不同骨密度下腰椎椎弓根螺钉固定在疲劳实验前后的生物力学比较
发布时间：2018-07-14 07:55
【摘要】：目的 研究不同骨密度下腰椎椎弓根螺钉固定在疲劳试验前后的生物力学比较,为临床工作提供生物力学参考。方法 取新鲜成年绵羊胸腰椎脊柱标本(T12~L5)27具,采用随机数字表法分为3组,分别为A组(盐酸脱钙0h,骨量正常)、B组(盐酸脱钙2h,骨量减少)、C组(盐酸脱钙4h,骨质疏松),每组9具。3组均采用在L4~L5上置入椎弓根钉棒系统。以(300±105)N的载荷对3组模型进行250 000次循环4个方向(前屈、后伸、左侧弯、右侧弯)加载,比较4组模型疲劳试验前后的脊柱活动范围、螺钉的最大拔出力、轴向压缩刚度。结果 与疲劳试验前相比,A组脊柱的运动范围值、轴向压缩刚度、螺钉的最大拔出力较试验前未见明显改变,差异无统计学意义(P0.05),B、C组脊柱的运动范围值、轴向压缩刚度明显增大,螺钉的最大拔出力明显减小,组内组间差异均有统计学意义(P0.05)。结论 疲劳试验后,骨量减少及骨质疏松对腰椎椎弓根螺钉固定影响较大,临床医师在该条件下不应行单纯椎弓根螺钉内固定。
[Abstract]:Objective to study the biomechanical comparison of lumbar pedicle screw fixation with different bone mineral density (BMD) before and after fatigue test, and to provide biomechanical reference for clinical work. Methods 27 fresh adult sheep thoracolumbar spine specimens (T12L5) were randomly divided into 3 groups. Group A (decalcification of hydrochloric acid for 0 h, normal bone mass) and group C (decalcification of hydrochloric acid for 4 h, osteoporosis) were used in group B (decalcification of hydrochloric acid for 2 hours, bone mass decreased). Three groups of models were loaded with (300 卤105) N load in four directions (forward flexion, extension, left bending, right bending). The range of spinal movement, the maximum pull out force and axial compression stiffness of the screws were compared before and after fatigue test in the four groups. Results compared with before fatigue test, the range of spine motion, axial compression stiffness and maximum pull out force of screw in group A were not significantly changed compared with those before fatigue test. There was no significant difference between group A and group B (P0.05). Axial compression stiffness increased significantly, the maximum pull-out force of screw decreased significantly, the differences between groups were statistically significant (P0.05). Conclusion after fatigue test, osteopenia and osteoporosis have great influence on lumbar pedicle screw fixation. Clinicians should not perform simple pedicle screw fixation under this condition.
【作者单位】： 河北北方学院附属第一医院脊柱外科;河北省张家口市第二医院脊柱外科;
【分类号】：R687.3
[Abstract]:Objective to study the biomechanical comparison of lumbar pedicle screw fixation with different bone mineral density (BMD) before and after fatigue test, and to provide biomechanical reference for clinical work. Methods 27 fresh adult sheep thoracolumbar spine specimens (T12L5) were randomly divided into 3 groups. Group A (decalcification of hydrochloric acid for 0 h, normal bone mass) and group C (decalcification of hydrochloric acid for 4 h, osteoporosis) were used in group B (decalcification of hydrochloric acid for 2 hours, bone mass decreased). Three groups of models were loaded with (300 卤105) N load in four directions (forward flexion, extension, left bending, right bending). The range of spinal movement, the maximum pull out force and axial compression stiffness of the screws were compared before and after fatigue test in the four groups. Results compared with before fatigue test, the range of spine motion, axial compression stiffness and maximum pull out force of screw in group A were not significantly changed compared with those before fatigue test. There was no significant difference between group A and group B (P0.05). Axial compression stiffness increased significantly, the maximum pull-out force of screw decreased significantly, the differences between groups were statistically significant (P0.05). Conclusion after fatigue test, osteopenia and osteoporosis have great influence on lumbar pedicle screw fixation. Clinicians should not perform simple pedicle screw fixation under this condition.
【作者单位】： 河北北方学院附属第一医院脊柱外科;河北省张家口市第二医院脊柱外科;
【分类号】：R687.3
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