發(fā)布時間：2018-07-14 07:55

【摘要】：目的 研究不同骨密度下腰椎椎弓根螺釘固定在疲勞試驗前后的生物力學(xué)比較,為臨床工作提供生物力學(xué)參考。方法 取新鮮成年綿羊胸腰椎脊柱標本(T12~L5)27具,采用隨機數(shù)字表法分為3組,分別為A組(鹽酸脫鈣0h,骨量正常)、B組(鹽酸脫鈣2h,骨量減少)、C組(鹽酸脫鈣4h,骨質(zhì)疏松),每組9具。3組均采用在L4~L5上置入椎弓根釘棒系統(tǒng)。以(300±105)N的載荷對3組模型進行250 000次循環(huán)4個方向(前屈、后伸、左側(cè)彎、右側(cè)彎)加載,比較4組模型疲勞試驗前后的脊柱活動范圍、螺釘?shù)淖畲蟀纬隽�、軸向壓縮剛度。結(jié)果 與疲勞試驗前相比,A組脊柱的運動范圍值、軸向壓縮剛度、螺釘?shù)淖畲蟀纬隽�較試驗前未見明顯改變,差異無統(tǒng)計學(xué)意義(P0.05),B、C組脊柱的運動范圍值、軸向壓縮剛度明顯增大,螺釘?shù)淖畲蟀纬隽γ黠@減小,組內(nèi)組間差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論 疲勞試驗后,骨量減少及骨質(zhì)疏松對腰椎椎弓根螺釘固定影響較大,臨床醫(yī)師在該條件下不應(yīng)行單純椎弓根螺釘內(nèi)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 鹵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.
【作者單位】： 河北北方學(xué)院附屬第一醫(yī)院脊柱外科;河北省張家口市第二醫(yī)院脊柱外科;
【分類號】：R687.3

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