CAJ | 학술논문

目的探讨联合应用普通椎弓根螺钉(单向钉)和万向钉经伤椎内固定治疗胸腰椎爆裂骨折的生物力学稳定性. 方法 6具新鲜冰冻小牛腰椎标本(L1～L5)制备成L3椎体爆裂骨折模型,将标本随机分为骨折未固定组、万向钉组(伤椎及伤椎上位、下位椎体均使用万向钉)和联合钉组(伤椎上位椎体使用单向钉,伤椎及伤椎下位椎体使用万向钉),比较L2～L4节段三维6个方向的运动范围和中性区的差异. 结果联合钉组与万向钉组两种固定方式在前屈、后伸、侧曲、旋转方向上的运动范围和中性区差异无统计学意义(P＞0.05),与骨折未固定组比较差异均有统计学意义(P＜0.01). 结论单向钉和万向钉联合应用不会降低内固定系统的生物力学稳定性,联合钉与万向钉均可为骨折模型提供可靠的生物力学稳定性.
목적 탐토연합응용보통추궁근라정(단향정)화만향정경상추내고정치료흉요추폭렬골절적생물역학은정성. 방법 6구신선빙동소우요추표본(L1～L5)제비성L3추체폭렬골절모형,장표본수궤분위골절미고정조、만향정조(상추급상추상위、하위추체균사용만향정)화연합정조(상추상위추체사용단향정,상추급상추하위추체사용만향정),비교L2～L4절단삼유6개방향적운동범위화중성구적차이. 결과 연합정조여만향정조량충고정방식재전굴、후신、측곡、선전방향상적운동범위화중성구차이무통계학의의(P＞0.05),여골절미고정조비교차이균유통계학의의(P＜0.01). 결론 단향정화만향정연합응용불회강저내고정계통적생물역학은정성,연합정여만향정균가위골절모형제공가고적생물역학은정성.
Objective To investigate the biomechanical stability of general pedicle screw (monoaxial screw) and multixial screws in treatment of thoracolumbar burst fractures.Methods Six calf fresh-frozen lumbar spines (L1-L5) were selected to produce models of L3 burst fractures.The specimens were assigned to none fracture fixation group,multiaxial screw group (fixation of the fractured vertebra and upper and lower adjacent vertebral bodies with monoaxial screws,) and combined screw group (fixation of the upper adjacent vertebral body with monoaxial screws and of the fractured vertebra and lower adjacent vertebral body with multiaxia[screw).Differences in range of motion and neutral zone at level of L2-L4 at six movement directions were compared between groups.Results Range of motion and neutral zone had insignificant differences between the two groups under anterior flexion,posterior extension,lateral bending,and rotation (P ＞ 0.05),but significant difference in comparison with none fracture fixation group (P ＜ 0.01).Conclusions Combined use of multixial and monoaxial screws produces no effect on biomechanical stability of the internal fixation.Multiaxial plus monoaxial screw fixation and monoaxial screw fixation can both provide reliable biomechanical stability.