CAJ | 학술논문

目的：测试并评价新型寰枢椎后路动态固定系统的生物力学性能。方法新鲜成人枕颈标本（C0～4）8例，分成4组：完整状态组、寰枢椎不稳状态组、寰枢椎后路动态固定状态组和寰枢椎后路椎弓根螺钉固定状态组。通过加载1．50 N· m的力矩，对4组标本C1/C2、C2/C3节段的前屈/后伸，左/右侧弯和左/右旋转等6种运动方式下的运动范围（range of movement， ROM）及稳定性指数（stability index，SI）进行测试。结果采用新型寰枢椎后路动态固定系统后，C1/C2、C2/C3节段的ROM与正常完整标本相比较，差异无统计学意义（ P＞0．05）；而采用常规椎弓根螺钉固定与动态固定法相比，C1/C2、C2/C3节段的ROM差异有统计学意义（P＜0．001）。采用寰枢椎后路动态固定系统固定与采用后路椎弓根螺钉固定，C1/C2SI均上升，与完整状态组相比差异均有统计学意义，分别为（P＜0．05）和（P＜0．001）。 C2/C3测试结果显示，采用动态固定时SI分别上升为109％、107％和112％；而采用椎弓根螺钉固定，三维运动范围SI反而分别下降为77％、71％和87％，比动态固定SI分别低29％、34％和22％，差异具有统计学意义（ P＜0．001）。结论新型寰枢椎后路动态固定系统既可维持寰枢椎的部分旋转功能，又可达到坚固固定的稳定性，同时能够有效地减少对邻近节段的影响，具有良好的研究前景。
목적：측시병평개신형환추추후로동태고정계통적생물역학성능。방법신선성인침경표본（C0～4）8례，분성4조：완정상태조、환추추불은상태조、환추추후로동태고정상태조화환추추후로추궁근라정고정상태조。통과가재1．50 N· m적력구，대4조표본C1/C2、C2/C3절단적전굴/후신，좌/우측만화좌/우선전등6충운동방식하적운동범위（range of movement， ROM）급은정성지수（stability index，SI）진행측시。결과채용신형환추추후로동태고정계통후，C1/C2、C2/C3절단적ROM여정상완정표본상비교，차이무통계학의의（ P＞0．05）；이채용상규추궁근라정고정여동태고정법상비，C1/C2、C2/C3절단적ROM차이유통계학의의（P＜0．001）。채용환추추후로동태고정계통고정여채용후로추궁근라정고정，C1/C2SI균상승，여완정상태조상비차이균유통계학의의，분별위（P＜0．05）화（P＜0．001）。 C2/C3측시결과현시，채용동태고정시SI분별상승위109％、107％화112％；이채용추궁근라정고정，삼유운동범위SI반이분별하강위77％、71％화87％，비동태고정SI분별저29％、34％화22％，차이구유통계학의의（ P＜0．001）。결론신형환추추후로동태고정계통기가유지환추추적부분선전공능，우가체도견고고정적은정성，동시능구유효지감소대린근절단적영향，구유량호적연구전경。
To evaluate biomechanics of a new posterior dynamic fixation system in atlanto-axial spine .Meth-ods Eight fresh human cadaveric specimens ( C0-4 ) were divided randomly into 4 groups: The intact state group , instable state group, posterior atlanto-axial dynamic fixation group and posterior atlanto-axial pedicle screw fixation group .Th range of movement (ROM) C1/C2 and C2/C3 by loading 1.50 N· m were measured under the 6 conditions of flexion/extension, left/right lateral bending and left/right rotation .Results Under the 6 conditions , there were no significant differences in ROM of C1/C2 and C2/C3 between dynamic fixation group and intact group (P>0.05), but there were significant differences in ROM of C1/C2 and C2/C3 between dynamic fixation group and pedicle fixation group (P<0.001).There were significant differ-ences between intact group and dynamic fixation group , pedicle fixation group in stability index ( SI) of C1/C2 under the condi-tions of flexion/extension, left/right lateral bending and left/right rotation, respectively (P<0.05) and (P<0.001).How-ever, the SI of dynamic fixation group was superior to pedicle fixation group in C 2/C3 .Conclusion In vivo biomechanical studies show that the new posterior atlanto-axial dynamic fixation may ideally restored the stability of atlanto-axial, meanwhile, maintain the atlanto-axial ROM.