摘要
目的:目前对TSRH内固定系统重新组合成钩钉系统还缺少相关的生物力学方面的比较及研究。实验对腰椎椎弓崩裂直接修复的4种内固定方法进行生物力学比较。方法:实验于2003-9/10在南方医科大学(原解放军第一军医大学)生物力学实验室完成。①实验材料:选用雄性健康小牛8具(上海市南汇区光明乳业特种屠宰场提供),实验符合动物伦理学要求,常规方法处死后截取L2～6脊柱标本。②实验分组及过程:正常标本作为对照组,然后制成L4双侧椎弓崩裂模型,分别以改良Scott法(内固定由通用公司提供)、钩螺钉法(为枢法模公司提供TSRH的重新匹配)、钉杆法(由枢法模公司提供)和Buck螺钉法(德国确卓公司提供)固定。③实验评估:通过计算机扫描观察L3～4及L4～5的活动范围。结果:4种内固定固定后脊柱稳定性均能得到有效恢复(P>0.05),但钩螺钉法、钉杆法和Buck钉固定法在提高屈曲稳定性方面优于改良Scott法(P<0.05);在旋转或侧弯状态,4种固定方法间差异都无显著性(P>0.05)。但是,从均值比较来看,钩螺钉法、钉杆法在抗旋转不稳方面要优于改良Scott法和Buck钉法。结论:改良Scott法、钩螺钉法、钉杆法和Buck螺钉法内固定方式均能有效恢复失稳脊柱的稳定性,但钩螺钉法、钩钉法在维持脊柱稳定性方面更具优势,且操作简单、易行、安全有效,是较理想的直接修复内固定器。
AIM： It is lack of biomechanical comparison and investigation to reassociate Hook-screw system from TSRH system. This study was aimed to investigate biomechanically the performance of four fixation techniques for the repair of spondylolytic defect in the pars interarticularis. METHODS： The experiment was performed at the Laboratory of Biodynamics of Southern Medical University from September to October 2003. ①Eight male healthy calves were bought from Shanghai Guangming Slaughter House. The experiment was accorded with the animal ethics. Calf cadaveric L2-6 spinal samples were obtained conventionally. ② Normal samples were as control group. Modified Scott＇s technique （internal fixation was bought from Tongyong Company）, screw-red-hook technique （renewal TSRH was purchased from Qufamo Company）, red-screw construct fixation （Qufamo Company） and Buck＇s technique （Jermany Quezhuo Company） were applied on the calf lumber spines in which bilateral spondylolytic defects were created in the I-4 verteber. ③The intervertebral rotation for each direction of L3-4 and L4-5 was measured by scanning. RESULTS： Spinal stabilization was effectively recovered after fixation techniques （P 〉 0.05）. But screw-red-hook, Hook screw and Buck＇s technique could provide more flexion/extension stability than modified Scott＇s technique （P 〈 0.05）. There was no significant different between any two of them in rotational and Lateral flexion stability （P 〉 0.05）. But compared means, screw-red-hook and Hook screw technique could provide more rotational stability than the other two. CONCLUSION： All four fixation techniques can restore the intervertebral rotation displacements. But the screw-red-hook and red-screw construct fixation technique do better than modified Scott＇s and Buck technique in intervertebral rotational stiffness. They are simple, easy, secure and effective and show good prospects in the direct repair.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2007年第40期8115-8118,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
