CAJ | 학술논문

背景：椎弓根螺钉技术是目前脊柱固定融合最常用的方法。为减少螺钉松动和拔出等并发症，研究人员在螺钉设计等方面进行了不断探索。 　　目的：比较单螺纹和双螺纹椎弓根螺钉应用于腰椎内固定术时的螺钉抗拔出力。 　　方法：78例行腰椎椎弓根螺钉固定术的患者随机分为两组，所有患者术前均测量髋部骨密度和腰椎骨密度。一组在术中植入单螺纹椎弓根螺钉，另一组则植入双螺纹椎弓根螺钉，测量拧入每枚螺钉时的最大扭矩（以下简称“螺钉扭矩”），比较两组患者的骨密度和螺钉扭矩。 　　结果：单螺纹螺钉组患者40例，术前髋部骨密度T值-1.82±0.57，腰椎骨密度T值-2.17±0.77，术中共植入单螺纹椎弓根螺钉150枚，螺钉扭矩（1.03±0.39）Nm。双螺纹螺钉组患者38例，术前髋部骨密度T值-1.90±0.62，腰椎骨密度T值-2.34±0.81，共植入双螺纹椎弓根螺钉150枚，螺钉扭矩（1.45±0.39）Nm。两组患者术前骨密度无明显差异（P＞0.05），双螺纹螺钉组的螺钉扭矩显著高于单螺纹螺钉组（P＜0.001）。 　　结论：相较于单螺纹椎弓根螺钉，双螺纹椎弓根螺钉应用于腰椎内固定术可增加螺钉的抗拔出力。
배경：추궁근라정기술시목전척주고정융합최상용적방법。위감소라정송동화발출등병발증，연구인원재라정설계등방면진행료불단탐색。 　　목적：비교단라문화쌍라문추궁근라정응용우요추내고정술시적라정항발출력。 　　방법：78례행요추추궁근라정고정술적환자수궤분위량조，소유환자술전균측량관부골밀도화요추골밀도。일조재술중식입단라문추궁근라정，령일조칙식입쌍라문추궁근라정，측량녕입매매라정시적최대뉴구（이하간칭“라정뉴구”），비교량조환자적골밀도화라정뉴구。 　　결과：단라문라정조환자40례，술전관부골밀도T치-1.82±0.57，요추골밀도T치-2.17±0.77，술중공식입단라문추궁근라정150매，라정뉴구（1.03±0.39）Nm。쌍라문라정조환자38례，술전관부골밀도T치-1.90±0.62，요추골밀도T치-2.34±0.81，공식입쌍라문추궁근라정150매，라정뉴구（1.45±0.39）Nm。량조환자술전골밀도무명현차이（P＞0.05），쌍라문라정조적라정뉴구현저고우단라문라정조（P＜0.001）。 　　결론：상교우단라문추궁근라정，쌍라문추궁근라정응용우요추내고정술가증가라정적항발출력。
Background:Nowadays, pedicle screws technology is the most commonly used method in spinal fixation and fusion. Much has been explored concerning pedicle screws designing process in order to reduce occurrence of complications such as screw loose and pullout. Objective:To compare the pullout strength between single-threaded and dual-threaded pedicle screws when applied in lum-bar spinal surgeries with internal fixation. Methods:A series of 78 patients undergoing lumbar surgeries with pedicle screws as internal fixation instruments were ran-domly assigned into two groups:Single-threaded pedicle screws and dual-threaded screws were implanted, respectively, in the two groups. Bone density measurement (BMD) of the hip region and lumbar vertebrae were acquired in all patients prior to surgeries. Additionally, maximum insertion torque (MIT) was measured when every screw was inserted during each sur-gery. Results of BMD (T value) and MIT (Nm) were compared between the two groups. Results:In the single-threaded group, there were 40 patients in whom a total number of 150 pedicle screws were implanted;T value of preoperative BMD of the hip region was-1.82±0.57 and that of the lumbar vertebrae was-2.17±0.77;mean MIT was 1.03±0.39. In the dual-threaded group, there were 38 patients with also a total number of 150 pedicle screws being in-strumented, and the parameters of preoperative BMD of the hip region and lumbar vertebrae as well as MIT were-1.90 ± 0.62,-2.34 ± 0.81 and 1.45 ± 0.39, respectively. No statistical significant difference was found between the two groups con-cerning preoperative BMD (P>0.05), however, MIT distinguished between each other with dual-threaded group demonstrat-ed a greater value than that of the single-threaded group (P<0.001). Conclusions:In comparison with single-threaded pedicle screws, dual-threaded pedicle screws, when applied in lumbar sur-geries with internal fixations, have been shown to have greater pullout strength.