本文選題：胸椎　切入點(diǎn)：椎弓根　出處：《中國生物醫(yī)學(xué)工程學(xué)報(bào)》2017年03期 　論文類型：期刊論文

【摘要】：胸椎后方不同程度咬除骨皮質(zhì)后,在椎弓根中置入螺釘,探討并評估其生物力學(xué)性能。采集新鮮小牛胸椎標(biāo)本21具,制成21個(gè)功能節(jié)段模型(T6~T10),隨機(jī)分為3組,分別為完整皮質(zhì)組、去皮質(zhì)A組和去皮質(zhì)B組,各7個(gè)功能節(jié)段。去皮質(zhì)A組咬除進(jìn)釘點(diǎn)周圍3~5 mm骨皮質(zhì),去皮質(zhì)B組咬除進(jìn)釘點(diǎn)周圍5~8 mm骨皮質(zhì),完整皮質(zhì)組未咬除皮質(zhì)。結(jié)果顯示:在位移-剛度測試上,在軸向壓縮、前屈、后伸、左右側(cè)屈及軸向旋轉(zhuǎn)狀態(tài)時(shí),3組內(nèi)固定標(biāo)本數(shù)值接近,差異無統(tǒng)計(jì)學(xué)意義(P0.05);在拔出強(qiáng)度測試上,去皮質(zhì)A組與完整皮質(zhì)組比較,差異無統(tǒng)計(jì)學(xué)意義(P=0.329);而去皮質(zhì)B組的拔出力顯著下降,并低于其他兩組,差異有顯著性意義(F=13.022,P=0.00)。胸椎進(jìn)釘點(diǎn)周圍不同程度咬除骨皮質(zhì)行椎弓根螺釘固定,可提高置釘?shù)臏?zhǔn)確性,對椎體固定的剛度無顯著影響;但咬除范圍應(yīng)慎重,不應(yīng)大于螺釘直徑,否則將顯著降低螺釘?shù)陌纬鰪?qiáng)度。
[Abstract]:The biomechanical properties of 21 fresh calf thoracic vertebrae specimens were studied and evaluated by inserting screws into the pedicle of thoracic vertebrae after different degrees of bone cortex bite. 21 functional segmental models were made and randomly divided into 3 groups. There were 7 functional segments in each of the intact cortical group, decortical A group and decortical B group. In the decortical group, 3 5 mm bone cortex was obliterated around the nail point, and 58 mm bone cortex around the nail point was obliterated in the decortical B group. The results showed that in the displacement-stiffness test, in axial compression, flexion, extension, left and right flexion and axial rotation, the values of fixed specimens were close to each other. There was no significant difference in pullout strength between group A and group A, but there was no significant difference between group A and group C (P < 0.01), but the pull-out power of group B was significantly lower than that of the other two groups. The difference was significant (P < 0.05). Pedicle screw fixation with pedicle screw fixation in different degree around the point of thoracic spine entry and nail could improve the accuracy of screw placement and had no significant effect on the stiffness of vertebral body fixation, but the range of bite should be careful and should not be larger than the diameter of screw. Otherwise, the pull-out strength of the screw will be significantly reduced.
【作者單位】： 溫州醫(yī)科大學(xué)附屬第三醫(yī)院;
【分類號】：R318.01;R687

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