颈椎单开门OsteoMedM3钉板内固定椎管扩大成形术的生物力学研究

Biomechanics of expansive unilateral open-door laminoplasty of the cervical spine with OsteoMed M3 plate and screws

目的观察在单开门术中应用OsteoMedM3钉板内固定重建颈椎稳定性的效果。方法6具新鲜颈椎标本，对每一标本先后行完整颈椎组、后路单开门OsteoMedM3钉板内固定组、后路椎板切除组、后路椎板切除加侧块钉棒内固定组的三维运动范围测试。结果行后路钢板内固定组，在前屈（22．65±2．39）、后伸（15．63±1．56）、左侧弯（19．83±3．16）、右侧弯（16．90±2．13）及右旋（19．45±3．00）状态下运动范围与椎板切除组及侧块钉棒组之间的差异有统计学意义（P〈0．05），与正常组的运动范围接近，差异无统计学意义（P〉0．05）；在左旋（20．67±2．89）状态下运动范围与其他各组之间的差异有统计学意义（P〈0．05）。椎板切除及侧块钉棒组与其他各组之间的差异有统计学意义（P〈0．05）。结论在单开门术中应用OsteoMed M3钉板内固定具有良好的生物力学性能，可重建颈椎稳定性。

Objective To investigate the stability of cervical vertebrae of the method for that OsteoMed M3 titanium plate and screws were used to secure the posterior elements in the open position after expansive unilateral open-door laminoplasty. Methods Six human cadaveric specimens were harvested freshly, and the range of motion of different groups was measured by a three-dimensional spinal stability test, including intact cervical specimens group, laminoplasty with plate group, laminectomy group, and laminectomy and fusion group. Results After expansive unilateral open-door laminoplasty, the plate group exhibited a more significant difference in angular motion than in laminectomy group, and laminectomy and fusion group in ROM of flexion （22. 65 ±2. 39）, extension （ 15.63 ＋ 1.56）, left lateral bending （ 19. 83±3. 16 ）, right lateral bending （ 16. 90 ± 2. 13 ） and right axial rotation （ 19.45 ± 3.00） （ P 〈 0. 05 ）, and it was not significantly different from intact cervical specimens group （ P 〉 0. 05 ）. The plate group exhibited a more significant difference in angular motion than other groups in ROM of left axial rotation （20. 67 ±2. 89 ） （ P 〈 0.05 ）. Laminectomy group, and laminectomy and fusion group exhibited a diference in angular motion in all directions （P 〈 0. 05 ）. Conclusion The biomechanical performance of expansive unilateral open-door laminoplasty with OsteoMed M3 plate and screws was excellent, and could remain initial stability of cervical vertebrae.