两种不同的腰椎弓根螺钉的生物力学研究
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潍坊市人民医院

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潍坊市科技发展计划项目(项目编号:2018YX001)


Biomechanical study of two different pedicle screws of lumbar spine
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1.Weifang People'2.'3.s Hospital

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    摘要:

    【摘要】 目的:探讨自主研发的新型腰椎后路内固定矫形螺钉在人类骨质疏松腰椎标本中的生物力学特性。方法:4例骨质疏松的腰椎标本(L1-5)。采用间隔分组的方法将标本分为观察组(A组)与对照组(B组)。观察组A1-A8椎体行新型腰椎后路矫形螺钉双螺钉固定,中间安装横向钛棒;对照组B1-B8行普通椎弓根螺钉双螺钉固定;A9、B9为双椎骨,四钉双侧纵向钛棒连接,A9同时两根横向钛棒连接。对上述标本行螺钉拔出测试,记录各标本的最大拔出力,并影像学观察钉道破坏情况。结果:生物力学试验中,观察组测得的最大拔出力(1173.24±244.57 N)均大于对照组(705.23±264.09 N),差异有统计学意义(t=3.678,P=0.002)。两组拔出测试后,螺钉拔出侧钉道的破坏情况不同:观察组4例出现单侧椎弓根外侧壁骨折,2例椎体骨折;对照组均无椎弓根、椎体骨折;观察组螺钉拔出时,螺钉与横向钛棒角度未发生改变;对照组螺钉拔出时,均出现外展角度变小、钉道内松动。结论:与普通椎弓根螺钉相比,新型腰椎后路内固定矫形螺钉在骨质疏松腰椎固定中的稳定性更好,能够降低螺钉松动的几率。

    Abstract:

    【Abstract】 Objective: To investigate the biomechanical characteristics of a new type of pedicle screws of lumbar spine designed by ourselves in human osteoporosis lumbar spine. Methods: 4 lumbar spine specimens (L1-5) with osteoporosis were studied. The specimens were divided into observation group (group A) and control group (group B) by Interval grouping method. The observation group A1- A8 vertebrae were fixed with 2 new type pedicle screws, and horizontal titanium rod was installed to connect the screws on both sides; B1-B8 in control group was fixed with 2 common pedicle screws; A9 and B9 were double vertebrae, four screws were connected with two longitudinal titanium rods, and A9 were also connected with two horizontal titanium rods. The screw pulling out test was performed on the above specimens, the maximum pulling output of each specimen was recorded, and the damage of the nail channel was observed by CT. Results: In biomechanical test, the maximum pulling out force (1173.24 ± 244.57 n) measured in the observation group was higher than that of the control group (705.23 ± 264.09 n), and the difference was statistically significant (t = 3.678, P = 0.002). After the pulling out test, the damage of screw channels were different in the two groups: 4 cases of had unilateral lateral pedicle fracture and 2 vertebral fractures in observation group; no pedicle or vertebral fracture were found in the control group; when the screws were pulled out in the observation group, the angle between the screw and the transverse titanium rod did not change; when the screws were pulled out in the control group, the abduction angle decreased and the nail channel loosened. Conclusion: Compared with the common pedicle screw, the new type of posterior fixation screw has better stability in osteoporosis and can reduce the probability of screw loosening.

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  • 收稿日期:2021-06-29
  • 最后修改日期:2021-06-29
  • 录用日期:2021-07-27
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