经口前路寰枢椎侧块关节间固定融合器的研制及生物力学分析

Biomechanical analysis of anterior transoral fixation and fusion device for atlantoaxial lateral mass joints

目的:研制经口前路寰枢椎侧块关节间固定融合器,并进行生物力学评价。方法:基于解剖学观察,设计和制作该融合器。取7例成年颈椎标本,先采用固定融合器固定,然后用万能生物力学试验机进行生物力学分析,记录30、50和70 N载荷下的轴向位移。拆卸器械,用后路寰枢椎钉棒固定后,进行生物力学分析。结果:30、50和70 N载荷下,前路固定融合器固定后标本轴向位移分别为(0.39±0.07)、(0.76±0.05)、(1.15±0.09)mm,后路钉棒固定后的轴向位移分别为(1.06±0.09)、(1.53±0.11)和(1.99±0.10)mm。相同载荷下,前路固定融合器固定的轴向位移均小于后路钉棒固定方式(t=11.130,17.120和16.150,P<0.001)。结论:设计的经口前路寰枢椎侧块关节间固定融合器具有更好的轴向稳定性。

Aim：To design a new anterior transoral fixation and fusion device for arthrodesis of atlantoaxial joints and test it biomechanically .Methods：Based on the previous anatomical study of the human cervical specimens , a new device for anterior transoral fixation and fusion of atlantoaxial lateral mass joints was developed .Seven human cervical specimens （ C1-C2） were fixed with this device ,and the axial displacement under the load of 30 N, 50 N, and 70 N were tested bio-mechanically with a universal testing machine ,then the specimens were removed the device and fixed again with the posteri-or screw-rod system including C lateral mass screws , C pedicle screws and rods ,and were tested again .Results：Under the load of 30, 50,and 70 N,the axial displacements were （0.39 ±0.07）,（0.76 ±0.05）, and （1.15 ±0.09） mm when fixed with the new device,and （1.06 ±0.09）,（1.53 ±0.11）, and （1.99 ±0.10） mm when fixed with the posterior screw-rod system.Under the same load ,the axial displacements of the new device fixation were less than those of the posteri -or screw-rod system（t=11.130,17.120 and 16.150,P〈0.001）.Conclusion：Anterior transoral fixation and fusion de-vice has higher axial stability .