金属框架固定行枕颈融合术的生物力学研究

Biomechanical study on occipitocervical fusion fixed by metallic-rectangular frame

[目的]评价金属框架重建枕颈部的稳定性，为其临床应用提供力学依据。[方法]在7具完整成人枕骨颈椎（C0-6）标本上对横韧带切除齿状突切骨后失稳的（C0-6）节段，分别安装金属框架和棘突枕颈钢板内固定，通过摄像将1．53Nm载荷下的三维运动记录脊柱三维运动稳定性评价方法，评价其重建枕颈部即时稳定性的效果，[结果]在1．53Nm载荷作用下，金属框架组（C0-6）节段的前屈、后伸、侧弯和轴向旋转的ROM分别为5．9°、7．7°、5．6°、11．2°，比棘突枕颈钢板组分别缩小了157．6％、68．8％、58．9％、131．3％：[结论]枕颈框架组较有效地恢复枕颈部失稳后的即时稳定性，是枕颈融合术中较可靠的内固定方法。

[ Objective ] To provide the mechanical evidence of self manufactured metallic-rectangular frame on the reconstruction of the stahilit.v of occipitocervical junction. [ Method] Seven of the adult cervical spinal specimens which were entire wetcadavers（ from occipitale to C6 ） were made to simulate the C0-2 fracture dislocation. These of specimens dislocated were fixed by metallic-rectangular frame and Occipito-cervical plate respectively. The three dimensional movements of C0-2 were recorded through photogrametry with a pure moment of 1.53 Nm. The range of motion（ROM） of each specimens in two fixation was caculated. [ Result] Loaded by 1.53Nm. in metallic-rectangular frame fixation, the ROM in flexion, extension, lateral bending and axial rotation were 5.9°,7.7°,5.6° , 11.2° respectively, decreased by 157.6% ,68.8% ,58.9% , 131.3% , compared with oceipitocervical plate/ixation group. [ Conclusion] Metallic-retangular frame fixation can reconstruct the stability of Oceipitocervicat junction immediaiev, and is a relativity effective internal fixation for occipitocervical fusion.