经口前路寰枢椎复位钢板系统枢椎固定螺钉拔出强度的实验研究

Experimental study of screw pull-out strength on axis of anterior transoral atlantoaxial reduction plate

目的对经口前路寰枢椎复位内固定钢板系统(TARP)枢椎螺钉进行固定螺钉拔出力实验,为螺钉固定方式的选择提供依据。方法 6例枢椎新鲜标本分别采用椎体、前路椎弓根及关节突螺钉固定,在生物力学实验机上通过传感器测定固定螺钉的最大拔出力并进行统计学分析。结果枢椎前路椎弓根螺钉拔出力(593.14±97.77)N,强于枢椎椎体和关节突螺钉,枢椎关节突螺钉拔出力(469.94±73.32)N,强于枢椎椎体螺钉(395.15±75.07)N(P均<0.05)。结论 TARP系统枢椎螺钉固定采用前路椎弓根及关节突固定优于枢椎椎体固定,固定安全可靠。临床应用尤以枢椎前路椎弓根螺钉固定为最佳。

Objective To evaluate the transoral screw pull-out strength on C2 of transoral atlantoaxial reduction plate（TARP） and provide biomechanical basis for clinical choice of screw fixation technique.Methods Six fresh C2 spine specimens were designed to compare screw pull-out strength on C2.C2 screw was separately implanted into pedicle,vertebrae and articular process.The pull-out strength was tested and compared.Results C2 pedicle screw got the strongest pull-out strength（593.14±97.77） N and it is stronger than C2 vertebrae screw（395.15±75.07） N and C2 articular process screw（469.94±73.32） N（P〈0.05）.The pull-out strength of C2 articular process screw is stronger than C2 vertebrae screw（P〈0.05）.Conclusion Experimentally,pedicle screw fixation transoral approach to C2 pedicle and C2 articular process of TARP is strong and safe,especially C2 pedicle.