Hangman骨折后Zephir钢板颈前路内固定技术的应变电测研究

Study of electric measure of intervertebral fusion and internal fixation with Hangman fracture

目的比较Hangman骨折后两种不同前路手术方式的生物力学特性。方法对6例新鲜尸体Hangman骨折模型后,依次采用C2-3开槽植骨融合钢板内固定术(C2-3组)和C3椎体大部分切除、植骨内固定术(C2-4组)2种术式,采用电测法测定其螺钉的拔出应力。结果 C2-3组在屈曲和伸展运动状态下,在不同载荷下所承受的应力均大于C2-4组(P<0.05),在左右旋转时两组间无显著性差异(P>0.05)。结论生理环境下C2-3植骨融合内固定术可能相对容易出现内植物相关并发症。

Objective To compare the biomechanical properties of C2-3 intervertebral fusion and C2-4 anterior fusion in Hangman fracture. Methods The model of Hangman fracture prepared from the six fresh human upper cervical vertebra specimens were fixed as C2-3 group and C2-4 group. Using strain electric measure,pull-out stress of the screws of the two fixations were calculated. Restilts In C2-3 group, the stress of flexion and extension under difference loading conditions was greater than that of C2-4 group （P〈0.05）;although the C2_3 group screws bore the greatest pull-out stress on extension at 2.5Nm （12.47＋3.23 Mpa）. Although the stress of C2-3 group screws was slightly greater than that of C2-4 group screws on left/fight axial rotation,the difference was not statistically significant （P〉0.05）. Conclusion Complications are more likely to occur in physiological settings when C2-3 intervertebral fusion fixation is used.