摘要
目的:比较Solis椎间融合器、椎间植骨及椎间植骨+钢板内固定治疗Ⅱ型Hangman骨折的生物力学稳定性,为临床应用Solis椎间融合器治疗Hangman骨折提供理论依据。方法:6具成人新鲜冷冻颈椎标本,每具依次制作成以下5种状态组,即正常对照组(A组)、Ⅱ型Hangman骨折模型组(B组)、Solis椎间融合器置入组(C组)、单纯椎间植骨组(D组)、椎间植骨+钢板内固定组(E组)。按以上顺序应用脊柱三维运动试验机和三维激光扫描仪测试每一状态下C2/3节段的三维运动范围(ROM)。结果:与A组比较,B组前屈、后伸、旋转及侧弯ROM均显著增大(P<0.05);C组旋转ROM显著增大(P<0.05),其他方向无显著性差异(P>0.05);D组前屈、后伸及旋转ROM显著增大(P<0.05),侧弯方向无显著性差异;E组旋转ROM显著增大(P<0.05),其他方向无显著性差异(P>0.05)。与B组比较,C组、E组均在前屈、后伸和侧弯方向及D组在后伸、侧弯方向ROM显著变小(P<0.05),C、D、E组旋转及D组前屈ROM与B组比较无显著性差异。C、D及E组相互比较,C组后伸ROM显著小于D组(P<0.05),其他方向与D组比较无显著性差异;C组前屈ROM显著大于E组(P<0.05),其他方向与E组比较无显著性差异;D组前屈、后伸及侧弯ROM均显著大于E组(P<0.05),旋转方向与E组比较无显著性差异。结论:在Ⅱ型Hangman骨折的治疗中,Solis椎间融合器有助于恢复前屈、后伸及侧弯方向上的稳定性,但在旋转方向上不能恢复稳定性,术后需辅以外固定,以确保融合;其稳定作用弱于钢板内固定,但优于单纯植骨。
Objective：To compare the biomechanical status among Solis cage plus interbody bone graft,interbody bone graft alone and plate fixation plus interbody bone graft on treating type Ⅱ Hangman＇s fracture, and to provide theoretical rational for the clinical use of Solis cage in Hangman＇s fracture.Method：6 fresh frozen human spine specimens were used,each of them was assigned into 5 conditions as following, ①intact condition（group A）,②type 11 Hangman＇s fracture condition（group B）,③Solis instrument condition（group C）, ④simple interhody bone graft condition （group D）, ⑤interbody bone graft plus plate fixation condition（group E）.Following this,three-dimension laser scanner and three-dimension motion testing machine were used to test range of motion（ROM） of C2/3 segment with respect to each condition.Result：Compared with group A,ROM of group B increased significantly on flexion,extension,axial rotation and lateral bending（P〈0.05） respectively. ROM of group C increased significantly on axial rotation （P〈0.05） rather than on other directions.ROM of group D increased significantly on flexion,extension and axial rotation（P〈0.05） rather than on lateral bending. ROM of group E was significantly larger on direction of axial rotation（P〈0.05）,while there was no significant difference on other directions （P〉0.05）.Compared with in group C and E and those of extension and lateral group B,ROM of flexion,extension and lateral bending bending in group D decreased significantly （P〈0.05）.Compare with group B,ROM of axial rotation in group C,D and E and those of flexion in group D increased less （P〉0.05）.There was no significant difference on direction of axial rotation among group C,D and E.There was no significant difference on direction of flexion of group D either.The ROM of extension rather than other direction in group C was lower than that in group D（P〈0.05）.The ROM of flexion rather than other direction in group D was higher than that in group E （P〈0.05）.The ROM of flexion,extension and lateral bending rather than axial rotation in group D was higher than that in group E （P〈0.05）.Conelusion：For type Ⅱ Hangman＇s fracture,Soils cage can reconstruct stability on direction of flexion,extension and lateral bending rather than axial rotation,which is superior over simple interbody bone graft while less than plate instrument, as a result,postoperative cervical collar is recommended to secure the final fusion.
出处
《中国脊柱脊髓杂志》
CSCD
北大核心
2009年第4期285-289,共5页
Chinese Journal of Spine and Spinal Cord
基金
广东省科技计划项目(编号:2008B030301303)
