中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (26): 4798-4803.doi: 10.3969/j.issn.1673-8225.2011.26.013

• 骨科植入物 orthopedic implant • 上一篇    下一篇

成人颈椎椎弓根螺钉在儿童腰椎应用的可行性

李现令1,张钦明1,李现今2,张学军1,李承鑫1,孙  琳1,鲁守彦3,张昆亚4,于凤章1,祈新禹1,孙保胜1   

  1. 1首都医科大学附属北京儿童医院骨科,北京市  100045
    2中国科学院力学研究所,北京市 100190
    3北京市中关村医院,北京市100090
    4首都医科大学生物工程学院生物力学实验室,北京市100069
  • 收稿日期:2011-02-12 修回日期:2011-03-16 出版日期:2011-06-25 发布日期:2011-06-25
  • 通讯作者: 张学军,主任医师,首都医科大学附属北京儿童医院骨科,北京市100045 zhang-X-J04@163.com 并列通讯作者:张钦明,首都医科大学附属北京儿童医院骨科,北京市 100045
  • 作者简介:李现令★,男,1978年生,山东省临沂市人,汉族, 2009年首都医科大学毕业,硕士,医师,主要从事小儿骨科学研究。 lixianling20002000@yahoo.com.cn
  • 基金资助:

    北京市优秀人才培养资助个人项目(20081B0300800085)。 

Feasibility of adult cervical pedicle screw in the lumbar spine of young children

Li Xian-ling1, Zhang Qin-ming1, Li Xian-jin2, Zhang Xue-jun1, Li Cheng-xin1, Sun Lin1, Lu Shou-yan3, Zhang Kun-ya4, Yu Feng-zhang1, Qi Xin-yu1, Sun Bao-sheng1   

  1. 1Department of Orthopedics, Beijing Children’s Hospital, Capital Medical University, Beijing  100045, China
    2Institute of Mechanics, Chinese Academy of Sciences, Beijing  100190, China
    3Beijing Zhongguancun Hospital, Beijing  100090, China
    4Biomechanics Laboratory, College of Bioengineering, Capital Medical University, Beijing  100069, China
  • Received:2011-02-12 Revised:2011-03-16 Online:2011-06-25 Published:2011-06-25
  • Contact: Zhang Xue-jun, Chief physician, Department of Orthopedics, Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China zhang-X-J04@163.com Correspondence to: Zhang Qin-ming, Department of Orthopedics, Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China
  • About author:Li Xian-ling★, Master, Physician, Department of Orthopedics, Beijing Children’s Hospital, Capital Medical University, Beijing 100045, China lixianling20002000@yahoo.com.cn
  • Supported by:

    Beijing Personal Project for Excellent Talents Culture, No. 20081B0300800085*

摘要:

背景:由于1~3岁幼年儿童椎体发育未完全成熟,各种解剖径线相对较成人小得多,尚无幼儿专用的椎弓根螺钉固定器械,现有能够利用的直径最小的椎弓根螺钉是用于成人颈椎侧块或椎弓根固定的钉棒系统。
目的:观察将成人颈椎椎弓根螺钉应用到成年猪颈椎与幼猪腰椎固定后的生物力学对比。
方法:将6具完整新鲜成年猪颈段C3~C6脊椎标本和6具完整8周龄新鲜幼猪腰段脊柱标本自椎间盘及关节处离断,游离成单个椎体,共54个椎体108侧椎弓根。按照标准操作将成人颈椎椎弓根螺钉分别安置在成年猪颈椎标本和幼猪腰椎标本的椎弓根上,应用生物力学方法测试螺钉的最大轴向拔出力。
结果与结论:颈椎标本最大轴向拔出力高于腰椎标本,但差异无显著性意义(P > 0.05);L1椎弓根螺钉的拔出力均值明显小于L3椎弓根螺钉的拔出力均值(P < 0.05);C5椎弓根螺钉的拔出力均值明显大于C3椎弓根螺钉的拔出力均值(P < 0.05);颈椎和腰椎标的骨密度差异有显著性意义(P < 0.01),椎体椎弓根力学数值与椎体骨密度之间存在线性正相关。说明取得了成人颈椎椎弓根螺钉在轴向拉力方面适应于幼儿腰椎的初步实验依据。

关键词: 椎弓根螺钉, 成人, 颈椎, 幼儿, 腰椎, 可行性

Abstract:

BACKGROUND: Because the vertebrae of children aged 1 to 3 years are not fully mature, there is no specific pedicle screw for children. At present, the existing pedicle screw with the smallest diameter is for adult cervical lateral mass or pedicle screw fixation.
OBJECTIVE: To compare the biomechanical changes of adult cervical pedicle screw used in cervical pedicle fixation of adult pigs and lumbar pedicle fixation of young pigs.
METHODS: C3-6 segments for six fresh adult pigs and lumbar spinal specimens from six 8-week-old young pigs were selected to prepare 54 single vertebrae with 108 pedicles. Adult cervical pedicle screw was placed into the prepared pedicles, and the maximum axial pull-out strength was detected using biomechanical methods.
RESULTS AND CONCLUSION: The maximum axial pull-out strength of the cervical specimen was lower than that of the lumbar specimen, but there was no significant difference (P > 0.05). The mean pull-out strength of L1 was significantly lower than that of L3 (P < 0.05). The mean pull-out strength of C5 was significantly higher than that of C3 (P < 0.05). There was a significant difference between the bone marrow density of the cervical and lumbar specimens (P < 0.01). From this study, we got the preliminary experimental foundation about applying adult cervical pedicle screw to the lumbar spine of young children from the viewpoint of axial pull-out strength.

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