摘要
目的测试自行设计的通用型脊柱内固定系统(generalspinesystem,GSS)椎弓根螺钉以及SOCON、TSRH和Diapason螺钉置入椎体的拔出力及旋入力矩,评价GSS螺钉的翻修作用。方法将36个正常成人腰椎椎体标本随机分为三组,每组12个椎体(24侧椎弓根)。各组标本每个椎体的每侧椎弓根均先拧入CCD螺钉(直径6.0mm,长45mm),行螺钉拔出试验,测试并记录螺钉的最大旋入力矩和最大轴向拔出力。然后各组标本每个椎体均随机选择一侧椎弓根经原钉道拧入GSS螺钉(直径6.5mm,长45mm);第一组另一侧拧入SOCON螺钉(直径7.0mm,长45mm),第二组另一侧拧入TSRH螺钉(直径7.0mm,长45mm),第三组另一侧拧入Diapason螺钉(直径6.7mm,长45mm)。分别测试螺钉最大旋入力矩及最大轴向拔出力。结果第一组GSS螺钉最大轴向拔出力为CCD螺钉的114%,SOCON螺钉为CCD螺钉的108%;GSS螺钉最大轴向拔出力大于SOCON螺钉,差异无显著性(P>0.05);GSS螺钉最大旋入力矩小于SOCON螺钉,差异无显著性(P>0.05)。第二组GSS螺钉最大轴向拔出力为CCD螺钉的127%,TSRH螺钉为CCD螺钉的64%;GSS螺钉最大轴向拔出力大于TSRH螺钉,差异有显著性(P<0.01);GSS螺钉最大旋入力矩大于TSRH螺钉,差异有显著性(P<0.01)。第三组GSS螺钉最大轴向拔出力为CCD螺钉的122%。
Objective To measure and compare the insertional torque and pull out strength of newly designed GSS screws with those of SOCON, TSRH and Diapason pedicle screws in normal human cadaveric vertebrae, and to evaluate the screw revision of GSS pedicle screws. Methods Thirty six cadaveric lumbar vertebral bodies were obtained from 18 fresh normal male cadavers and were assigned into 3 groups randomly, 24 pedicles per group. CCD (6.0 mm×45 mm) screws were first inserted as control in both pedicles of every vertebral body. Control pull out test of the screws was performed. For each pedicle pairs in Group 1, salvage of one CCD screw site was performed using a GSS screw (6.5 mm×45 mm), and salvage of the other CCD screw site was performed using a SOCON screw (7.0 mm×45 mm). For pedicle pairs in Group 2, salvage of one screw site was performed using a GSS screw (6.5 mm×45 mm), and salvage of the other screw site was performed using a TSRH screw (7.0 mm×45 mm). For pedicle pairs in Group 3, salvage of one screw site was performed using a GSS screw (6.5 mm×45 mm), and salvage of the other screw site was performed using a Diapason screw (6.7 mm ×45 mm). For each pedicle pair of a given group, the choice of which pedicle received which of the two screws tested was made at random. The maximum axial pull out strength and the torques were recorded. Results In Group 1, the mean maximum pull out strength of the GSS screws was 114% of that of the CCD control screws, while the mean maximum pull out strength of the SOCON screws was 108% of that of the CCD control screws. The maximum pull out strength of the GSS screws was larger than that of the SOCON screws, but there was no significant difference (P >0.05). The mean maximum insertional torque of SOCON screws was larger than that of GSS screws, but there was also no significant difference (P >0.05). In Group 2, the mean maximum pull out strength of the GSS screws was 127% of that of the CCD control screws, while the mean maximum pull out strength of the TSRH screws was 64% of that of the CCD control screws. The mean maximum pull out strength of the GSS screws was significantly higher than that of the TSRH screws (P< 0.01). The mean maximum insertional torque of the GSS screws was also significantly higher than that of the TSRH screws (P< 0.01). In Group 3, the mean maximum pull out strength of the GSS screws was 122% of that of the CCD control screws, while the mean maximum pull out strength of the Diapason screws was 89% of that of the CCD control screws. The mean maximum pull out strength of the GSS screws was significantly higher than that of the Diapason screws (P< 0.01). The maximum insertional torque of the GSS screws was higher than that of the Diapason screws, but there was no significant difference (P >0.05). Conclusion GSS screws offer better anchoring in revision surgery than most of the currently used screws do.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2002年第11期648-652,共5页
Chinese Journal of Orthopaedics
基金
卫生部科学研究基金资助课题(98-1-03)
