背景:下颈椎椎弓根钉因具有优良的生物力学优势而广泛用于创伤、肿瘤及畸形导致的多种颈椎疾病。如何提高置钉准确性,减少术后并发症,一直是下颈椎椎弓根钉技术研究的热点。目的:查阅国内外相关文献,综述近年国内外有关下颈椎椎弓根钉...背景:下颈椎椎弓根钉因具有优良的生物力学优势而广泛用于创伤、肿瘤及畸形导致的多种颈椎疾病。如何提高置钉准确性,减少术后并发症,一直是下颈椎椎弓根钉技术研究的热点。目的:查阅国内外相关文献,综述近年国内外有关下颈椎椎弓根钉技术的相关解剖形态学特点、下颈椎后路椎弓根钉生物力学特点及其置钉技术的研究,分析各置钉技术的优点与不足。方法:分别以"cervical,pedicle"及"颈椎,椎弓根"为检索词检索PubMed、Web of Science及CNKI、万方等数据库中的相关文献,中文检索2015年1月至2020年12月发表的相关文献,英文检索近5年发表的相关文献。最终纳入文献52篇,其中中文文献22篇,英文文献30篇。结果与结论:(1)对于椎弓根的皮质厚度与强度而言,内侧壁均高于外侧壁;从C3-C7椎弓根的外展角逐渐减小,而椎弓根的形态则类似于长圆形;椎弓根上缘距其上位神经根从C3-C7逐渐增大,椎弓根下缘距其下位神经根从C3-C7逐渐减小,而椎弓根前外侧壁紧贴椎动脉,椎弓根前内侧壁紧贴硬膜外窦;(2)椎弓根的上、下、外侧三侧壁的突破力均小于内侧壁;在抗拔出力方面,直接拔出力椎弓根钉优于椎间孔钉与侧块螺钉,疲劳拔出力椎弓根钉与椎间孔钉优于侧块螺钉;(3)目前下颈椎后路椎弓根钉置钉技术主要包括徒手置钉、计算机导航辅助置钉、3D打印导板辅助置钉、手术机器人辅助置钉等,但各种技术流派均有一定不足,今后一段时间内徒手置钉技术仍将是下颈椎椎弓根钉置钉技术的主流,随着技术水平的提升和配套人工智能辅助科技设备的完善,人工智能辅助置钉技术将是未来的发展方向。展开更多
The introduction of compressive residual stress is an effective way to reduce fretting fatigue and fretting wear between a spinal implant rod and its holding fixture. The objective of this paper is to demonstrate that...The introduction of compressive residual stress is an effective way to reduce fretting fatigue and fretting wear between a spinal implant rod and its holding fixture. The objective of this paper is to demonstrate that cavitation peening can introduce compressive residual stress into the surface of a spinal implant rod manufactured from medical grade titanium alloy Ti-6Al-4V, which has already been processed by glass shot peening. In order to apply the cavitation peening for the small rod, whose diameter is only 5.5 mm, the cavitating region was concentrated by increasing the ambient pressure. The depth profiles of the resulting residual stress were evaluated by X-ray diffraction following layer removal by electropolishing. The results show that cavitation peening creates compressive residual stress deeper into the rod, even though the stress value at the near surface is saturated due to initial processing using glass shot peening. The depth of the compressive residual stress continuously increases from 44 μm to 230 μm with an increase in the cavitation peening processing time. In addition, the full width at half maximum value of the X-ray diffraction profile, which is closely related to the micro-strain, decreases by up to 32% following the application of cavitation peening.展开更多
依据标准ASTM F 1717-01,对通用脊椎植入物组件进行了静态测试(压缩弯曲、拉伸弯曲和扭转)及疲劳测试。结果表明,通用脊椎植入物组件静态压缩弯曲屈服载荷850N,2％时屈服位移1．52mm,屈服弹性位移13．63mm,压弯刚度62．30N／mm,屈服时...依据标准ASTM F 1717-01,对通用脊椎植入物组件进行了静态测试(压缩弯曲、拉伸弯曲和扭转)及疲劳测试。结果表明,通用脊椎植入物组件静态压缩弯曲屈服载荷850N,2％时屈服位移1．52mm,屈服弹性位移13．63mm,压弯刚度62．30N／mm,屈服时总位移15．15mm;静态拉伸弯曲屈服载荷1240N,2％时屈服位移1．52mm,屈服弹性位移19．56mm,拉弯刚度63．25 N／mm,屈服时总位移21．06 mm;屈服扭矩30N·m,2％时屈服角位移1．95°,位移屈服弹性角位移4．61°,扭转刚度6．43 N·m／(°)。屈服时总角位移6．57°,疲劳极限载荷参考值380N。展开更多
文摘背景:下颈椎椎弓根钉因具有优良的生物力学优势而广泛用于创伤、肿瘤及畸形导致的多种颈椎疾病。如何提高置钉准确性,减少术后并发症,一直是下颈椎椎弓根钉技术研究的热点。目的:查阅国内外相关文献,综述近年国内外有关下颈椎椎弓根钉技术的相关解剖形态学特点、下颈椎后路椎弓根钉生物力学特点及其置钉技术的研究,分析各置钉技术的优点与不足。方法:分别以"cervical,pedicle"及"颈椎,椎弓根"为检索词检索PubMed、Web of Science及CNKI、万方等数据库中的相关文献,中文检索2015年1月至2020年12月发表的相关文献,英文检索近5年发表的相关文献。最终纳入文献52篇,其中中文文献22篇,英文文献30篇。结果与结论:(1)对于椎弓根的皮质厚度与强度而言,内侧壁均高于外侧壁;从C3-C7椎弓根的外展角逐渐减小,而椎弓根的形态则类似于长圆形;椎弓根上缘距其上位神经根从C3-C7逐渐增大,椎弓根下缘距其下位神经根从C3-C7逐渐减小,而椎弓根前外侧壁紧贴椎动脉,椎弓根前内侧壁紧贴硬膜外窦;(2)椎弓根的上、下、外侧三侧壁的突破力均小于内侧壁;在抗拔出力方面,直接拔出力椎弓根钉优于椎间孔钉与侧块螺钉,疲劳拔出力椎弓根钉与椎间孔钉优于侧块螺钉;(3)目前下颈椎后路椎弓根钉置钉技术主要包括徒手置钉、计算机导航辅助置钉、3D打印导板辅助置钉、手术机器人辅助置钉等,但各种技术流派均有一定不足,今后一段时间内徒手置钉技术仍将是下颈椎椎弓根钉置钉技术的主流,随着技术水平的提升和配套人工智能辅助科技设备的完善,人工智能辅助置钉技术将是未来的发展方向。
文摘The introduction of compressive residual stress is an effective way to reduce fretting fatigue and fretting wear between a spinal implant rod and its holding fixture. The objective of this paper is to demonstrate that cavitation peening can introduce compressive residual stress into the surface of a spinal implant rod manufactured from medical grade titanium alloy Ti-6Al-4V, which has already been processed by glass shot peening. In order to apply the cavitation peening for the small rod, whose diameter is only 5.5 mm, the cavitating region was concentrated by increasing the ambient pressure. The depth profiles of the resulting residual stress were evaluated by X-ray diffraction following layer removal by electropolishing. The results show that cavitation peening creates compressive residual stress deeper into the rod, even though the stress value at the near surface is saturated due to initial processing using glass shot peening. The depth of the compressive residual stress continuously increases from 44 μm to 230 μm with an increase in the cavitation peening processing time. In addition, the full width at half maximum value of the X-ray diffraction profile, which is closely related to the micro-strain, decreases by up to 32% following the application of cavitation peening.
