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下胸部皮质骨通道螺钉固定技术的生物力学分析与优化:研究方案临床试验(符合SPIRIT标准)

Biomechanical analysis and optimization of screw fixation technique for the cortical bone channel of lower thorax: Study protocol clinical trial (SPIRIT Compliant).

作者信息

Yu Yang, Xie YiZhou, Jian Qiang, Shi Yin, Zhang Guilong, Fan Xiaohong

机构信息

Hospital of Chengdu University of Traditional Chinese Medicine.

Chengdu University of Traditional Chinese Medicine, Sichuan Province, P.R.China.

出版信息

Medicine (Baltimore). 2020 Feb;99(7):e19046. doi: 10.1097/MD.0000000000019046.

Abstract

It is well known that the main segments of spinal fracture is thoracolumbar (T11-L11). Therefore, in addition to the lumbar, the lower thoracic vertebra (T9-T12) often has the clinical needs of implantation of cortical bone trajectory (CBT) screws. However, the anatomic parameters of the lower thoracic vertebrae are quite different from those of the lumbar vertebrae, which means that if CBT screws are to be implanted in the lower thoracic vertebrae, the selection of the screw entry point, the length, diameter, angle and path of the screws in each segment need to be redefined. Methods In this part, 3-dimensional finite element model was established to analyze the stress and fixation efficiency of CBT screws in thoracic vertebrae after 5000 times of fatigue loading of normal model and osteoporosis model. Discussion If the outcomes indicate the trial is feasible and there is evidence to provide some basic anatomical parameters for CBT screw implantation in the lower thoracic spine, so that the ideal insertion point, length, diameter, and angle of CBT screw in different segments of the lower thoracic spine were determined.Trial Registration Chinese Clinical Trial Registry, ChiCTR1900026915.Registered on September 26, 2019.

摘要

众所周知,脊柱骨折的主要节段是胸腰段(T11-L11)。因此,除腰椎外,下胸椎(T9-T12)也常有植入皮质骨轨迹(CBT)螺钉的临床需求。然而,下胸椎的解剖参数与腰椎有很大不同,这意味着若要在下胸椎植入CBT螺钉,各节段螺钉的进钉点、长度、直径、角度及路径的选择都需要重新确定。方法 在本部分中,建立三维有限元模型,分析正常模型和骨质疏松模型在5000次疲劳加载后胸椎CBT螺钉的应力及固定效率。讨论 如果结果表明该试验可行,并有证据为下胸椎CBT螺钉植入提供一些基本解剖参数,从而确定下胸椎不同节段CBT螺钉的理想进钉点、长度、直径和角度。试验注册 中国临床试验注册中心,ChiCTR1900026915。于2019年9月26日注册。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cbe9/7035084/6001954dd369/medi-99-e19046-g001.jpg

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