两种不同椎弓根螺钉内固定术式对腰椎稳定性影响的生物力学对比研究

doi:10.13418/j.issn.1001-165x.2016.02.020

Abstract

Abstract:

Objective　To analyze and evaluate the impact on biomechanical stability between the bilateral pedicle screws fixation and the one side pedicle screw combined transfaect screw in the opposite side internal fixation, so as to provide theoretical basis in clinics to select different fixation method.　Method　 Ten lumbar samples (L4-5 functional spinal units)of fresh corpses were tested. The range of motion(ROM) of these lumbar samples were tested by experimental machine under flexion, extension, right and left lateral bending, right and left rotating state before and after different fixations.　Results 　All of the six ROMs of bilateral pedicle screws fixation and zygopophysis screw with single pedicle screw fixation were reduced compared to preoperativestate, and the difference were statistically significant（P<0.05）.Compared with the bilateral pedicle screws fixation, the differences were statistically significant under left lateral rotating and right bending（P<0.05）and not statistically significant under flexion, extension, left(transfaect screw side) lateral bending, right(pedicle screw side) rotating state.　Conclusion　Both of bilateral pedicle screws fixation and one side pedicle screw combined transfaect screw in the opposite side internal fixation could add to the biomechanic stability obviously. Compared with the bilateral pedicle screws fixation, the biomechanic stability of one side pedicle screw combined transfaect screw in the opposite side internal fixation is inferior under left lateral rotating and right bending.

Key words: Lumbar vertebrae, Internal fixation, Biomechanics

References

[1] Weistein JN, Tosteson TD, LurieJD, et al. Surgical versus nonsurgical therapy for lumbar spinal stenosis. [J]. N Engel J Med, 2008, 358(10):794-810.
[2] Paul PF. The current treatment-a survey of osteoporotic fracture treatment: osteoporotic spine fracture: the spine surgeon’s perspective[J]. Osteoporosis Int, 2005, 16(Suppl 2): S85-92.
[3] Matsudaira K, Yamazaki T, Seichi A, et al. Modified fenestration with restorative spinoplasty for lumbar spinal stenosis[J]. J Neurosurg Spine, 2009,10(6): 587-594.
[4] Bresnahan L, Ogden AT, Natarajan RN, et al. A biomechanical evaluation of graded posterior element removal for treatment of lumbar stenosis: comparison of a minimally Invasive approach with two standard laminectomy techniques [J]. Spine, 2009, 34(1):17-23.
[5] 毛路，刘栋，郝剑，等. 腰椎动力固定装置治疗下腰痛的研究进展[J].中国骨与关节损伤杂志, 2007, 22(10): 262-264.
[6] Kabins MB, Weinstein JN, Spratt KF, et al. Isolated L4-L5 fusions using the variable screw placement system: unilateral versus bilateral[J]. J Spinal Diaord, 1992,5(1): 39-49.
[7] Goel VK, Lim TH, Gwon J, et al. Effects of an internal fixation device: a comprehensive biomechanical investigation[J]. Spine,1991, 16(Suppl 3):S155-161.
[8] Burton D, Mclff T, Fox T, et al. Biomechanical analysis of posterior fixation techniques in a 360 degrees arthrodesis model[J]. Spine, 2005, 30(24): 2765-2768.
[9] Parker JW, Lane JR, Karaikovic EE, et al. Successful short-segment instrumentation and fusion for thoracolumbar spine fractures: a consecutive 41/2-year series[J]. Spine (Phila Pa 1976), 2000, 25(9):1157-1170.
[10] Moeini SM, Nasca RJ, Lemons JE, et al. Intervertebral spacer as an adjunct to anterior lumbar fusion. Part I. Desing, fabrication, and testing of three prototypes[J]. J Spinal Disord, 1998, 11(2): 129-135.
[11] Suk KS, Lee HM, Kim NH, et al. Unilateral versus bilateral pedicle screw fixation in lumbar spinal fusion[J]. J Spine, 2000, 25(14):1843-1847.
[12] 薛厚军, 潘磊, 黄必留,等. 椎旁间隙入路与传统入路置钉技术在胸腰椎骨折中的效果比较研究[J]. 中国临床解剖学杂志, 2015, 33(3): 354-356.

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A biomechanical comparison of influence of lumbarstability by different pedicle screws fixation

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