CAJ | 학술논문

目的：评价改良 Galveston 技术固定骶髂关节时，不同螺钉数量对腰骶部生物力学的影响。方法建立骶骨次全切除术后的骨盆有限元模型，在此模型基础上行改良 Galveston 技术双侧固定腰骶部，分别建立4枚螺钉和6枚螺钉两种内固定方式。施加相同的压力载荷，经计算后对模型的有效性进行验证，进而比较不同螺钉内固定的模型位移以及内固定器械上的应力分布差异。结果模型经验证与文献中尸体模型实验结果近似，可以认为有效。尽管腰椎固定节段的数目对于腰骶部的刚度和器械整体应力的影响较小，但比较两种重建方式下 L5椎弓根螺钉上的应力发现，螺钉数目越少，螺钉上的应力越大，从而也增加了断钉或松动的风险。结论改良 Galveston 技术腰椎螺钉的数目与螺钉本身的应力有关，减少螺钉会增加断钉及松动的风险，但对棒以及钉尾的应力没有影响。
목적：평개개량 Galveston 기술고정저가관절시，불동라정수량대요저부생물역학적영향。방법건립저골차전절제술후적골분유한원모형，재차모형기출상행개량 Galveston 기술쌍측고정요저부，분별건립4매라정화6매라정량충내고정방식。시가상동적압력재하，경계산후대모형적유효성진행험증，진이비교불동라정내고정적모형위이이급내고정기계상적응력분포차이。결과모형경험증여문헌중시체모형실험결과근사，가이인위유효。진관요추고정절단적수목대우요저부적강도화기계정체응력적영향교소，단비교량충중건방식하 L5추궁근라정상적응력발현，라정수목월소，라정상적응력월대，종이야증가료단정혹송동적풍험。결론개량 Galveston 기술요추라정적수목여라정본신적응력유관，감소라정회증가단정급송동적풍험，단대봉이급정미적응력몰유영향。
Objective To evaluate the number of screws on the biomechanics of the sacral joint in the modified Galveston technology. Methods Based on the finite element postoperative pelvic model with subtotal sacrectomy previously established, two finite element models of modified Galveston technique were built,with 4 screws and 6 screws respectively. The same pres-sure load was applied on the two models,and the validity of the model was verified,the displacement of model and the stress distribution on screws and rods were compared. Results The model was validated to be effective according to the result of the experimental results of the cadaver model in the literature. Number of lumbar screws had little impact on the lumbosacral stiff-ness and equipment total stress. However,L5 pedicle screw stress of 4 screws reconstruction methods were higher than that of 6 screws reconstruction methods. Conclusion The less the number of screws,the greater stress on L5 pedicle screw. And the risk of screw breaking or loosening also increases with less screws. More pedicle screws should be used on osteoporosis pa-tients.