摘要
目的 探讨联合应用普通椎弓根螺钉（单向钉）和万向钉经伤椎内固定治疗胸腰椎爆裂骨折的生物力学稳定性. 方法 6具新鲜冰冻小牛腰椎标本（L1～L5）制备成L3椎体爆裂骨折模型,将标本随机分为骨折未固定组、万向钉组（伤椎及伤椎上位、下位椎体均使用万向钉）和联合钉组（伤椎上位椎体使用单向钉,伤椎及伤椎下位椎体使用万向钉）,比较L2～L4节段三维6个方向的运动范围和中性区的差异. 结果 联合钉组与万向钉组两种固定方式在前屈、后伸、侧曲、旋转方向上的运动范围和中性区差异无统计学意义（P＞0.05）,与骨折未固定组比较差异均有统计学意义（P＜0.01）. 结论 单向钉和万向钉联合应用不会降低内固定系统的生物力学稳定性,联合钉与万向钉均可为骨折模型提供可靠的生物力学稳定性.
Objective To investigate the biomechanical stability of general pedicle screw （monoaxial screw） and multixial screws in treatment of thoracolumbar burst fractures. Methods Six calf fresh-frozen lumbar spines （ Ll-L5 ） were selected to produce models of L3 burst fractures. The speci- mens were assigned to none fracture fixation group, multiaxial screw group （ fixation of the fractured verte- bra and upper and lower adjacent vertebral bodies with monoaxial screws, ） and combined screw group （ fixation of the upper adjacent vertebral body with monoaxial screws and of the fractured vertebra and low- er adjacent vertebral body with muhiaxial screw）. Differences in range of motion and neutral zone at level of L2-L4 at six movement directions were compared between groups. Results Range of motion and neu- tral zone had insignificant differences between the two groups under anterior flexion, posterior extension, lateral bending, and rotation （P 〉 0.05 ）, but significant difference in comparison with none fracture fixa- tion group （P 〈 0.01 ）. Conclusions Combined use of muhixial and monoaxial screws produces no effect on biomechanical stability of the internal fixation. Multiaxial plus monoaxial screw fixation and monoaxial screw fixation can both provide reliable biomechanical stability.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2014年第2期160-163,共4页
Chinese Journal of Trauma
基金
国家高技术研究发展计划（＂863＂计划）分课题资助项目（2011AA030106）
关键词
脊柱骨折
内固定器
关节不稳定性
Spinal fractures
Internal fixators
Joint instability
