南方医科大学学报 ›› 2006, Vol. 26 ›› Issue (10): 1436-1438.

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颈椎前路减压阶梯状植骨可吸收螺钉内固定的生物力学稳定性研究

张健; 贺西京; 李浩鹏; 王栋; 赵卫东;   

  1. 西安交通大学第二医院骨二科; 南方医科大学解剖生物力学教研室 陕西西安710004; 陕西西安710004; 广东广州510515;
  • 出版日期:2006-10-20 发布日期:2006-10-20
  • 基金资助:
    陕西省科技攻关项目~~

Biomechanical evaluation of anterior cervical spine stabilization with step-cut grafting and absorbable screw fixation

ZHANG Jian1, HE Xi-jing1, LI Hao-peng1, WANG dong1, ZHAO Wei-dong2 1Department of Orthopedics, Second Hospital of Xi’an Jiaotong University, Xi’an 710004, China; 2Department of Anatomy and Biomechanics, Southern Medical University, Gugangzhou 510515, China   

  1. 西安交通大学第二医院骨二科; 南方医科大学解剖生物力学教研室 陕西西安710004; 陕西西安710004; 广东广州510515;
  • Online:2006-10-20 Published:2006-10-20

摘要: 目的观察颈椎前路单椎体次全切除减压,阶梯状植骨,可吸收螺钉内固定的颈椎弯曲稳定性和植骨水平拔出力的变化。方法12具新鲜成人尸体颈椎标本,随机分为两组,实验组:行C5椎体次全切除阶梯状植骨可吸收螺钉内固定;对照组:行C5椎体次全切除柱状植骨前路CSLP钉板系统内固定。两组标本均在固定前后行弯曲稳定性实验,测定C4-C6固定节段在屈曲、伸展、左/右侧屈,左/右轴向旋转6个自由度的运动范围和中性区;同时在固定前后行植骨块水平拔出力实验,测定植骨块的水平拔出力。两实验均行组内和组间固定前后t检验。结果椎弯曲稳定性实验:实验组和对照组固定后,C4-C6节段在6个自由度的稳定性均较固定前增高;组间对比,实验组屈曲和左右轴向旋转稳定性与对照组相当,伸展稳定性较对照组增强,左右侧弯稳定性则弱于对照组。植骨块水平拔出力实验:两组固定后植骨块水平拔出力均较固定前显著提高,但实验组固定后植骨块的POS则明显不及对照组。结论路阶梯状植骨可吸收螺钉内固定具有良好的弯曲稳定性和较高的植骨稳定性,同时具有许多促植骨融合减少相关并发症的优点。 

Abstract: Objective To determine the initial stability of a novel construct in cadaveric cervical spine in comparison with a conventional method. Methods Twelve specimens of fresh human cadaveric cervical spines (C3-C7) were randomly divided into the test group and control group. In the former group, one-level corpectomy of C5 and three cortical iliac step-cut grafting with absorbable screw fixation was performed, and one-level corpectomy of C5 and three cortical iliac strut grafting with anterior plate fixation in the control group. Flexibility test and graft push of strength test were carried out before and after grafting and fixation to determine the range of motion (ROM), neutral zone (NZ) and graft push out strength (POS). Results The cervical spines of the two groups all had increased initial stability in all 6 rotational degrees of freedom with also enhanced graft POS after fixation. Compared with the control group, the test group had higher stability in extension and comparable stability in flexion and axial rotation, but lower stability in lateral bending. The graft POS after fixation in the test group, however, was lowered in comparison with the control group. Conclusion Step-cut grafting and absorbable screw fixation provides sufficient stability potential for the cervical spine in vitro and allows optimum biomechanical and biological environments to enhance graft fusion and reduce complications. 

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