CAJ | 학술논문

目的：研究腰椎微创经椎间孔椎体间融合术( MI-TLIF)不对称内固定条件下节段稳定性和椎体前柱应变分布特点。方法采用新鲜小牛腰椎标本8例,完成L4~L5节段完整状态测试后建立TLIF手术损伤模型,分别测试右侧椎弓根螺钉固定( UPS)、右侧椎弓根螺钉加对侧经关节突椎弓根螺钉( UPS+TFPS)固定、双侧椎弓根螺钉固定( BPS)状态的三维运动范围( ROM),同时在L4椎体前柱表面用电阻应变片技术测量在前屈和侧弯运动中电阻应变数据。结果 UPS+TFPS和BPS固定状态的稳定性效果接近,UPS固定抗旋转稳定性不足。 UPS+TFPS固定后椎体前柱应变在前屈和侧弯运动下较BPS固定分别增加21.8%和24.2%。结论 UPS+TFPS固定提供有效稳定的同时可以实现更好的椎体-内植物载荷共享。
목적：연구요추미창경추간공추체간융합술( MI-TLIF)불대칭내고정조건하절단은정성화추체전주응변분포특점。방법채용신선소우요추표본8례,완성L4~L5절단완정상태측시후건립TLIF수술손상모형,분별측시우측추궁근라정고정( UPS)、우측추궁근라정가대측경관절돌추궁근라정( UPS+TFPS)고정、쌍측추궁근라정고정( BPS)상태적삼유운동범위( ROM),동시재L4추체전주표면용전조응변편기술측량재전굴화측만운동중전조응변수거。결과 UPS+TFPS화BPS고정상태적은정성효과접근,UPS고정항선전은정성불족。 UPS+TFPS고정후추체전주응변재전굴화측만운동하교BPS고정분별증가21.8%화24.2%。결론 UPS+TFPS고정제공유효은정적동시가이실현경호적추체-내식물재하공향。
Objective To assess the biomechanical stability and vertebra strain distribution of asymmetrical posterior internal fixation for minimally invasive transforaminal lumbar interbody fusion ( MI-TLIF) . Methods Range of motion ( ROM) and strain distribution testing were performed in 8 fresh-frozen calf lumbar spine motion segments in flexion/extension, lateral bending, and axial rotation using 5. 0 Nm torques at the L4-5 motion segment. The sequential test configurations included intact motion segment, TLIF with unilateral pedicle screw ( UPS) , TLIF with UPS plus transfacet pedicle screws ( UPS+TFPS) , and TLIF with bilateral pedicle screw ( BPS) . The ROM was deter-mined to assess the construct stability. Strain distribution was recorded along with flexion and lateral bending configurations. Results In flexion/extension, lateral bending, and axial rotation, there was no significant difference in the ROM between BPS and UPS+TFPS fixation after TLIF. After TLIF, the UPS construct provided less segment stability than BPS and UPS+TFPS fixation in flexion, lateral bending. Strain distribution under UPS+TFPS fixation was respectively 21. 8% and 24. 2% higher than that under BPS fixation along with flexion and lateral bending. Conclusion UPS+TFPS fixation provides stability comparable to that of MI-TLIF with bilateral PS, with better load share with the vertebrae body.