Bioflex弹性椎弓根钉内固定系统对全椎板切除术与椎间植骨融合术后腰椎活动范围的影响

The influence of bioflex flexible transpedicle fixation system on lumbar mobility after total leminectomy

[目的]比较施行全椎板切除术后Bioflex弹性椎弓根钉内固定与传统刚性椎弓根钉内固定对腰椎活动范围的影响,为临床应用选择提供实验依据。[方法]12具新鲜小牛脊柱标本,随机平均分为弹性内固定组和刚性内固定组,首先测试术前腰椎活动范围,再按照后路全椎板切除术式行硬膜囊和神经根减压手术,分别安装弹性椎弓根钉内固定与刚性椎弓根钉内固定,再比较同一标本减压术前术后活动范围差异。最后两组均进行PLIF手术,比较同一标本融合术前术后活动范围差异。[结果]Bioflex弹性椎弓根钉内固定系统与传统刚性椎弓根钉内固定系统相比,更能有效的保留全椎板切除术后的正常腰椎活动功能和提供足够的稳定性,有效减少椎间植骨融合区应力遮挡。[结论]Bioflex后路弹性内固定系统是一种后路椎节动态稳定装置,可充当椎体后方附件与韧带的功能;且比传统的刚性椎弓根内固定更有效的保留术后腰椎的活动范围和提供足够的稳定性,能有效的提高融合率。

[ Objective] To compare the influences on lumbar mobility after total leminectomy, between Bioflex flexible transpedicle fixation system and traditional rigid fixation system, that provides the evidence for clinical application. [ Method ] Twelve fresh cadaver bovine spines were randomly divided into flexible fixation group and rigid fixation group. Lumbar R0M was measured for every specimen before decompression. Dural and radiclular decompressions were performed in total leminectomy procedures. Flexible transpedicle fixation and traditional rigid fixation systems were assembled respectively in the two groups af- ter decompression. Biomechanical tests were performed to evaluate lumbar R0M after operation. Then PLIF was conducted for every specimen, Comparison for pre- and postoperation about Biomechanical tests was created. [ Result] Bioflex flexible trans- pedicle fixation system can better preserve lumbar mobility after total leminectomy than rigid system. When used for PLIF,it can reduce stress shelter between vertebra. [ Conclusion] Bioflex flexible transpedicle system is a posterior dynamic stabilization de- vice for lumbar segments, which functions as posterior appendixes and ligaments, and better preserves postoperative lumbar mobility than rigid fixation system. It can enhance the fusion rate and provide dynamic stabilization of the spine.