腰椎峡部裂机翼型记忆合金节段内固定器研制的解剖学基础
张西兵, 朱立新, 王 健, 史本超, 叶文明
中国临床解剖学杂志 ›› 2011, Vol. 29 ›› Issue (4) : 407-410.
腰椎峡部裂机翼型记忆合金节段内固定器研制的解剖学基础
The design of the aliform memory alloy intrasegmental fixation instrument for lumbar spondylolysis: applied anatomic study
目的 解剖测量L1~5, S1形态学参数为研制腰椎峡部裂机翼型记忆合金节段内固定器提供解剖学依据。 方法 采用20套正常成人腰骶椎标本测量L1~5,S1的相关参数,据此设计机翼型记忆合金节段内固定器。 结果 以L4/L5为例:(1)腰椎棘突下面两侧缘与椎板的交点至同侧横突根部上缘的距离(DITR)为(35.30±2.38)mm;(2)腰椎横突根部上缘前后两侧面的夹角(AFR)为(30.47±6.38)°;横突根部上下缘宽度(WRT)为(11.43±1.76)mm;(3)腰椎两侧横突、上关节突及椎弓根交界处中心点间距(DTAP) 为(46.44±2.55)mm;(4)腰骶椎棘突的厚度(TSP)为(9.04±1.12)mm;(5)腰骶椎棘突间距 (DAP)为(7.10±1.83) mm;(6)腰椎棘突下面两侧缘与椎板的交点到横突根部、上关节突、椎弓根交界处中心点的连线和相应棘突下面侧缘的夹角(ATL)为(58.31±7.02)°;(7) 腰骶椎棘突后面到椎板的距离(LSP)为(20.40±2.80)mm。该内固定器由“U”形体部及两侧翼构成,初步设计大、中、小3个型号。 结论 机翼型记忆合金节段内固定器的设计在形态学上具有可行性,且利用了镍钛合金的记忆效应、超弹性、耐腐蚀等特性,是一种牢靠安全,操作简便的新型内固定器。
Objective To explore anatomic features of L1~5 and S1 vertebrae, and provide parameters for the development of the aliform memory alloy intrasegmental fixation instrument(AMAIFI). Methods 20 sets of antiseptic lumbar specimens (L1~5,S1) of Chinese normal adults were used. The distance from the intersection of the lateral margin of the inferior surface of the lumbar spinous process and lamina of vertebra to the superior border of the root segment of transverse process (DITR), the angle between the anterior and posterior sides sitting at the superior border of the root segment of transverse process (AFR), the width of the root segment of transverse process (WRT), the distance from one side of the junction of the transverse process, superior articular process and pedicle of vertebral arch to the another (DTAP), the thickness of the spinous process (TSP), the distance between adjacent spinous process (DAP), the angle between two lines [(ATL), one is the line between the intersection of the lateral margin of the inferior surface of the lumbar spinous process and lamina of vertebra and the junction of the transverse process, superior articular process and pedicle of vertebral arch, another was the lateral margin of the inferior surface of the spinous process], the length of the spinous process (LSP) were measured and analyzed respectively. Results Taken L4/L5 as the example: DITR was about (35.30±2.38)mm, AFR (30.47±6.38)°, WRT (11.43±1.76)mm, DTAP (46.44±2.55)mm, TSP (9.04±1.12)mm, DAP (7.10±1.83)mm, ATL (58.31±7.02)°, and LSP (20.40±2.80)mm respectively. Conclusions The design of AMAIFI is feasible, which is a safe and convenient device, for mixing together the advantage of the shape memory effects, hyperelasticity and anticorrosion characters of the nickel-titanium shape memory alloy.
Applied anatomy / Lumbar spondylolysis / Memory alloy / Intrasegmental fixation
[1] 傅世儒,张如一,周英男,等.运动员腰椎峡部裂的病因和预防
[J].中华骨科杂志,1987,7(6):401-404.
[2] Ciullo JV, Jackson DW. Pars interarticularis stress reaction, spondylolysis, and spondylolisthesis in gymnasts
[J].Clin Sports Med,1985, 4(1):95-110.
[3] Moller H, Hedlund R. Surgery versus conservative management in adult isthmic spondylolisthesis: A prospective randomized study: part 1
[J]. Spine, 2000, 25(13):1711-1715.
[4] Buck JE. Direct repair of the defect in spondylolisthesis:Preliminary report
[J].J Bone and joint Surg Br,1970,52(3):432-437.
[5] Nicol RO, Scott JHS. Lytic spondylolysis:repair by wiring
[J].Spine,1986, 11(10):1027-1030.
[6] Hefti F, Seelig W, Morscher E.Repair of lumbar spondylolysis with a hook-screw
[J].Internal Orthop,1992,16(1):81-85.
[7] 张效三. 新型翼状形态记忆合金节段内固定器治疗腰椎峡部裂的实验研究
[D].广州:南方医科大学, 2004.
[8] 徐国洲, 涂强, 钟润泉, 等. 椎弓根螺钉张力带治疗腰椎峡部裂
[J].临床骨科杂志, 2005, 8(2):120-121.
[9] 靳安民,朱立新,童斌辉,等.自制节段记忆合金固定器治疗腰椎峡部裂(附10例报告)
[J].南方医科大学学报, 2001, 21(6):440-441.
[10] 余铮, 李振宇, 罗新乐, 等. SOCON椎弓根钉钩系统在青少年腰椎椎弓根峡部裂的临床应用
[J].中国骨与关节损伤杂志, 2005, 20(6):385-386.
[11] Adelt D, Samani J, Kim WK, et al. Coflex interspinous stabilization: clinical and radiographic results from an international multicenter retrospective study
[J].Paradigm Spine Journal, 2007,1(1):1–4.
[12] 李重茂, 陈昌伟, 幸永明, 等. 镍钛记忆卡钩治疗腰椎椎弓峡部崩裂15例
[J].中华创伤杂志, 2004, 20(2):119-120.
[13] 邹德威, 杨惠林, 金大地, 等. 脊柱功能重建外科学
[M].北京:人民军医出版社,2008:545-552.
广东省科技计划项目(2009B030801217)
/
〈 |
|
〉 |