经口咽前路寰枢椎蝶形钢板系统的设计及生物力学评估

Design and biomechanical evaluation of transoralpharyngeal atlantoaxial reduction plate

目的 设计经口咽前路寰枢椎蝶形钢板内固定系统 ,评价其生物力学性能。方法 设计研制各种型号经口咽前路寰枢椎蝶形钢板、自锁螺钉和复位器等配套器械。选 12具新鲜成年颈椎标本 ,分别进行三维运动范围实验和螺钉拔出力实验。与其他内固定方法作比较分析。结果三维运动范围 ,TARP、Brooks、Magerl、前路经枢椎体寰椎侧块螺钉和Magerl+Brooks组的屈伸方向的运动范围分别为平均 4.0、6.2、5 .1、6.6和 3 .7度 ;在侧屈方向的活动范围分别为平均 2 .3、3 .6、2 .7、4.2和 1.8度 ;在旋转活动范围分别为平均 7.4、8.9、8.6、10 .7和 6.0度。结果显示该蝶形钢板固定和Magerl +Brooks固定在各个方向上差异均无显著性 (P >0 .0 5 )。其抗屈伸、侧屈和旋转均强于其他 3种内固定方法。寰椎、枢椎和第 3颈椎组的螺钉固定的最大拔出力分别为平均491.5 8、3 96.73和 3 85 .5 3N。结果显示寰椎螺钉的最大拔出力显著高于枢椎和C3 椎体固定螺钉 ,枢椎螺钉与C2 螺钉等效。结论 经口咽前路蝶形钢板系统设计新颖、独特 ,具有良好的生物力学性能。为临床应用提供了生物力学依据。

Objective To design transoralpharyngeal atlantoaxial reduction plate (TARP) and evaluate its biomechanical performance.Methods A brand-new TARP system was designed,including butterfly titanium alloy plate,self-locking screws,atlantoaxial reductor and other operation instruments.Twelve fresh C_0-C_3 specimens were selected for biomechanical test includling range of motion (ROM) and screw pull-out strength.Results TARP had equal effect with Magerl+Brooks and was more stable than the other three atlantoaxial fixators:Magerl,Brooks and anterior transarticalar screw.TARP's C_1 and C_2 screws were strong enough for atlantoaxial arthrodesis and their antipull-out performance were excellent.Conlusion TARP's design was novel and TARP had excellent biomechanical performance.