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[相邻上下位及单侧骨折椎体椎弓根螺钉固定治疗胸腰椎骨折的生物力学研究]

[BIOMECHANICAL STUDY ON ADJACENT UPPER AND LOWER AND UNILATERAL FRACTURED VERTEBRAL PEDICLE SCREW FIXATION IN TREATMENT OF THORACOLUMBAR FRACTURE].

作者信息

Xiao Bin, Li Jian, Cai Houhong, Lin Shaoyi

机构信息

Department of Orthopaedics, Lecong Hospital of Guangzhou Medical University, Foshan Guangdong, 528315, P. R. China.

Department of Orthopaedics, the Third Affiliated Hospital of Guangzhou Medical University.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 May 8;30(5):580-584. doi: 10.7507/1002-1892.20160117.

Abstract

OBJECTIVE

To investigate the stability of unilateral fractured vertebral pedicle screw fixation in the treatment of thoracolumbar fracture.

METHODS

Eighteen fresh calf thoracolumbar spine specimens (T-L) were obtained to establish the L burst fracture models with Panjabi's high speed trauma apparatus, and were divided into 3 groups:pedicle fixation for adjacent upper and lower vertebrae of fractured vertebra (4 pedicle screws in group A), combined with pedicle screw fixation for unilateral fractured vertebrae (5 pedicle screws in group B), and three-level 6 pedicle fixation (group C). Under normal, fractured, and reconstructed conditions, the range of motion (ROM) of adjacent upper and lower vertebrae of fractured vertebra were measured in flexion, extension, bilateral bending, and axial rotation. Axial stiffness under flexion-compression was measured on the MTS-858 testing system.

RESULTS

There was no significant difference in ROM and axial stiffness under normal and fractured conditions in all directions among groups (<0.05), indicating load balance in the groups. ROM of groups B and C were significantly less than that of group A under reconstructed condition in all directions (<0.05), but no significant difference was found between group B and group C (>0.05). Biomechanical test showed that group B was significantly higher than group A in the axial stiffness value (<0.05), but difference was not significant between group B and group C (>0.05).

CONCLUSIONS

Transpedicular fixation of fractured vertebrae can enhance the stability of the spine. Both unilateral and bilateral fractured vertebral pedicle screw fixations have the same stability.

摘要

目的

探讨单侧骨折椎体椎弓根螺钉固定治疗胸腰椎骨折的稳定性。

方法

获取18个新鲜小牛胸腰椎脊柱标本(T-L),用潘贾比高速创伤装置建立L爆裂骨折模型,并分为3组:对骨折椎体相邻上下椎体进行椎弓根固定(A组4枚椎弓根螺钉)、联合单侧骨折椎体椎弓根螺钉固定(B组5枚椎弓根螺钉)和三级6枚椎弓根固定(C组)。在正常、骨折和重建状态下,测量骨折椎体相邻上下椎体在屈伸、双侧弯曲和轴向旋转时的活动范围(ROM)。在MTS-858测试系统上测量屈伸压缩时的轴向刚度。

结果

各组在正常和骨折状态下各方向的ROM和轴向刚度均无显著差异(<0.05),表明各组负荷平衡。在重建状态下,B组和C组各方向的ROM均显著小于A组(<0.05),但B组和C组之间无显著差异(>0.05)。生物力学测试表明,B组的轴向刚度值显著高于A组(<0.05),但B组和C组之间差异不显著(>0.05)。

结论

骨折椎体椎弓根固定可增强脊柱稳定性。单侧和双侧骨折椎体椎弓根螺钉固定的稳定性相同。

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