颈椎前路椎弓根螺钉固定术后生物力学分析。

PubMed ID
G H
发表日期 2018年12月

原始出处 临床生物力学(布里斯托尔,雅芳)
Clinical biomechanics (Bristol, Avon)
作者 Zhao  Liujun  Chen  Jianqing  Liu  Jiayong  Elsamaloty  Lina  Liu  Xiaochen  Li  Jie  Elgafy  Hossein  Zhang  Jihui  Wang  Leining 

文献标题 颈椎前路椎弓根螺钉固定术后生物力学分析。
Biomechanical analysis on of anterior transpedicular screw-fixation after two-level cervical corpectomy using finite element method.
Biomechanical analysis on of anterior transpedicular screw-fixation after two-level cervical corpectomy using finite element method.

文献摘要 BACKGROUND

颈椎前路椎弓根螺钉内固定克服了颈椎前路椎体切除和融合的一些缺点。经椎弓根螺钉内固定的体外生物力学研究显示出良好的拔出强度和良好的稳定性。然而,对于经椎弓根螺钉内固定的生物力学性能的研究还很缺乏。

METHODS

对照组计算机断层扫描图像(C2-T2)取自一名22岁男性志愿者。利用计算机断层扫描技术建立了一个下颈椎(C3-T1)的三维计算模型。应用有限元软件对完整C3-T1(完整组)、颈椎前路椎弓根螺钉固定(经椎弓根组)和颈椎前路椎体切除融合(传统组)模型进行分析。C3的上表面和上关节面承受1 N·m的力矩和73.6 N的压缩载荷。在6个条件下,测量两个治疗组的运动范围、钛网种植体应力、终板应力和骨螺钉应力等4个参数,并进行比较。

FINDINGS

与完整模型相比,治疗组的运动范围减小。与颈椎椎体切除融合术相比,经椎弓根组钛植体、C4上端板和C7下端板应力降低。两组患者侧屈和旋转时螺钉应力无明显差异,但经椎弓根组螺钉应力较传统组小。除个体差异外,经椎弓根组在运动范围、钛网片应力、终板应力和骨螺钉应力方面均优于传统组。

INTERPRETATION

与颈椎前路椎体切除融合术相比,椎弓根入路具有更好的生物力学性能,是一种可行的颈椎固定方法。


BACKGROUND

Anterior cervical trans-pedicle screw fixation was introduced to overcome some of the disadvantages associated with anterior cervical corpectomy and fusion. In vitro biomechanical studies on the trans-pedicle screw fixation have shown excellent pull-out strength and favorable stability. Comprehensive biomechanical performance studies on the trans-pedicle screw fixation, however, are lacking.

METHODS

The control computed tomography images (C2-T2) were obtained from a 22-year-old male volunteer. A three dimensional computational model of lower cervical spine (C3-T1) was developed using computed tomography scans from a 22 year old human subject. The models of intact C3-T1 (intact group), anterior cervical trans-pedicle screw fixation (trans-pedicle group), and anterior cervical corpectomy and fusion (traditional group) were analyzed with using a finite element software. A moment of 1 N·m and a compressive load of 73.6 N were loaded on the upper surface and upper facet joint surfaces of C3. Under six conditions, four parameters such as the range of motion, titanium mesh plant stress, end-plate stress, and bone-screw stress were measured and compared on two treatment groups.

FINDINGS

Compared with the intact model, the range of motions for treatment groups were decreased. Compared with cervical corpectomy and fusion, the titanium plant, C4 upper end-plate and C7 lower end-plate stresses in trans-pedicle group were reduced. No significant difference was discovered on bone-screw stress between the two groups for lateral flexion and rotation, but bone-screw stress is smaller in trans-pedicle group when compared with traditional group. With exception of individual difference, trans-pedicle group had better biomechanical results than traditional group in range of motions, titanium mesh plant stress, end-plate stress and bone-screw stress.

INTERPRETATION

The trans-pedicle method has better biomechanical properties than the anterior cervical corpectomy and fusion making it a viable alternative for cervical fixations.

BACKGROUND

Anterior cervical trans-pedicle screw fixation was introduced to overcome some of the disadvantages associated with anterior cervical corpectomy and fusion. In vitro biomechanical studies on the trans-pedicle screw fixation have shown excellent pull-out strength and favorable stability. Comprehensive biomechanical performance studies on the trans-pedicle screw fixation, however, are lacking.

METHODS

The control computed tomography images (C2-T2) were obtained from a 22-year-old male volunteer. A three dimensional computational model of lower cervical spine (C3-T1) was developed using computed tomography scans from a 22 year old human subject. The models of intact C3-T1 (intact group), anterior cervical trans-pedicle screw fixation (trans-pedicle group), and anterior cervical corpectomy and fusion (traditional group) were analyzed with using a finite element software. A moment of 1 N·m and a compressive load of 73.6 N were loaded on the upper surface and upper facet joint surfaces of C3. Under six conditions, four parameters such as the range of motion, titanium mesh plant stress, end-plate stress, and bone-screw stress were measured and compared on two treatment groups.

FINDINGS

Compared with the intact model, the range of motions for treatment groups were decreased. Compared with cervical corpectomy and fusion, the titanium plant, C4 upper end-plate and C7 lower end-plate stresses in trans-pedicle group were reduced. No significant difference was discovered on bone-screw stress between the two groups for lateral flexion and rotation, but bone-screw stress is smaller in trans-pedicle group when compared with traditional group. With exception of individual difference, trans-pedicle group had better biomechanical results than traditional group in range of motions, titanium mesh plant stress, end-plate stress and bone-screw stress.

INTERPRETATION

The trans-pedicle method has better biomechanical properties than the anterior cervical corpectomy and fusion making it a viable alternative for cervical fixations.


获取全文 10.1016/j.clinbiomech.2018.09.008