腰椎棘突钉-钩-板静态固定装置的生物力学研究

张红军; 邵高海; 李敬花; 张涛; 李波; 余雨; 王群波

doi:10.13406/j.cnki.cyxb.000654

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腰椎棘突钉-钩-板静态固定装置的生物力学研究

骨科学 | 更新时间：2024-01-17

- 腰椎棘突钉-钩-板静态固定装置的生物力学研究
- Biomechanical study of the spinous screw-hook-laminar static system
- 重庆医科大学学报 2016年41卷第2期页码：113-117
- 作者机构：
  
  重庆医科大学附属永川医院骨科
- 作者简介：
- 基金信息：
  
  重庆市科技计划攻关项目（编号:CSTC2011AC5199）
- DOI：10.13406/j.cnki.cyxb.000654
  中图分类号： R687.3;R318.01
- 纸质出版日期：2016，
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[1]张红军,邵高海,李敬花,张涛,李波,余雨,王群波.腰椎棘突钉-钩-板静态固定装置的生物力学研究[J].重庆医科大学学报,2016,41(02):113-117.

Zhang Hongjun, Shao Gaohai, Li Jinghua, et al. Biomechanical study of the spinous screw-hook-laminar static system[J]. Journal of Chongqing Medical University, 2016,41(2):113-117.
[1]张红军,邵高海,李敬花,张涛,李波,余雨,王群波.腰椎棘突钉-钩-板静态固定装置的生物力学研究[J].重庆医科大学学报,2016,41(02):113-117. DOI： 10.13406/j.cnki.cyxb.000654.

Zhang Hongjun, Shao Gaohai, Li Jinghua, et al. Biomechanical study of the spinous screw-hook-laminar static system[J]. Journal of Chongqing Medical University, 2016,41(2):113-117. DOI： 10.13406/j.cnki.cyxb.000654.

摘要

目的:探讨腰椎棘突钉-钩-板静态固定装置固定后对固定及邻近节段椎间盘、关节突载荷的影响。方法:采用10具新鲜成人脊柱标本（L1

1）

采用自身前后对照

分为完整组（N组）;损伤组（I组）;棘突钉-钩-板组（L组）;置入Wallis系统（W组）;椎弓根螺钉固定组（P组）

每组2具标本。用WDW-4100电子万能试验机

分别重复测试中立位（AC）、前屈后伸（Flex/Ext）、左右侧弯（LB）、旋转运动加载模式下

完整标本、损伤标本和各种固定方式之间的稳定性的差异

以及固定后对邻近节段椎间盘及关节突力学载荷影响。结果:力学稳定性

L组固定节段标本的生物学稳定性与I组相比有显著差异[垂直位移:AC（3.17±0.43）mm

Flex（3.13±0.34）mm

Ext（5.52±0.63）mm

LB（5.62±0.53）mm;水平位移:AC（0.72±0.06）mm

FLex（0.57±0.06）mm

Ext（0.72±0.06）mm

LB（0.67±0.06）mm

0.05]

与N组及W组比较无显著性差异（P

0.05）。即L组稳定性与N组和W组相仿。L组与P组比较

稳定性有差异（P

0.05）。即L组稳定性较P组稳定性差。对邻近节段椎间盘、关节突应力载荷的影响。L、W组在相同力学载荷下

对邻近节段椎间盘、关节突力学载荷影响比较无统计学差异[垂直位移:AC（3.12±0.43）mm

Flex（2.72±0.36）mm

Ext（4.32±0.36）mm

LB（4.82±0.55）mm;水平位移:AC（0.67±0.01）mm

Flex（0.54±0.04）mm

Ext（0.70±0.04）mm

LB（0.78±0.05）mm

0.05];L组与P组在相同力学载荷下

对固定邻近节段椎间盘、关节突力学载荷影响比较有统计学差异[垂直位移:AC（2.91±0.53）mm

Flex（4.22±0.59）mm

Ext（5.22±0.56）mm

LB（5.42±0.49）mm;水平位移:AC（0.92±0.06）mm

Flex（0.62±0.06）mm

Ext（0.98±0.09）mm

LB（0.99±0.09）mm

0.05]

即L组固定对邻近节段椎间盘、关节突载荷的影响小于P组。结论:腰椎棘突钉-钩-板静态稳定装置生物力学性能优良

刚度适中

能为病变节段腰椎提供可靠的稳定性固定

且能有效降低邻近节段椎间盘及关节突关节应力载荷。

Abstract

Objective:To investigate the biomechanical effects and stability of the spinous screw-hook-laminar static system on fixed and adjacent segment. Methods:Ten fresh adult human cadaveric lumbar spine specimens(L1~S1)were divided into intact group(N)

instable mode group(I)

spinous process screw-hook- laminar static system implantation group(L)

pedicle screw implantation group(P)and Wallis system implantation group(W). Each group had two specimens. In five groups

the stability of lumbar spine and the stress changes of adjacent segment under flexion extension

lateral bending and axial motion were examined repeatedly on the WDW-4100 electronic universal testing machine. Results:Mechanical stability:The stability of the damaged section was notably increased in L group than in I group[vertical displacement:AC(3.17±0.43)mm

Flex(3.13±0.34)mm

Ext(5.52±0.63)mm

LB(5.62±0.53)mm;lateral displacement:AC(0.72±0.06)mm

Flex(0.57±0.06)mm

Ext(0.72±0.06)mm

LB(0.67±0.06)mm

P<0.05]. The stability of fixed segments was equally increased in L group than in N group and W group(P >0.05). The stability of L group was inferior to pedicle screw-rod fixation(P)group(P<0.05). Biomechanical effects to adjacent segment disc and zygapophysial joints:under the same mechanical load

there was no significant difference between L group and W group in the stress changes of adjacent segment(vertical displacement:AC(3.12±0.43)mm

Flex(2.72±0.36)mm

Ext(4.32 ±0.36) mm

LB(4.82 ±0.55) mm;lateral displacement:AC(0.67 ±0.01) mm

Flex(0.54 ±0.04) mm

Ext(0.70±0.04)mm

LB(0.78±0.05)mm

P>0.05). L group had low impact on adjacent segment disc and zygapophysial joints than P group [vertical displacement:AC(2.91±0.53)mm

Flex(4.22±0.59)mm

Ext(5.22±0.56)mm

LB(5.42±0.49)mm;lateral displacement:AC(0.92±0.06)mm

Flex(0.62±0.06)mm

Ext(0.98±0.09)mm

LB(0.99±0.09)mm

P<0.05]. Conclusions:With the excellent biomechanics performance and moderate stiffness

spinous process screw-hook- laminar static system can increase the stability of injury spinal segments

and relive the stress concentration of adjacent intervertebral disc and zygapophysial joints.

关键词

腰椎棘突静态固定装置生物力学

Keywords

lumbar spinespinousinterspinous stabilization systembiomechanics

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