摘要
目的比较前路椎弓根螺钉内固定（ATPS）和传统颈椎前路钢板固定（AP）、前后路联合固定（CAP）在下颈椎三柱损伤模型中的初始稳定性，以期为其临床应用提供生物力学依据。方法采集6具人颈椎标本并测定其完整状态的三维运动范围（ROM），制成三柱损伤模型，模拟钛网植骨后依次行ATPS、AP、CAP固定，测量3种内固定技术下的ROM，将结果标准化并进行比较。结果AP组前屈（119．68％±8．34％）、后伸（119．63％±6．74％）、左侧弯（115．20％±7．91％）、右侧弯（117．47％±7．81％）、左旋转（120．67％±5．99％）、右旋转（112．35％±8．42％）ROM标准化数值明显大于完整状态组，差异均有统计学意义（P〈0．05）；ATPS组和CAP组各方向ROM标准化数值明显小于完整状态组，差异均有统计学意义（P〈0．05）。ATPS组的前屈ROM标准化数值87．48％±5．31％大于CAP组的69．60％±2．06％，差异有统计学意义（P〈0．05）。ATPS组后伸（65．53％±4．36％）、左侧弯（82．13％±2．85％）、右侧弯（81．78％±3．42％）、左旋转（83．20％±2．30％）、右旋转（83．03％±1．30％）的ROM标准化数值与CAP组（（67．17％±3．10％、82．30％±4．69％、81．27％±2．79％、82．95％±2．40％、83．60％±6．56％）比较差异均无统计学意义（P〉0．05）。结论ATPS的初始稳定性优于AP，和CAP相近，可以为下颈椎三柱损伤提供足够的初始稳定性。
Objective To compare the initial stability between anterior transpedicular screw （ATPS） fixation, anterior plate （AP） fixation and combining anterior and posterior （CAP） fixation for subaxial cervical three-column injury. Methods Six specimens of cervical spine were prepared. After measurement of the range of motion （ROM） of the intact cervical spine, the specimens were made into models of three-column injury. After the models were simulatively reconstructed using an anterior cervical cage, they were stabilized by ATPS, AP and CAP. After the ROMs of the models in the 3 fixation states were measured, the data were normalized by standardizing them to the intact state ROM which was set at 100%. The normalized ROMs of the models in the 3 fixation states were compared. Results The normalized ROMs of AP fixation state in flexion, extension, left lateral bending, right lateral bending, left axial rotation and right axial rotation were 119.68±8.34% , 119.63±6.74% , 115.20±7.91% , 117.47±7.81% , 120.67±5.99% and 112. 35 ± 8.42%, respectively, significantly larger than those of the intact state （ P 〈 0.05）. The normalized ROMs of the other 2 states in all directions were significantly smaller than those of the intact state （ P 〈 0. 05）. The normalized ROM of ATPS state in flexion was 87.48 ± 5.31%, significantly larger than that of CAP state （69. 60 ± 2. 06% ） （ P 〈 0. 05） . There were no significant differences between the normalized ROMs of ATPS state and those of CAP state in extension （65.53 ± 4.36% versus 67.17 ± 3.10% ）, in left lateral bending （82. 13 ±2. 85% versus 82.30 ±4. 69% ）, in right lateral bending （81.78 ±3.42% versus 81.27 ±2. 79% ）, in left axial rotation （83.20 ± 2. 30% versus 82. 95 ± 2. 40% ）, or in right axial rotation （83.03 ± 1.30% versus 83.60 ± 6. 56% ） （ P 〉 0. 05）. Conclusions In subaxial cervical three-column injury, the initial stability of ATPS fixation may be superior to that of AP fixation and similar to that
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2017年第10期897-901,共5页
Chinese Journal of Orthopaedic Trauma
基金
浙江省医药卫生科技计划项目（2013KYB235）
宁波市医学科技计划项目（2013A13）
关键词
颈椎
骨钉
生物力学
三柱损伤
稳定性
Cervical vertebrae
Bone screws
Biomechanics
Three-column injury
Stability
