前路经寰枢关节锁定钛板螺钉内固定系统三维稳定性的实验研究

Biomechanical evaluation on three- dimensional stability of anterior atlantoaxial transarticular locking titanium plate- screw fixation system

[目的]评价前路经寰枢关节锁定钛板螺钉内固定系统治疗寰枢椎不稳的三维稳定性。[方法]8例颈椎新鲜标本,对每一标本分别测定完整状态、齿状突Ⅱ型骨折、前路经寰枢关节锁定钛板螺钉内固定和后路椎弓根螺钉内固定的三维运动范围,并对结果进行统计学分析。[结果]前路固定的前屈为(1.39±0.26)°,后伸为(1.40±0.22)°,侧屈为(1.43±0.23)°,旋转为(1.77±0.34)°。后路固定的前屈为(1.37±0.23)°,后伸为(1.39±0.20)°,侧屈为(1.41±0.22)°,旋转为(1.77±0.33)°,前路经寰枢关节锁定钛板螺钉固定和后路椎弓根螺钉固定的寰枢椎三维运动范围无显著统计学差异(前屈P=0.930,后伸P=0.952,左右侧屈P=0.947,左右旋转P=0.950)。[结论]前路经寰枢关节锁定钛板螺钉固定术的三维稳定性与后路椎弓根螺钉固定术相当,为寰枢椎不稳患者提供了一种手术治疗选择。

[ Objective ] To evaluate the three -dimensional stability of anterior atlantoaxial transarticular locking titanium plate-screw fixation. [ Methods] Eight fresh adult cadaveric speeiemens （C0-4 ） were used to test the three- dimensional stability in the following sequence ： intact , instability , anterior atlantoaxial transarticular locking titanium plate - screw fixation and posterior pedicle screws fixation , and the results were statistically analyzed. [ Results ] The three - dimensional ROM of anterior atlantoxial transarticular locking titanium plate - screw fixation group was （ 1.39 ± 0. 26 ） °in flexion, （ 1.40 ± 0. 22 ） ° in extension, （ 1.43 ± 0. 23 ） °in lateral bending and （ 1.77 ± 0. 34） °in the axial rotation. The three - dimensional ROM of posterior pedicle screws fixation group was （ 1.37 ± 0. 23 ） ° in flexion, （ 1.39 ± 0. 20） ° in extension , （ 1.41 _± 0. 22 ） ° in lateral bending and （ 1.77 ± 0. 33） °in the axial rotation. There was no significant difference between anterior fixation and posterior fixation. [ Conclusion] According to the biomechanical testing , anterior atlantoaxial transarticular locking titanium plate - screw fixation provides satisfying stability, which provides the same effect as that by posterior pedicle screws fixation. It will be another alternative choice for the treatment of atlantoaxial instability.