摘要
目的 探讨前路单节段融合内固定治疗伴椎弓根断裂的Denis B型胸腰椎爆裂骨折后的脊椎生物力学稳定性。方法 取6具新鲜成人尸体胸腰椎标本（T11-L3）作为正常组（A组）,采用椎体切除法依次建立L1Denis B型爆裂骨折模型并行前路单节段融合内固定,分别为椎弓根完整组（B组）、单侧椎弓根切断组（C组）和双侧椎弓根切断组（D组）。通过脊柱三维运动机依次测定各组在8.0 N·m纯力偶矩下屈伸、左右侧弯及左右旋转活动度（range of motion,ROM）。结果 B、C、D组T12、L1脊柱运动单元前屈、后伸、左右侧弯ROM均显著低于A组（P〈0.05）,D组显著高于B、C组（P〈0.05）,B、C组间差异无统计学意义（P〉0.05）;B、C组左右旋转ROM均显著低于A、D组（P〈0.05）,B、C组间及A、D组间比较差异无统计学意义（P〉0.05）。各组间L1、L2脊柱运动单元前屈、后伸、左右侧弯、左右旋转ROM比较,差异均无统计学意义（P〉0.05）。结论 前路单节段融合内固定治疗Denis B型胸腰椎爆裂骨折伴一侧椎弓根断裂时,在屈伸、侧弯及旋转方向能提供足够初始生物力学稳定性,而伴双侧椎弓根断裂时生物力学稳定性差。
Objective To investigate the effects of anterior single segment fixation on the spinal biomechanical stabilization in the treatment of thoracolumbar burst fracture of Denis type B with pedicle injury. Methods Six fresh human cadaveric spine specimens （T11-L3） were harvested as normal control （group A）. Then the L1 Denis type B fracture model was created by the hemi-corpectomy method. Each specimen was tested in 3 different scenarios： anterior single segment （T12, L1） fixation with the integrity of the pedicle （group B）, anterior single segment fixation with the resection of the unilateral pedicle （group C）, and anterior single segment fixation with the resection of the bilateral pedicles （group D）. Range of motion （ROM） in flexion/extension, bilateral bending, and bilateral axial rotation was measured by spinal three-dimensional measuring system under pure moments of 8.0 N·m. Results The ROM values of T12, L1 in flexion, extension, and right/left lateral bending of groups B, C, and D were significantly lower than those of group A （P〈0.05）; group D was significantly higher than groups B and C （P〈0.05）; but groups B and C showed no significant difference （P〉0.05）. The ROM values of T12, L1 in right/left axial rotation of groups B and C were significantly lower than those of groups A and D （P〈0.05）, but there was no significant difference （P〉0.05） between groups B and C and between groups A and D. The ROM values of L1, 2 in flexion, extension, right/left lateral bending, and right/left axial rotation showed no significant difference between groups （P〉0.05）. Conclusion Resection of the unilateral pedicle has litter effects on the spine biomechanical stabilization of the anterior single segment fixation in the 6 degrees of freedom. However, the bilateral resection results show significant decrease in flexion, extension, lateral bending, and rotation motion stability by the single segment fixation devices, especially in the axial rotation aspect.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2015年第10期1275-1278,共4页
Chinese Journal of Reparative and Reconstructive Surgery
