中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (39): 7251-7253.doi: 10.3969/j.issn.1673-8225.2010.39.008

• 数字化骨科 digital orthopedics • 上一篇    下一篇

颈前路钢板置入内固定加椎间植骨治疗Ⅱ型Hangman骨折的生物力学评价　

黄阳亮1，刘少喻1，赵卫东2，李浩淼1，魏富鑫1，陈克冰1   

  1. 1中山大学附属第一医院脊柱外科，广东省广州市 510700；2南方医科大学生物力学实验室，广东省广州市 510515
  • 出版日期:2010-09-24 发布日期:2010-09-24
  • 通讯作者: 刘少喻，教授，博士生导师，科主任，主任医师，中山大学附属第一医院脊柱外科， 广东省广州市 510700 gzsyliu@tom.com
  • 作者简介:黄阳亮★，男，1982年生，湖南省湘潭县人，汉族，2008年中山大学毕业，硕士，医师，主要从事脊柱疾患研究。 lansedeahi@yahoo.com.cn
  • 基金资助:

    广东省科技计划项目资助 ( 2008B0303013 03)；广州市黄埔区科技计划项目资助(0931)。

Biomechanical evaluation of anterior cervical plate fixation combined with intervertebral bone graft for the treatment of Hangman’s fracture

Huang Yang-liang1, Liu Shao-yu1, Zhao Wei-dong2, Li Hao-miao1, Wei Fu-xin1, Chen Ke-bing1　   

  1. 1 Department of Spine Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou  510700, Guangdong Province, China; 2 Laboratory of Biomechanics, Southern Medical University, Guangzhou  510515, Guangdong Province, China　
  • Online:2010-09-24 Published:2010-09-24
  • Contact: Liu Shao-yu, Professor, Doctoral supervisor, Chief physician, Department of Spine Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, Guangdong Province, China gzsyliu@tom.com
  • About author:Huang Yang-liang★, Master, Physician, Department of Spine Surgery, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510700, Guangdong Province, China lansedeahi@yahoo.com.cn
  • Supported by:

     the Science and Technology Planning Project of Guangdong Province, No. 2008B030301303*; the Science and Technology Planning Project of Huangpu Area, No. 0931*

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摘要：

背景：C 2/3椎间盘切除，钢板置入内固定加椎间植骨是治疗Hangman骨折的常用术式。该术式在临床应用广泛，但目前尚缺乏相关实验评价钢板置入内固定治疗Hangman骨折的生物力学特点研究。
目的：评价钢板置入内固定+椎间植骨治疗Ⅱ型Hangman骨折的生物力学稳定性。
方法：6具正常成人新鲜冷冻颈椎，每一标本依次制作成以下3种状态组：即正常对照组、Ⅱ型Hangman骨折模型组、椎间植骨+钢板内固定组。按以上顺序应用脊柱三维运动试验机和三维激光扫描仪测试每一状态C 2/3节段的三维运动范围。
结果与结论：与正常对照组比较，Ⅱ型Hangman骨折模型组C 2/3节段前屈、后伸、旋转及侧弯关节活动度均显著增大(P < 0.05)，钢板内固定+椎间植骨组旋转方向关节活动度显著增大(P < 0.05)；与Ⅱ型Hangman骨折模型组相比，钢板内固定+椎间植骨组C2/3节段前屈、后伸及侧弯关节活动度均显著减小(P < 0.05)。结果提示钢板置入内固定能够在前屈、后伸及侧弯方向恢复Ⅱ型Hangman骨折的稳定性，然而在旋转方向缺乏稳定作用，术后需辅以外固定以确保融合。

关键词: 颈椎, Hangman骨折, 生物力学, 内固定, 融合, 医学植入物

Abstract:

BACKGROUND: C 2/3 discectomy, intervertebral autograft combined with plate fixation were commonly seen in surgical treatment of Hangman’s fracture. This method was used widely in clinical practice, however, the investigation of its biomechanical feature was not sufficient.
OBJECTIVE: To evaluate the biomechanical stabilities of intervertebral autograft combined with plate fixation in treatment of type Ⅱ Hangman’s fracture.
METHODS: Totally 6 fresh frozen human spine specimens were used, each of them was made into 3 conditions: intact condition (blank control group), type Ⅱ Hangman’s fracture condition (Hangman group) and plate fixation condition (plate fixation group). On above sequences, three-dimensional laser scanner and three-dimensional motion testing machine were used to test range of motion (ROM) of C 2/3 segment under each condition.
RESULTS AND CONCLUSION: Compare with the blank control group, ROM of joint of the Hangman group was significantly larger on flexion, extension, axial rotation and lateral bending (P < 0.05); ROM of joint of the plate fixation group was significantly larger on direction of axial rotation (P < 0.05). Compare with Hangman group, ROM of joint of plate fixation group was significant smaller on direction of flexion, extension and lateral bending (P < 0.05). The results indicated that in treatment of type Ⅱ hangman’s fracture, plate fixation is helpful in resuming stability on direction of flexion, extension and lateral bending, however, stability can not be achieved on direction of axial rotation, therefore, postoperative external fixation is recommended to secure fusion.

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