with a polyetheretherketone graft and plate .Results Relative to the normal,the range of C5~6 motion in each construct was:33.3%in the bilateral C5~6 lateral mass construct,113.6%in the unilateral C5~6 lateral mass construct,90.3%in the unilateral lateral mass construct supplemented by an interspinous cable ,44.2% in the bilateral C4~6 lateral mass construct,and 66.9%in the C5~6 ACDF construct.Conclusion A dorsal approach is used and the unilateral con-struct with a cable should only be considered in selected instances .
