CAJ | 학술논문

目的设计一种新型板棒复合胸腰椎前路内固定装置(D-rod),并评价其生物力学效果.方法 18具家猪脊柱(T12～L3)标本按随机数字表法分为D-rod组、Z-plate组和Ventrofix组,每组6具,测量3组标本的骨密度并进行比较.制作3组标本L1爆裂骨折模型,钛笼植入重建椎体并分别采用D-rod系统、Z-plate系统和Ventrofix系统内固定.对标本施加6.0 Nm纯力偶矩,依次测试3组标本前屈、后伸、左侧弯、右侧弯、左轴向旋转、右轴向旋转6种状态下的相对角位移运动范围,比较其稳定性.结果 D-rod组、Z-plate组和Ventrofix组3组标本骨密度值分别为(1.265±0.073) g/cm2、(1.126±0.082) g/cm2、(l.4030.095) g/cm2,组间比较差异无统计学意义(P＞0.05).生物力学测试显示,前屈、后伸及左、右侧弯状态下,D-rod组和Ventrofix组的稳定性优于Z-plate组(均P＜0.05);左、右轴向旋转状态下,D-rod组与Z-plate组的稳定性优于Ventrofix组(均P＜0.05).结论自行设计的D-rod系统作为一个锁定系统,具有低切迹、易调整的优点,可为胸腰椎前路修复重建提供足够的稳定性.
목적 설계일충신형판봉복합흉요추전로내고정장치(D-rod),병평개기생물역학효과.방법 18구가저척주(T12～L3)표본안수궤수자표법분위D-rod조、Z-plate조화Ventrofix조,매조6구,측량3조표본적골밀도병진행비교.제작3조표본L1폭렬골절모형,태롱식입중건추체병분별채용D-rod계통、Z-plate계통화Ventrofix계통내고정.대표본시가6.0 Nm순력우구,의차측시3조표본전굴、후신、좌측만、우측만、좌축향선전、우축향선전6충상태하적상대각위이운동범위,비교기은정성.결과 D-rod조、Z-plate조화Ventrofix조3조표본골밀도치분별위(1.265±0.073) g/cm2、(1.126±0.082) g/cm2、(l.4030.095) g/cm2,조간비교차이무통계학의의(P＞0.05).생물역학측시현시,전굴、후신급좌、우측만상태하,D-rod조화Ventrofix조적은정성우우Z-plate조(균P＜0.05);좌、우축향선전상태하,D-rod조여Z-plate조적은정성우우Ventrofix조(균P＜0.05).결론 자행설계적D-rod계통작위일개쇄정계통,구유저절적、역조정적우점,가위흉요추전로수복중건제공족구적은정성.
Objective To evaluate the biomechanical performance of a self-designed new complex rod-plate system (D-rod) for anterior thoracolumbar internal fixation.Methods Eighteen specimens of pig spine (T12-L3) were allocated to 3 groups (n=6 each) by random digits table.Bone mineral density (BMD) in each group was measured and compared.Models of L1 bust fracture were created in each group,titanium mesh cage was implanted for vertebral reconstruction,and then fixed respectively with D-rod system (group A),Z-plate system (group B) and Ventrofix system (group C).Range of motion on relative angular displacement in T12-L2 under 6.0 Nm pure moment of couple was measured for specimens in each group at six motions (anterior flexion,posterior extension,left lateral bending,right lateral bending,left axial rotation and right axial rotation).Stability was compared among 3 groups.Results The BMD for groups A,B and C was respectively(1.265±0.073) g/cm2,(1.126±0.082) g/cm2 and (1.403±0.095) g/cm2,with no significant between-group difference(P＞0.05).D-rod and Ventrofix yielded significantly greater stability than Z-plate at anterior flexion,posterior extension,left and right lateral bending (all P＜0.05).D-rod and Z-plate yielded significantly greater stability than Ventrofix at axial rotations (both P＜0.05).Conclusions The selfdesigned D-rod system,as a locking system with low profile and greater adjustability,can result in adequate stability for anterior thoracolumbar reconstruction.