摘要
目的 评价自行设计的齿状突螺钉钢板内固定系统在治疗Ⅰ型Hangman骨折伴Ⅱ型齿状突骨折联合C2～C3椎间盘损伤时的生物力学性能.方法 选取8具新鲜尸体颈椎标本（包括C1～C3颈椎节段）,在生物力学试验机上依次测试以下各组C1～C2及C2～C3节段的三维运动范围（ROM）值及中性区值：完整标本状态（A组）;失稳状态：Hangman Ⅰ型骨折＋Ⅱ型齿状突骨折＋C2～C3椎间盘切除（B组）;颈椎前路钢板＋齿状突螺钉＋ cage固定组（C组）;齿状突螺钉钢板固定组（D组）;后路C2～C3椎弓根侧块螺钉＋齿状突螺钉固定组（E组）和后路C1～C3椎弓根侧块螺钉固定组（F组）,并对结果进行统计学分析.结果 在C1～C2节段,D组和F组的ROMC1～c2值在各个方向上差异均有统计学意义（P＜0.05）.在C2～C3节段,D组与C组相比,ROMC2～c3值在各个方向上均较小,且差异有统计学意义（P＜0.05）;D组与E、F组相比,ROMC2～C3值在前屈、后伸方向上较小,且差异有统计学意义（P＜0.05）.结论 齿状突螺钉钢板内固定系统在治疗Hangman Ⅰ型骨折伴Ⅱ型齿状突骨折联合C2～ C3椎间盘损伤时具有良好的生物力学性能,可以作为治疗此类合并伤的一种补充方法.
Objective To evaluate the biomechanical stability of anterior odontoid screw plate （AOSP）.Methods Eight fresh-frozen cadaveric cervical spine specimens were subjected to stepwise destabilization of the C1-Ca complex,simulating a type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury.Intact specimens,fractured specimens,and fractured specimens with posterior,anterior fixation techniques were divided into six groups：control group （intact）,injury group of type Ⅱ odontoid fracture and type Ⅰ Hangman fracture combined with C2-3 disk injury,after anterior cervical plate ＋ odontoid screw ＋ cage （ACP ＋ OS ＋ cage） group,after anterior odontoid screw plate （AOSP） fixation system group,after affixing rods from pedicle screws in C2 to lateral mass screws in C3 ＋ odontoid screw （C2PS ＋ C3LMS ＋OS） group,after affixing rods from pedicle screws in C1 to pedicle screws in C2 and lateral mass screws in C3 （C1 PS ＋ C2PS ＋ C3LMS） group.The range of motion （ROM） and neutral zone of C1-C2 and C2-C3 segment was tested.Results There was statistically significant difference between the C1PS ＋ C2PS ＋ C3LMS fixation group and the AOSP fixation group of ROMC1-C2 （P 〈 0.05）.During all loading modes,AOSP ＋ Bone graft fixation significantly outperformed the ACP ＋ OS ＋ cage fixation in limiting ROMC2-C3.During flexion and extension,AOSP fixation significantly outperformed the C1PS ＋ C2PS ＋ C3LMS fixation and C2PS ＋ C3LMS ＋ OS fixation in limiting ROMC2-C3.Conclusion The AOSP fixation system has excellent biomechanical performance when dealing with type Ⅰ Hangman fracture,type Ⅱ odontoid fracture,and the C2-3 disc injury,and appear to be a safe and effective technique for dealing with the combined injury.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2016年第3期212-216,共5页
Chinese Journal of Surgery
基金
浙江省医药卫生一般研究计划资助项目（2015KYA202）
关键词
骨折固定术
内
颈椎
齿状突
钢板
生物力学
Fracture fixation,internal
Cervical vertebrae
Odontoid
Plate
Biomechanical
