中国组织工程研究

中国组织工程研究 ›› 2017, Vol. 21 ›› Issue (3): 362-366.doi: 10.3969/j.issn.2095-4344.2017.03.007

• 脊柱植入物 spinal implant • 上一篇    下一篇

腰椎皮质骨通道螺钉固定系统的生物力学实验

姚 羽1，薛华伟2，赵 剑3，张 烽1，曹 涌1，陈向东1，赵金龙1，姜星杰1   

  1. 1南通大学附属医院骨科，江苏省南通市 226001；2南通市第三人民医院，江苏省南通市 226001；3解放军第二军医大学附属长征医院，上海市 200003
  • 修回日期:2016-11-18 出版日期:2017-01-28 发布日期:2017-03-14
  • 通讯作者: 姜星杰，主治医师，南通大学附属医院骨科，江苏省南通市 226001
  • 作者简介:姚羽，男，1981年生，江苏省南通市人，汉族，硕士，主治医师，主要从事脊柱外科研究。
  • 基金资助:

    南通市科技项目(MS22015074)

Biomechanics of lumbar cortical bone trajectory screw fixation

Yao Yu1, Xue Hua-wei2, Zhao Jian3, Zhang Feng1, Cao Yong1, Chen Xiang-dong1, Zhao Jin-long1, Jiang Xing-jie1   

  1. 1Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China; 2Nantong Third People’s Hospital, Nantong 226001, Jiangsu Province, China; 3Changzheng Hospital Affiliated to The Second Military Medical University, Shanghai 200003, China
  • Revised:2016-11-18 Online:2017-01-28 Published:2017-03-14
  • Contact: Jiang Xing-jie, Attending physician, Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
  • About author:Yao Yu, Master, Attending physician, Department of Orthopedics, Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
  • Supported by:

    the Nantong Municipal Science and Technology Project , No.MS22015074

PDF

270

被引次数

4

摘要：

文章快速阅读：

 

 

文题释义：
皮质骨通道螺钉：经过椎板皮质骨和椎弓根外侧与椎体移行处的皮质骨，较传统椎弓根螺钉进钉点更偏内侧、偏下方，进钉方向是由内侧向外侧、由尾侧向头端进钉，因此比传统椎弓根螺钉在皮质内的长度更长，螺钉与皮质骨的接触达到最大化，皮质骨通道螺钉经过椎板皮质骨和椎弓根外侧与椎体移行处的皮质骨达到双皮质固定的效果，相较传统椎弓根螺钉固定增加了钉-骨界面之间的把持力，从而增加了螺钉内固定的固定稳定性。
皮质骨通道螺钉的优势：①由于皮质骨通道螺钉螺钉自内向外上置入，术中所需的软组织剥离范围减少；②皮质骨通道螺钉螺钉没有穿破椎弓根内壁、干扰椎管造成神经损伤的危险；③对于骨质疏松的患者，皮质骨通道螺钉技术或是一种可选的提高螺钉抗拔出力的手术方式；④对于返修手术病例，无需因顾虑前次手术而更换更粗直径螺钉或改建或强化原先的钉道，避免了增粗或加长螺钉造成的椎弓根骨折，以及周围神经、椎前大血管及内脏的损伤。
 
摘要
背景：通过改变现行的传统椎弓根螺钉置入方式，以获得更佳的螺钉与骨的把持力，2009年Santoni等提出将皮质骨通道技术应用于腰椎内固定。
目的：分析皮质骨通道螺钉固定系统在腰椎间融合固定时的生物力学稳定性。
方法：获取20个新鲜初生小牛L3/4、L5/6运动节段标本，在非破坏状况下检测其不同状态下的活动度，作为正常对照；随后将20个标本分为皮质骨通道螺钉组与传统椎弓根螺钉组，分别进行皮质骨通道螺钉固定辅助腰椎后路椎间融合固定、传统椎弓根螺钉辅助腰椎后路椎间融合固定，在非破坏状况下检测两组不同状态下的活动度；翻修组为传统椎弓根螺钉组测试结束后撤钉，改用皮质骨通道螺钉固定，检测其不同状态下的活动度。
结果与结论：皮质骨通道螺钉组、传统椎弓根螺钉组左右弯曲、前屈、后伸、轴向旋转运动状态下的活动度较正常对照组明显降低(P < 0.05)，皮质骨通道螺钉组、翻修组左右弯曲、前屈、后伸、轴向旋转运动状态下的活动度与传统椎弓根螺钉组比较差异无显著性意义(P > 0.05)。结果表明，椎弓根皮质骨通道技术辅助腰椎后路融合固定可获得与传统椎弓根螺钉辅助腰椎后路融合固定相同的稳定性，同时是传统椎弓根螺钉固定失败后翻修的一种新选择。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程
ORCID: 0000-0002-6827-3975(姜星杰)

关键词: 骨科植入物, 脊柱植入物, 椎弓根皮质骨通道, 椎弓根螺钉, 生物力学, 腰椎融合固定

Abstract:

BACKGROUND: Santoni put forward the cortical bone trajectory technology by changing the traditional pedicle screw placement for lumbar internal fixation in order to obtain better control of the screw and bone in 2009.

OBJECTIVE: To analyze biomechanical stability of cortical bone trajectory system in the lumbar fusion. 
METHODS: Twenty fresh newborn calf L3/4, L5/6 motion segment specimens were obtained, and their ranges of motion were detected under different states, as normal controls. Subsequently, twenty samples were divided into cortical bone trajectory screw group and traditional pedicle screw group, which underwent cortical bone trajectory screw fixation combined with posterior lumbar fusion and traditional pedicle screw fixation combined with posterior lumbar fusion, respectively. Without destruction, ranges of motion were detected under different states in both groups. In the revision group, after the test in the traditional pedicle screw group, screw was withdrawn, and cortical bone trajectory screw was used to detect its range of motion under different states.
RESULTS AND CONCLUSION: Ranges of motion at bending to the left and right, anteflexion, posterior extension and axial rotation were significantly lower in the cortical bone trajectory screw group and traditional pedicle screw group than in the normal control group (P < 0.05). No significant difference in bending to the left and right, anteflexion, posterior extension and axial rotation was detected between the cortical bone trajectory screw and revision groups and traditional pedicle screw group (P > 0.05). These results confirmed that cortical bone trajectory technology combined with posterior lumbar fusion can obtain identical stability as the traditional pedicle screw fixation combined with posterior lumbar fusion. Simultaneously, it is a new choice for revision after traditional pedicle screw fixation. 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

Key words: Spinal Fusion, Biomechanics, Tissue Engineering

中图分类号: 

','1');return false;" target="_blank">
R318