下颈椎单侧侧块钢板内固定的稳定性研究

Research of the stability of single posterior lateral fixation of cervical spine

目的研究并比较颈椎侧块钢板单侧固定与双侧固定对颈椎稳定性的影响。方法取新鲜成年男性尸体颈椎(C1-T1)9例,制成骨、韧带标本,分别测量完整状态、单开门术后状态(实验时以双侧椎板切除状态模拟)、单侧颈椎侧块钢板固定、双侧侧块钢板固定状态下,相同力偶作用下各椎体在屈伸、侧弯方向上角位移的变化,并进行生物力学比较分析。结果1.双侧固定与单侧固定在屈伸方向中性区(NZ)及活动范围(ROM)均有统计学差异,P<0.05;在侧屈方向两者均无统计学差异。2.单侧固定与完整颈椎间NZ及ROM在屈伸和侧弯上均有明显统计学差异,P<0.01。结论单开门术后颈椎侧块单侧固定的即刻稳定性远大于完整颈椎。

Objective To compare the biomechanical character between single posterior lateral mass plate fixation and double posterior lateral mass plate fixation,and try to give guidance in clinic. Methods Nine Chinese fresh multi-segmental cervical spine specimens （CI-T1）were tested intact,lose stability,singLe posterior lateral mass plate fixation and double posterior lateral mass plate fixation. The angular displacements of the vertebrae were recorded by a digital camera in the load. The neutral zone（NZ） and range of movement（RM） of C4-5 and C5-6 were analyzed statistically. Results The single means and the double means had a statistical difference of neutral zone （NZ） and range of movement （RM） in flexion and extension,and had no difference of neutral zone （NZ） and range of movement （RM） in lateral bending. There were much difference of neutral zone（NZ） and range of movement（RM） between the single means and intact specimen in flexion, extension and lateral bending. There were no difference of neutral zone （NZ） and range of movement （RM） between C4-5 and C5-6 in flexion,extension and lateral bending. Conclusion Single posterior lateral mass plate fixation after a wide laminectomy is much stronger than intact specimen.