一种新型寰枢椎后路动态固定系统的稳定性研究
Stability evaluation of a new posterior atlanto-axial dynamic fixation system
目的 评价新型寰枢椎后路动态固定系统的稳定性。 方法 8具较新鲜的成人枕颈标本(C0~4),随机分成4组:①完整状态组(A组)、②寰枢椎不稳状态组(B组)、③寰枢椎后路动态固定状态组(C组)和④寰枢椎后路椎弓根螺钉固定状态组(D组)。测量在1.50 Nm的力矩下,寰枢关节前屈/后伸,左/右侧弯和左/右旋转等6种运动方式下的运动范围(ROM)及稳定性指数(Sf值),进行统计学分析。 结果 C组与A组的各方向ROM比较,差异无统计学意义(P>0.05);而C组与D组的各方向ROM比较,差异有统计学意义(P<0.001)。C组与B组和D组的屈伸、侧屈和旋转的稳定性指数(Sf值)比较,差异有统计学意义(P<0.05);C组的屈伸、侧屈和旋转的Sf值最接近完整状态组(A组),差异无统计学意义(P>0.05)。 结论 寰枢椎后路动态固定在重建寰枢关节稳定性上有独特优势,既可维持寰枢椎的活动性,又可达到坚强固定的稳定性,为寰枢椎后路固定提供一种新的选择。
Objective To evaluate the stability of a new posterior dynamic fixation system in atlanto-axial spine. Methods Eight fresh human cadaveric specimens (C0~4) were divided randomly into 4 groups: The intact state group (group A), instable state group (group B), posterior atlanto-axial dynamic fixation group (group C) and posterior atlanto-axial pedicle screw fixation group (group D). The rage of motions C1 relative to C2 by loading 1.50 Nm were measured under the six conditions of flexion/extension, left/right lateral bending and left/right rotation.The obtained data was statistically analyzed. Results Under the six conditions, there were no significant differences between group C and group A in ROM (P>0.05), but there were significant differences between group C and group D in ROM (P<0.001). There were significant differences between group C and group B, D in stability index under the conditions of flexion/extension, left/right lateral bending and left/right rotation (P<0.05). However, the stability index of group C was mostly similar to the intact state group.Conclusion In vivo biomechanical studies show that the new posterior atlanto-axial dynamic fixation has unique superiority in the reconstruction of atlanto-axial stability. It may ideally restore the stability of atlanto-axial joint, as well maintain the atlanto-axial range of motion.It is a new surgical choice for treatment of atlanto-axial instability.
Atlanto-axial / Dynamic fixation system / Stability / Biomechanics
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浙江省医药卫生科技计划项目(2011RCB034);浙江省自然科学基金项目(LY02H06001)
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