Department of Orthopaedics, The Methodist Hospital, Spine Surgery, 6550 Fannin Street, Houston, TX 77030, USA.
Spine J. 2011 May;11(5):447-51. doi: 10.1016/j.spinee.2011.03.021. Epub 2011 Apr 16.
Currently, there is no reproducible method that produces thoracolumbar burst fractures in human cadavers wherein the fracture configuration mirrors that seen naturally, and soft tissues are maintained.
To describe a novel method of burst fracture production.
Biomechanical.
Five cadaveric specimens were potted in polymethymethacrylate at T10 and L4; T10 to T12 and L2 to L4 were encased in a pourable rigid foam; flexion of 15° was created focused at L1; and a drop tower weight of 25 kg via "free fall" was used. On load delivery, the spine was allowed to flex without restriction (native bony and soft-tissue constraints). X-ray, computed tomography scan, and open dissection were used to confirm burst configuration.
All five specimens were found to have the "classic" burst configuration characterized by superior end plate comminution, depression of the anterior column, middle column burst with three to five fragments; the classic central fragment retropulsed into the canal, and the pedicular spread via basilar fracture.
This novel method affords true burst fracture reproduction without "prestressing" (notching, osteotomies, laminectomy, stripping) used in previous methods. This should allow greater accuracy for the translation of biomechanical testing to clinical applications.
目前，还没有一种可重复的方法能在人体尸体上制造出与自然状态下相似的胸腰椎爆裂骨折，且能保持软组织完整。
描述一种新的爆裂骨折制作方法。
生物力学。
将 5 个尸体标本在 T10 和 L4 处用聚甲基丙烯酸甲酯盆式固定；T10 到 T12 和 L2 到 L4 用可浇注的刚性泡沫包裹；在 L1 处产生 15°的弯曲；通过“自由落体”使用 25kg 的落重塔重量。在负载传递时，允许脊柱在无限制的情况下弯曲（自然的骨性和软组织约束）。使用 X 射线、计算机断层扫描和开放解剖来确认爆裂骨折的配置。
所有 5 个标本都具有“经典”的爆裂骨折特征，表现为上终板粉碎、前柱凹陷、中柱爆裂成三到五个碎片；经典的中央碎片向后突入椎管，通过基底骨折使椎弓根扩散。
这种新方法在不使用（开槽、截骨、椎板切除术、剥离）先前方法中的“预加载”的情况下，提供了真正的爆裂骨折复制。这应该可以提高生物力学测试向临床应用的转化的准确性。
