期刊文献+

单侧椎弓根钉棒固定单节段腰椎及其邻近节段生物力学研究 被引量:52

Biomechanical efficiency of single-level unilateral pedicle screw fixation on the instrumented lumbar segment and adjacent segments
原文传递
导出
摘要 目的分析单侧椎弓根钉棒固定对单节段腰椎的生物力学稳定性及其对邻近节段活动度的影响。方法新鲜成人尸体腰椎标本6具,测定L4~5不稳固定节段及其上下邻近节段屈伸、左右侧弯、左右旋转6个方向ROM,按4组顺序依次测试:A组(完整组);B组(模拟L4~5不稳组);C组(单侧椎弓根钉棒固定+椎间单枚cage);D组(双侧椎弓根钉棒固定+椎间单枚cage)。结果L4~5节段除左侧弯外,C组与D组相比各运动方向ROM差异无统计学意义(P>0.05);L3~4、L5~S1节段除左、右侧弯外,C组与D组相比各运动方向ROM差异无统计学意义(P>0.05)。结论单侧椎弓根钉棒固定对单节段腰椎在大部分运动方向上具有与双侧固定相似的即刻稳定性,邻近节段侧弯活动度较双侧固定后更少。 Objective To evaluate the biomechanical efficiency of single-level unilateral pedicle screw fixation on the instrumented lumbar segment and adjacent segments.Methods Six fresh-frozen human cadaveric lumbar spines of simulated instability at L4~5 were conducted to a serial of biomechanical tests including flexion,extension,lateral bending and axial rotation.The range of motion in each specimen was tested in sequence according to such four groups:intact in group A,L4-5 segmental instability in group B,unilateral pedicle screw fixation combined with single cage in group C and bilateral pedicle screw fixation combined with single cage in group D.Results Apart from the ROM of left lateral bending,there was no significant difference of ROM at L4-5 between group C and group D(P0.05).Apart from the ROM of left and right lateral bending,there was no significant difference of ROM at L3-4 and L5-S1 between group C and group D(P0.05).Conclusions All tested single-level unilateral pedicle screw fixation can achieve similar initial biomechanical stability and cause less lateral bending motion at adjacent segments in comparison with bilateral pedicle screw fixation.
出处 《中国临床解剖学杂志》 CSCD 北大核心 2010年第1期85-89,共5页 Chinese Journal of Clinical Anatomy
基金 广东省科技计划项目(2008B030301129)
关键词 腰椎 失稳 单侧固定 椎间融合器 生物力学 Lumbar Instability Unilateral pedicles crew fixation Cage Biomechanics
  • 相关文献

参考文献21

  • 1Kabins MB, Weinstein JN, Spratt KF, et al. Isolated L4-L5 fusions using the variable screw placement system: unilateral versus bilateral [J]. J Spinal Disord, 1992, 5(1): 39-49.
  • 2Suk KS, Lee HM, Kim NH, et al. Unilateral versus bilateral pedicle screw fixation in lumbar spinal fusion [J]. Spine, 2000, 25(14): 1843-1847.
  • 3Chen HH, Cheung NN, Wang WK, et al. Biomechanical analysis of unilateral fixation with interbody cage [J]. Spine, 2005, 30(4): 92-96.
  • 4DiPaola CP, Molinari RW. Posterior lumbar interbody fusion [J]. J Am Acad Orthop Surg, 2008, 16(3): 130-139.
  • 5Brantigan JW, Neidre A, Toohey JS. The Lumbar I/F Cage for posterior lumbar interbody fusion with the variable screw placement system:10-year results of a Food and Drug Administration clinical trial [J]. Spine J, 2004, 4(6): 681-688.
  • 6Robertson JT. Role ofperidural fibrosis in the failed back: a review [J]. Eur Spine J, 1996, 5 (Suppl 1): 2-6.
  • 7Park P, Garton HJ, Gala VC, et al. Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature [J]. Spine, 2004, 29(17): 1938-1944.
  • 8Mariano FF, Pedro S, Heman R, et al. A prospective randomized study of unilateral versus bilateral instrumented posterolateral lumbar fusion in degenerative spondylolisthesis [J]. Spine, 2007, 32(4): 395-401.
  • 9Tuttle J, Shakir A, Choudhri HF. Paramedian approach for transforaminal lumbar interbody fusion with unilateral pedicle screw fixation. Technical note and preliminary report on 47 cases [J]. Neurosurg Focus, 2006, 20 (3): E5.
  • 10Deutsch H, Musacchio MJ Jr. Minimally invasive transforaminal lumbar interbody fusion with unilateral pedicle screw fixation [J]. Neurosurg Focus, 2006, 20(3): E 10.

二级参考文献19

  • 1李慧友,朱青安,李桂兰,钟世镇,卢海俊,李忠华.双侧小关节分级切除对腰椎稳定性影响的三维运动研究[J].中华骨科杂志,1995,15(10):692-694. 被引量:25
  • 2罗刚,李长青,腾海军,周跃.单节段腰椎小关节分级切除对腰椎稳定性影响的生物力学研究[J].第三军医大学学报,2005,27(18):1871-1873. 被引量:21
  • 3Lund T, Oxland TR, Jost B, et al. Interbody cage stabilization in the lumbar spine: biomechanical evaluation' of cage design, posterior instrumentation and bone density [J]. J Bone Joint Surg Br, 1998, 80 (2):351-359.
  • 4Vadapalli S, Robon M, Biyani A, et al. Effect of Lumbar Interbody Cage Geometry on Construct Stability: A Cadaveric Study[J]. Spine, 2006, 31 (19): 2189-2194.
  • 5Zander T, Rohlman A, Klockner C, et al. Influence of graded facetectomy an laminotomy on spinal biomechancis [J]. Eur Spine J, 2003, 12(3): 427-434.
  • 6Oxland TR, Lund T. Biomechanics of stand-alone cages and cages in combination with posterior fixation: a literature review [J]. Eur Spine J, 2000, 9(1s):95-101.
  • 7Chen HH, Cheung NN, Wang WK, et al. Biomechanical analysis of unilateral fixation with interbody cages. Spine, 2005, 30 : E92 - E96.
  • 8McAfee PC, Farey ID, Sutterlin CE, et al. The effects of spinal implant rigidity on vertebral bone densitometry. A canine model. Spine, 1991, 16:190 -197.
  • 9Shono Y, kaneda K, Abumi K, et al. Stability of posterior spinal instrumentation and its effects on adjacent motion segments in the lumbosacral spine. Spine, 1998, 23:1550 - 1558.
  • 10Tuttle J, Shakir A, Choudhri HF. Paramedian approach for transforaminal lumbar interbody fusion with unilateral pedicle screw fixation. Neurosurg Focus, 2006, 20 : E5 - E10.

共引文献51

同被引文献631

引证文献52

二级引证文献309

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部