本文選題：骨質(zhì)疏松人工骨模塊 + Y型椎弓根螺釘�。� 參考：《中國修復(fù)重建外科雜志》2017年10期

【摘要】：目的評價新型設(shè)計的Y型椎弓根螺釘(Y type pedicle screw,YPS)在骨質(zhì)疏松人工骨模塊(簡稱"模塊")中的生物力學(xué)穩(wěn)定性。方法將模塊隨機分成3組(n=20),用手鉆垂直鉆入模塊中,制備直徑3.0 mm、深30.0 mm的釘?shù)�。分別將YPS、膨脹式椎弓根螺釘(expansive pedicle screw,EPS)、中空骨水泥椎弓根螺釘(bone cement-injectable cannulated pedicle screw,CICPS)打入已制備好釘?shù)赖母鹘M模塊中。12 h后行X線檢查,并在E10000萬能材料試驗機上分別對YPS組、EPS組、CICPS組進行生物力學(xué)穩(wěn)定測試,記錄最大軸向拔出力、最大旋出力和周期抗屈最大載荷。結(jié)果 X線片觀察示,YPS組主釘和中芯釘均被周圍的聚氨酯材料包繞,中芯釘從主螺釘?shù)闹邢?/3穿出后,與主釘形成15°夾角,插入的中芯釘最低點與主螺釘位于同水平線上;EPS組螺釘尖端明顯膨脹,形成爪型結(jié)構(gòu);CICPS組骨水泥主要分布于螺釘前部,在骨小梁中彌散,形成穩(wěn)固的"螺釘-骨水泥-骨小梁"復(fù)合體。生物力學(xué)檢測示,YPS、EPS、CICPS組的最大軸向拔出力分別為(98.43±8.26)、(77.41±11.41)、(186.43±23.23)N,最大旋出力矩分別為(1.42±0.33)、(0.96±0.37)、(2.27±0.39)N/m,周期抗屈試驗的最大載荷分別為(67.49±3.02)、(66.03±2.88)、(143.48±4.73)N。CICPS組各指標(biāo)均明顯高于YPS組和EPS組,差異有統(tǒng)計學(xué)意義(P0.05);YPS組最大軸向拔出力和最大旋出力矩顯著高于EPS組,差異有統(tǒng)計學(xué)意義(P0.05),但YPS組和EPS組間比較最大載荷差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論相比于EPS,YPS能有效提升其在模塊中的最大軸向拔出力和最大旋出力,為骨質(zhì)疏松條件下的螺釘設(shè)計和不同固定方式選擇提供了新思路。
[Abstract]:Objective to evaluate the biomechanical stability of a new Y type pedicle screw Y type pedicle screwYPS in osteoporosis artificial bone module. Methods the modules were randomly divided into 3 groups, which were drilled perpendicularly into the module by hand drill, and the diameter was 3.0 mm and the depth was 30.0 mm. The expanded pedicle screwCICPSs (hollow bone cement pedicle screws) were injected into each module of the prepared nail canal for X-ray examination after 12 hours, and the bone cement-injectable cannulated pedicle screwCICPSs of the hollow bone cement pedicle screw were injected into the each module of the nail canal, respectively, after 12 hours, the bone cement-injectable cannulated pedicle crewCICPSs of the hollow bone cement pedicle screw were injected into each module which had been prepared. The biomechanical stability of YPS group EPS group CICPS group was tested on the E10000 universal material testing machine, and the maximum axial pull-out force, maximum rotation force and cycle flexural maximum load were recorded. Results X-ray observation showed that the main nail and the middle core nail in the YPS group were all wrapped in the surrounding polyurethane material, and the middle core nail was perforated from the middle and lower third of the main screw and formed a 15 擄angle with the main screw. The lowest point of the inserted core nail and the main screw are located on the same horizontal line as the EPS group. The CICPS group has a claw-type structure. The cement of the CICPS group mainly distributes in the anterior part of the screw and diffuses in the trabeculae of the bone. Form a solid "screw-bone cement-trabecular" complex. The biomechanical tests showed that the maximum axial pull-out force of the YPS EPSN CICPS group was 98.43 鹵8.26, respectively 77.41 鹵11.41 鹵11.41 鹵23.23Nm, and the maximum rotation torque was 1.42 鹵0.33Nm, 0.96 鹵0.372.27 鹵0.39Nm, respectively. The maximum load of the periodic flexural test was 67.49 鹵3.02mnm, 66.03 鹵2.882.2ng, 143.48 鹵4.73N.CICPS respectively, which was significantly higher than that of the YPS group and the EPS group, and the maximum axial pull-out force of the CICPS group was significantly higher than that of the YPS group and the EPS group, respectively, and the maximum axial pull-out force of the CICPS group was significantly higher than that of the YPS group and the EPS group, respectively. The maximum axial pull-out force and maximum spin-out moment of YPS group were significantly higher than that of EPS group, and the difference was statistically significant (P 0.05), but there was no significant difference in maximum load between YPS group and EPS group. Conclusion compared with EPS, YPS can effectively enhance the maximum axial pull-out force and maximum spin-out force in the module, which provides a new idea for the screw design and the choice of different fixation methods in the condition of osteoporosis.
【作者單位】： 重慶醫(yī)科大學(xué)附屬永川醫(yī)院骨科;
【基金】：重慶市衛(wèi)生計生委醫(yī)學(xué)科研項目(2015ZDXM020)~~
【分類號】：R580;R687

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本文編號：2018109