CAJ | 학술논문

目的通过比较经半椎弓根固定技术与传统经椎弓根固定技术固定中上胸椎的螺钉拔出强度,评价半椎弓根螺钉固定中上胸椎的生物力学效果. 方法中上胸椎标本3具共24个椎体,分别采用传统经椎弓根螺钉固定(经椎弓根组)和经半椎弓根螺钉固定(经半椎弓根组).根据所用螺钉规格不同将其分为3种不同测试条件:C1螺钉直径4.0 mm,长度40 mm;C2螺钉直径5.0 mm,长度45 mm;C3螺钉直径6.0 mm,长度45 mm.测试并比较两组螺钉的拔出力. 结果 C1条件下经椎弓根组的拔出力[(890.0±102.0)N]大于经半椎弓根组[(780.0±100.2) N],差异有统计学意义(P＜0.05);C2条件下经椎弓根组的拔出力[(940.2±116.3)N]与经半椎弓根组[(906.0±103.3) N]比较差异无统计学意义(P＞0.05);C3条件下经椎弓根组拔出力[(899.3±119.2)N]与半经椎弓根组[(962.0±119.2)N]比较差异无统计学意义(P＞0.05). 结论当使用较细的螺钉(直径4.0 mm)固定时,中上胸椎半椎弓根螺钉固定不如椎弓根螺钉固定坚强;但当使用较粗的螺钉(直径6.0 mm)固定时,中上胸椎传统经椎弓根固定因椎弓根较细小,螺钉挤爆了椎弓根壁致使把持力明显下降,经半椎弓根螺钉固定拔出力与经椎弓根固定无显著差异,安全性明显优于经椎弓根固定.
목적 통과비교경반추궁근고정기술여전통경추궁근고정기술고정중상흉추적라정발출강도,평개반추궁근라정고정중상흉추적생물역학효과. 방법 중상흉추표본3구공24개추체,분별채용전통경추궁근라정고정(경추궁근조)화경반추궁근라정고정(경반추궁근조).근거소용라정규격불동장기분위3충불동측시조건:C1라정직경4.0 mm,장도40 mm;C2라정직경5.0 mm,장도45 mm;C3라정직경6.0 mm,장도45 mm.측시병비교량조라정적발출력. 결과 C1조건하경추궁근조적발출력[(890.0±102.0)N]대우경반추궁근조[(780.0±100.2) N],차이유통계학의의(P＜0.05);C2조건하경추궁근조적발출력[(940.2±116.3)N]여경반추궁근조[(906.0±103.3) N]비교차이무통계학의의(P＞0.05);C3조건하경추궁근조발출력[(899.3±119.2)N]여반경추궁근조[(962.0±119.2)N]비교차이무통계학의의(P＞0.05). 결론 당사용교세적라정(직경4.0 mm)고정시,중상흉추반추궁근라정고정불여추궁근라정고정견강;단당사용교조적라정(직경6.0 mm)고정시,중상흉추전통경추궁근고정인추궁근교세소,라정제폭료추궁근벽치사파지력명현하강,경반추궁근라정고정발출력여경추궁근고정무현저차이,안전성명현우우경추궁근고정.
Objective To compare the pull-out strength between middle-upper thoracic semi-pedicular screwing versus conventional pedicular screwing.Methods Three specimens of middle-upper thoracic vertebrae with 24 vertebral bodies were used in this experiment.The vertebral bodies were divided into 2 equal groups which were subjected to conventional fixation with transpedicular screws (group A) and fixation with trans-semi-pedicular screws (group B),respectively.Each group were tested with screws of different specifications:C1 screws of 4.0 mm in diameter and 40 mm in length,C2 screws of 5.0 mm in diameter and 45 mm in length,C3 screws of 6.0 mm in diameter and 45 mm in length.The pull-out strengths of different screws were compared between the 2 groups.Results The pull-out strength of C 1 in group A (890.0 ± 102.0 N) was significantly larger than in group B (780.0 ± 100.2 N) (P ＜ 0.05).The pull-out strength of C2 in group A (940.2 ± 116.3 N) was similar to that in group B (906.0 ± 103.3 N) (P ＞ 0.05).The pull-out strength of C3 in group A (899.3 ± 119.2 N) was also similar to that in group B (962.0 ± 119.2 N) (P ＞ 0.05).Conclusions When a small screw is used,middle-upper thoracic semi-pedicular screwing is not as strong as conventional pedicular screwing.When a large screw is used,there is no significant difference between middle-upper thoracic semi-pedicular screwing and conventional pedicular screwing in pull-out strength but the former may be superior in safety due to its more lateral approach.