文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

椎弓根峡部裂椎体中腰椎椎弓根螺钉的生物力学评估:传统进钉轨迹与皮质骨轨迹固定强度的比较

Biomechanical evaluation of lumbar pedicle screws in spondylolytic vertebrae: comparison of fixation strength between the traditional trajectory and a cortical bone trajectory.

作者信息

Matsukawa Keitaro, Yato Yoshiyuki, Imabayashi Hideaki, Hosogane Naobumi, Asazuma Takashi, Chiba Kazuhiro

机构信息

Department of Orthopaedic Surgery, National Defense Medical College, Tokorozawa, Saitama; and.

Department of Orthopaedic Surgery, National Hospital Organization, Murayama Medical Center, Musashimurayama, Tokyo, Japan.

出版信息

J Neurosurg Spine. 2016 Jun;24(6):910-5. doi: 10.3171/2015.11.SPINE15926. Epub 2016 Feb 19.


DOI:10.3171/2015.11.SPINE15926
PMID:26895531
Abstract

OBJECTIVE In the management of isthmic spondylolisthesis, the pedicle screw system is widely accepted surgical strategy; however, there are few reports on the biomechanical behavior of pedicle screws in spondylolytic vertebrae. The purpose of the present study was to compare fixation strength between pedicle screws inserted through the traditional trajectory (TT) and those inserted through a cortical bone trajectory (CBT) in spondylolytic vertebrae by computational simulation. METHODS Finite element models of spondylolytic and normal vertebrae were created from CT scans of 17 patients with adult isthmic spondylolisthesis (mean age 54.6 years, 10 men and 7 women). Each vertebral model was implanted with pedicle screws using TT and CBT techniques and compared between two groups. First, fixation strength of a single screw was evaluated by measuring axial pullout strength. Next, vertebral fixation strength of a paired-screw construct was examined by applying forces simulating flexion, extension, lateral bending, and axial rotation to vertebrae. RESULTS Fixation strengths of TT screws showed a nonsignificant difference between the spondylolytic and the normal vertebrae (p = 0.31-0.81). Fixation strength of CBT screws in the spondylolytic vertebrae demonstrated a statistically significant decrease in pullout strength (21.4%, p < 0.01), flexion (44.1%, p < 0.01), extension (40.9%, p < 0.01), lateral bending (38.3%, p < 0.01), and axial rotation (28.1%, p < 0.05) compared with those in the normal vertebrae. In the spondylolytic vertebrae, no statistically significant difference was observed for pullout strength between TT and CBT (p = 0.90); however, the CBT construct showed lower vertebral fixation strength in flexion (39.0%, p < 0.01), extension (35.6%, p < 0.01), lateral bending (50.7%, p < 0.01), and axial rotation (59.3%, p < 0.01) compared with the TT construct. CONCLUSIONS CBT screws are less optimal for stabilizing the spondylolytic vertebra due to their lower fixation strength compared with TT screws.

摘要

目的 在峡部裂型腰椎滑脱症的治疗中,椎弓根螺钉系统是广泛接受的手术策略;然而,关于椎弓根螺钉在峡部裂椎体中的生物力学行为的报道较少。本研究的目的是通过计算机模拟比较在峡部裂椎体中经传统轨迹(TT)置入的椎弓根螺钉与经皮质骨轨迹(CBT)置入的椎弓根螺钉之间的固定强度。方法 从17例成人峡部裂型腰椎滑脱症患者(平均年龄54.6岁,男10例,女7例)的CT扫描中创建峡部裂椎体和正常椎体的有限元模型。每个椎体模型采用TT和CBT技术植入椎弓根螺钉,并在两组之间进行比较。首先,通过测量轴向拔出力评估单枚螺钉的固定强度。其次, 通过对椎体施加模拟前屈、后伸、侧弯和轴向旋转的力来检查双螺钉结构的椎体固定强度。结果 TT螺钉在峡部裂椎体和正常椎体之间的固定强度无显著差异(p = 0.31 - 0.81)。与正常椎体相比,峡部裂椎体中CBT螺钉的拔出强度(21.4%,p < 0.01)、前屈(44.1%,p < 0.01)、后伸(40.9%,p < 0.01)、侧弯(38.3%,p < 0.01)和轴向旋转(28.1%,p < 0.05)的固定强度在统计学上显著降低。在峡部裂椎体中,TT和CBT之间的拔出强度无统计学显著差异(p = 0.90);然而,与TT结构相比,CBT结构在椎体前屈(39.0%,p < 0.01)、后伸(35.6%,p < 0.01)、侧弯(50.7%,p < 0.01)和轴向旋转(59.3%,p < 0.01)时显示出较低的椎体固定强度。结论 与TT螺钉相比,CBT螺钉固定强度较低,因此在稳定峡部裂椎体方面不太理想。

相似文献

[1]
Biomechanical evaluation of lumbar pedicle screws in spondylolytic vertebrae: comparison of fixation strength between the traditional trajectory and a cortical bone trajectory.

J Neurosurg Spine. 2016-6

[2]
Biomechanical evaluation of the fixation strength of lumbar pedicle screws using cortical bone trajectory: a finite element study.

J Neurosurg Spine. 2015-10

[3]
Biomechanical evaluation of fixation strength among different sizes of pedicle screws using the cortical bone trajectory: what is the ideal screw size for optimal fixation?

Acta Neurochir (Wien). 2016-3

[4]
Biomechanical Evaluation of Cross Trajectory Technique for Pedicle Screw Insertion: Combined Use of Traditional Trajectory and Cortical Bone Trajectory.

Orthop Surg. 2015-11

[5]
Biomechanical Fixation Properties of the Cortical Bone Trajectory in the Osteoporotic Lumbar Spine.

World Neurosurg. 2018-11

[6]
Posterior lumbar interbody fusion with cortical bone trajectory screw fixation versus posterior lumbar interbody fusion using traditional pedicle screw fixation for degenerative lumbar spondylolisthesis: a comparative study.

J Neurosurg Spine. 2016-11

[7]
Cortical screws used to rescue failed lumbar pedicle screw construct: a biomechanical analysis.

J Neurosurg Spine. 2015-2

[8]
Traditional and cortical trajectory screws of static and dynamic lumbar fixation- a finite element study.

BMC Musculoskelet Disord. 2020-7-14

[9]
Biomechanical investigation of the hybrid lumbar fixation technique with traditional and cortical bone trajectories in transforaminal lumbar interbody fusion: finite element analysis.

J Orthop Surg Res. 2023-7-31

[10]
Radiographic feasibility study of cortical bone trajectory and traditional pedicle screw dual trajectories.

J Neurosurg Spine. 2016-12

引用本文的文献

[1]
Biomechanical impact of cortical bone vs. traditional pedicle screw trajectories: a finite element study on lumbar spinal instrumentation.

Front Bioeng Biotechnol. 2025-2-18

[2]
Adjacent vertebral fractures in the lumbar and thoracic spine after balloon kyphoplasty: A finite element analysis.

Medicine (Baltimore). 2024-4-26

[3]
Longitudinal Study on Pre- and Post-Operation CT Imaging for Predicting Pedicle Screw Loosening in Patients with Lumbar Degenerative Disease.

Ther Clin Risk Manag. 2024-3-11

[4]
Comparing Cortical Bone Trajectory and Traditional Pedicle Screws in Transforaminal Lumbar Interbody Fusion: A Retrospective Cohort Study of One-Year Outcomes.

Cureus. 2023-8-9

[5]
Visible trephine-based foraminoplasty in PTED leads to asymmetrical stress changes and instability in the surgical and adjacent segments: a finite element analysis.

J Orthop Surg Res. 2023-6-13

[6]
Complication, fusion, and revision rate in the lumbar cortical bone trajectory and pedicle screw fixation techniques: a systematic review and meta-analysis.

J Orthop Surg Res. 2023-5-25

[7]
The Fusion Rate of Cortical Bone Trajectory Screw Fixation and Pedicle Screw Fixations in L4-5 Interbody Fusion: A Retrospective Cohort Study.

Orthop Surg. 2023-5

[8]
Evaluating the contact anatomy and contact bone volume of spinal screws using a novel drilled surface image.

PLoS One. 2023

[9]
Comparison of Cortical Bone Trajectory to Pedicle-Based Dynamic Stabilization: An Analysis of 291 Patients.

Neurospine. 2023-3

[10]
Biomechanical comparative analysis of conventional pedicle screws and cortical bone trajectory fixation in the lumbar spine: An in vitro and finite element study.

Front Bioeng Biotechnol. 2023-1-19

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索