颈椎后路手术Mayfield头架固定颅骨耐受压力和拉力的实验研究

A Biomechanical Study on the Compression and Tensile Load on Skull of Mayfield Head Holder in Cervical Posterior Approach

目的测试模拟手术中安置Mayfield头架固定头部,在标准固定位置(距离耳廓上缘2.5cm)和固定磅数(60磅)时Mayfield头架固定颅骨的稳定性,从而为Mayfield头架固定系统在颈椎后路手术的应用提供依据。方法模拟术中头部承受压力和术前、术中行手法牵拉复位两种情况,分别测定Mayfield头架在标准固定位置和固定磅数时,压缩/拉伸受力的情况,得出压缩/拉伸受力与位移的曲线以及最大位移时受力大小。结果Mayfield头架固定系统在尸头上模拟手术中应用测得,在受力后移动3mm状态下能承受的最大平均压力为63.71N,最大平均拉伸力83.21N。结论在颈椎后路手术的体位摆放中,Mayfield头架在标准固定位置和固定磅数固定头部,去除头部重力(一般为35.28N),完成颈椎后路手术的一般操作压力不超过28.43N,即3kg,牵引复位力量不超过47.93N,即5kg,都不会影响Mayfield头架固定头部的稳定性。

Objective To test, by means of simulated surgeries, the stability of Mayfield head holder fixed at the standard position （2.5 cm off the upper edge of the auricle） and with the fixed weight （60 pounds）, and thus to provide the basis for the application of the head holder of this kind in cervical posterior approach. Methods While-operation load on the skull, and before-operation and while- operation dragging and repositioning were simulated, each of whose compression and tensile were tested with the head holder fixed at the standard position and with the fixed weight. Then on this basis the graph of the compression, tensile and displacement was formulated, and the tensile and compression at the greatest displacement was worked out. Results When moved 3 mm under force, the maximum compression and tensile that the head holder could stand was 63.71 N and 83.21 N, respectivley. Conclusion In cervical posterior approach body posture, the stability of the head holder, fixed at the standard position and with the fixed weight, will not be affected, when the operational compression and the tensile of dragging and repositioning was not above 3 kg and 5 kg, respectively.