拱桥弹性钢板椎弓根固定器的研制与临床应用

Invention and clinical application of the arch bridge type elastic pedicle fixation system

目的:探讨自行研制的椎弓根系统固定器的性能及临床效果。方法:对拱桥式弹性钢板椎弓根固定器(archbridgetypeelasticpediclefixationsystem,ABPF)进行生物力学实验与临床应用分析。结果:ABPF在应变、应力、位移、强度、刚度方面性能良好。应用ABPF治疗胸腰椎骨折57例,53例平均随访26个月,术前椎体前高度平均54郾36%,术后2周98郾5%,术后26个月97%。未发生弯钉、断钉。结论:ABPF利用拱形钢板和钉板角能对脊柱骨折产生过伸折顶复位与纵向撑开复位。术后对脊柱骨折产生持续向前的推力与弹性固定,可防止后凸畸形复发和椎体高度丢失。

Objective:In order to improve the result of treating thoracolumbar fracture,a new pedicle screw instrumentation was invented.Method:The arch bridge type elastic pedicle fixation system(ABPF)had undergone a biomechanical test and a comparative analysis.Result:It was by far better than RF?Steffee?Deck in loadresponsive change,loaddisplacement,torsion intensity and ultimate stength(P<0.01).57cases of thoracolumbar spine fracture had been treated with ABPF,and53of them were followedup for12～33months,the average height of anterior border of the preoperative vertebra body was54.36%.It was improved98.5%two weeks after the operation,and97%one year postoperatively.The height of the postoperative vertebra body showed no distinct loss.Neither the deformation of the plate nor bending or breaking of pedicle screw due to metal fatigue was occurred.Conclusion:ABPF useing the special arch plate and screwplate angle can achieve the extension tureback and correct longitudinal distraction displacement on spinal frecture and can keep forward pushing force continously and elastic fixation to the spine after operation,which possibly prevents kyphosis relapse and vertebral height loss.