摘要
目的探讨螺钉直径对椎体骨折合并椎弓根皮质劈裂绵羊内固定稳定性的影响。方法选取32具新鲜绵羊脊柱椎体(T13 ~ L3)作为标本,建立单纯压缩骨折和单纯压缩骨折合并伤椎一侧椎弓根劈裂模型,将标本按制作模型先后顺序分为四组,每组各8具标本,A组椎弓根劈裂使用直径6.0 mm螺钉,B组椎弓根劈裂使用直径6.5 mm螺钉,C组椎弓根皮质完整使用直径6.0 mm螺钉,D组椎弓根皮质完整使用直径6.5 mm螺钉。均进行10 000次疲劳实验,测量并比较各组标本最大活动范围、螺钉最大拔出力及轴向压缩刚度。结果 A组和B组前屈、后伸、左侧弯、右侧弯的最大运动范围均明显大于C组和D组(均P < 0.05),A组4个方位的最大运动范围均显著大于B组(均P < 0.05),C组4个方位的最大运动范围均显著大于D组(均P < 0.05)。C组和D组最大拔出力和压缩刚度均显著大于A组和B组(均P < 0.05),B组最大拔出力和压缩刚度均显著大于A组(均P < 0.05),D组最大拔出力和压缩刚度均显著大于C组(均P < 0.05)。结论椎弓根皮质完整,螺钉直径越接近椎弓根直径,其内固定稳定性越好,而椎弓根皮质劈裂不利于内固定稳定,螺钉直径越大,其内固定稳定性越好。
Objective To investigate the effect of screw diameter on stability of internal fixation in sheep with vertebral fracture combined with pedicle cortical splitting. Method 32 fresh sheep spines(T13~L3) were selected as specimens, established a single compression fracture model and a single compression fracture model with unilateral pedicle splitting of the injured vertebrae, the specimens were divided into four groups according to the order of making models, 8 specimens in each group. In group A, 6.0 mm diameter screw was used for pedicle splitting;in group B, 6.5 mm diameter screw was used for pedicle splitting;in group C, the pedicle cortex was completely screwed with a diameter of 6.0 mm;in group D, the pedicle cortex was completely screwed with a diameter of 6.5 mm. Then 10 000 fatigue tests were carried out to measure and compare the maximum range of motion, the maximum pull-out force of screw and the axial compression stiffness of each specimen. Result The maximal range of motion of forward bending, backward extension, left bending and right bending in group A and group B were significantly larger than those in group C and group D(all P<0.05), the maximal range of motion in group A was significantly larger than that in group B(all P<0.05),the maximal range of motion in group C was significantly larger than that in group D(all P<0.05). The maximum pullout force and compression stiffness of group C and group D were significantly larger than those of group A and group B(all P<0.05),the maximum pullout force and compression stiffness in group B were significantly larger than those in group A(all P<0.05),the maximum pullout force and compression stiffness in group D were significantly larger than those in group C(all P<0.05).Conclusion Pedicle cortex is intact, the closer the diameter of screw is to the diameter of pedicle, the better the stability of internal fixation. Pedicle cortical splitting is not conducive to the stability of internal fixation. The larger the diameter of screw, the better the stability of internal fixation.
作者
李超艺
陈荣
孙培栋
张伟
吴国志
唐捷
刘立柱
LI Chao-yi;CHEN Rong;SUN Pei-dong;ZHANG Wei;WU Guo-zhi;TANG Jie;LIU Li-zhu(Department of Orthopedics Two District, Second Affiliated Hospital of Hainan Medical College, Haikou 570311, China;Department of Human Anatomy, Basic Medical College of Southern Medical University, Guangzhou 510515, China)
出处
《中国医学前沿杂志（电子版）》
2019年第7期92-95,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
基金
海南省自然科学基金资助(819MS126)
关键词
椎体骨折
椎弓根皮质劈裂
螺钉直径
内固定稳定性
Vertebral fractures
Pedicle cortical cleavage
Screw diameter
Internal fixation stability
