中国组织工程研究 ›› 2018, Vol. 22 ›› Issue (15): 2367-2372.doi: 10.3969/j.issn.2095-4344.0227

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

脊椎椎管成形结合螺钉不同内固定方式的生物力学性质分析

王林锋,陆成武,叶  宏,陈小杰,邱必成   

  1. 福建医科大学附属南平市第一医院脊柱外科,福建省南平市 353000
  • 出版日期:2018-05-28 发布日期:2018-05-28
  • 通讯作者: 陈小杰,硕士,主任医师,福建医科大学附属南平市第一医院脊柱外科,福建省南平市 353000
  • 作者简介:王林锋,男,1983 年生,福建省政和县人,汉族,2010 年吉林大学白求恩医学部毕业,硕士,主治医师,主要从事脊柱外科方面的研究。
  • 基金资助:

    福建省南平市科技项目基金项目(N2015Y03)

Biomechanical study of different fixation with hollow screws in spinal laminoplasty

Wang Lin-feng, Lu Cheng-wu, Ye Hong, Chen Xiao-jie, Qiu Bi-cheng   

  1. Department of Spine Surgery, Nanping First Hospital Affiliated to Fujian Medical University, Nanping 353000, Fujian Province, China
  • Online:2018-05-28 Published:2018-05-28
  • Contact: Chen Xiao-jie, Master, Chief physician, Department of Spine Surgery, Nanping First Hospital Affiliated to Fujian Medical University, Nanping 353000, Fujian Province, China
  • About author:Wang Lin-feng, Master, Attending physician, Department of Spine Surgery, Nanping First Hospital Affiliated to Fujian Medical University, Nanping 353000, Fujian Province, China
  • Supported by:

    the Science and Technology Project Foundation of Nanping City of Fujian Province, No. N2015Y03

摘要:

文章快速阅读:

 
 
文题释义:
棘突椎板复合体回植:对于椎管内肿瘤患者,完整摘除椎管内肿瘤和保护脊柱解剖结构与功能是手术的基本原则。肿瘤摘除后采用空心钉重建棘突椎板复合体结构,可提供即刻的力学支持,维持脊柱结构的完整性。该研究通过制作人工仿形椎体、山羊脊椎标本椎管成形术标本,依据单双侧及螺钉固定深度设计分组,测量分析生物力学性质。
空心钉技术:采用单侧单枚空心钉技术对棘突椎板复合体进行重建,因空心钉固定有一定的加压作用,可对截骨面产生即刻稳定性,可提供足够力学稳定性及促进骨愈合。
 
摘要
背景:脊柱椎板回植辅助空心钉椎管成形已取得良好临床疗效;检索文献发现目前国内外尚无关于单侧与双侧空心钉固定椎管成形生物力学特性的研究实验。
目的:测试人工椎体及山羊椎体椎管成形结合螺钉不同内固定方式的生物力学性质。
方法:人工仿形骨常规棘突椎板复合体回植辅助螺钉原位回植内固定实验分成3组,A组单枚螺钉置入深度5 mm,B组单枚螺钉置入深度8 mm,C组双侧分别置入螺钉5 mm。成年山羊胸椎标本椎管成形结合螺钉内固定实验分成2组,A组为单枚螺钉固定加压组,B组为双侧置入螺钉组。在生物力学试验机上通过传感器测出固定螺钉的最大拔出力及对棘突的静态压缩力。
结果与结论:①在人工仿形骨的拔出测试实验中,单钉置入8 mm的拔出力值约为单钉置入5 mm失效力值的2倍(P < 0.01);而置入双钉5 mm的拔出力值远低于单侧置入8 mm的拔出力值(P < 0.01),且低于单钉置入5 mm的拔出力值(P < 0.05)。静态压缩测试实验中,2个单钉置入组的结果相近,差异无显著性意义;双钉置入的静态压缩力值低于2个组单钉置入组,且差异有显著性意义(P < 0.01);②成年羊骨单钉置入的拔出力值及静态压缩力均高于双钉置入组,且差异有显著性意义(P < 0.05);③结果表明,与双钉置入相比,脊柱椎板回植结合单枚螺钉内固定加压可以提供更大的生物力学稳定性,其强度与螺钉置入深度呈正相关。

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: 0000-0003-3542-1377(王林锋)

关键词: 人工椎体, 山羊椎体, 椎管成形术, 空心螺钉, 生物力学, 拔出力, 静态压缩力

Abstract:

BACKGROUND: Spinal lamina reimplantation assisted hollow screw laminoplasty has achieved good clinical efficacy. The search literature found that there is no research at home and abroad on the biomechanical properties of unilateral and bilateral hollow screw fixation.

OBJECTIVE: To evaluate the biomechanical property of different fixation with hollow screws in artificial and goat vertebrate laminoplasty.
METHODS: A laminoplasty was conducted by using hollow screws. Based on the artificial vertebrate laminoplasty model, new models were generated by simulating unilateral screws fixation with a depth of screw insertion 5 mm (A group), unilateral screw fixation with a depth of screw insertion 8 mm (B group) and bilateral screw fixation with a depth of screw insertion 5 mm (C group). Based on the goat vertebrate laminoplasty model, new models were generated by simulating unilateral screws fixation (A group) and bilateral screw fixation (B group). The pull-out strength and static pressure were tested in the biomechanical testing machine with a sensor.
RESULTS AND CONCLUSION: (1) In the artificial vertebrate model, the average pull-out strength of the group B was stronger than that of the groups A and C (P < 0.01); the average pull-out strength of the group A was stronger than that of group C (P < 0.01), the difference was statistically significant (P < 0.05). However, the average static compression of the group A and group B was similar; the average static compression of the group C was lower than that of the groups A and B, and the difference was statistically significant (P < 0.01). (2) In the goat vertebrate model, the average pull-out strength and static compression of the group A were stronger than that of the group B, and the difference was statistically significant (P < 0.05). (3) Results suggest that unilateral screw fixation in the artificial and goat vertebrate laminoplasty can provide sufficient pull-out strength and static compression, and the biomechanical strength is positively related to the depth of the screw.

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: Vertebroplasty, Bone Nails, Biomechanics, Tissue Engineering

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