胸椎后方不同程度去皮质在椎弓根螺钉置入中的稳定性研究

发布时间：2018-03-13 22:26

本文选题：胸椎　切入点：椎弓根　出处：《中国生物医学工程学报》2017年03期 　论文类型：期刊论文

【摘要】：胸椎后方不同程度咬除骨皮质后,在椎弓根中置入螺钉,探讨并评估其生物力学性能。采集新鲜小牛胸椎标本21具,制成21个功能节段模型(T6~T10),随机分为3组,分别为完整皮质组、去皮质A组和去皮质B组,各7个功能节段。去皮质A组咬除进钉点周围3~5 mm骨皮质,去皮质B组咬除进钉点周围5~8 mm骨皮质,完整皮质组未咬除皮质。结果显示:在位移-刚度测试上,在轴向压缩、前屈、后伸、左右侧屈及轴向旋转状态时,3组内固定标本数值接近,差异无统计学意义(P0.05);在拔出强度测试上,去皮质A组与完整皮质组比较,差异无统计学意义(P=0.329);而去皮质B组的拔出力显著下降,并低于其他两组,差异有显著性意义(F=13.022,P=0.00)。胸椎进钉点周围不同程度咬除骨皮质行椎弓根螺钉固定,可提高置钉的准确性,对椎体固定的刚度无显著影响;但咬除范围应慎重,不应大于螺钉直径,否则将显著降低螺钉的拔出强度。
[Abstract]:The biomechanical properties of 21 fresh calf thoracic vertebrae specimens were studied and evaluated by inserting screws into the pedicle of thoracic vertebrae after different degrees of bone cortex bite. 21 functional segmental models were made and randomly divided into 3 groups. There were 7 functional segments in each of the intact cortical group, decortical A group and decortical B group. In the decortical group, 3 5 mm bone cortex was obliterated around the nail point, and 58 mm bone cortex around the nail point was obliterated in the decortical B group. The results showed that in the displacement-stiffness test, in axial compression, flexion, extension, left and right flexion and axial rotation, the values of fixed specimens were close to each other. There was no significant difference in pullout strength between group A and group A, but there was no significant difference between group A and group C (P < 0.01), but the pull-out power of group B was significantly lower than that of the other two groups. The difference was significant (P < 0.05). Pedicle screw fixation with pedicle screw fixation in different degree around the point of thoracic spine entry and nail could improve the accuracy of screw placement and had no significant effect on the stiffness of vertebral body fixation, but the range of bite should be careful and should not be larger than the diameter of screw. Otherwise, the pull-out strength of the screw will be significantly reduced.
【作者单位】：温州医科大学附属第三医院;
【分类号】：R318.01;R687

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