中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (53): 8615-8620.doi: 10.3969/j.issn.2095-4344.2015.53.015

• 骨与关节生物力学 bone and joint biomechanics • 上一篇    下一篇

“X”形弹性脊柱内固定与传统椎弓根内固定的应力分析

王 宇,梅继文,穆尚强,高 峰,黄 锐   

  1. 吉林医药学院附属医院骨外科,吉林省吉林市 132013
  • 收稿日期:2015-10-13 出版日期:2015-12-24
  • 作者简介:王宇,男,1978年生,吉林省吉林市人,汉族,硕士,副主任医师,主要从事骨外科基础、教学及临床研究。
  • 基金资助:
    吉林市科技计划项目(201133104);吉林医药学院附属医院青年医师科研课题(院资2014-3号)

Stress analysis between “X”-shaped spine dynamic fixation and traditional pedicle screw fixation 

Wang Yu, Mei Ji-wen, Mu Shang-qiang, Gao Feng, Huang Rui   

  1. Department of Orthopedics, the Affiliated Hospital of Jilin Medical University, Jilin 132013, Jilin Province, China
  • Received:2015-10-13 Online:2015-12-24
  • About author:Wang Yu, Master, Associate chief physician, Department of Orthopedics, the Affiliated Hospital of Jilin Medical University, Jilin 132013, Jilin Province, China
  • Supported by:

     the Science and Technology Project of Jilin City, No. 201133104; the Young Physician Research Project of Affiliated Hospital of Jilin Medical University, No. Yuanzi 2014-3

摘要:

 
吉林市科技计划项目(201133104);吉林医药学院附属医院青年医师科研课题(院资2014-3)
背景:目前国内外许多学者研发了多种动态弹性脊柱内固定器,经过生物力学研究、动物实验及临床应用发现,尚无一种脊柱弹性内固定器得到临床上的普遍认可。                                 
目的:比较自制“X”形弹性内固定器与传统椎弓根螺钉内固定的应力差异。
方法:根据成人脊柱影像学资料,分别建立“X”形弹性脊柱内固定器与传统椎弓根螺钉内固定系统三维有限元模型,比较两组模型在垂直压缩、屈、伸、侧屈、扭转时的力学差异。
结果与结论:两模型在垂直压缩状态应下的应力均小于屈、伸、侧屈及扭转状态下的应力;在垂直压缩、前屈、后伸、侧弯及旋转时,“X”形弹性脊柱内固定器的应力更多集中在“X”形连接棒上,而传统椎弓根螺钉内固定的应力更多集中在螺钉近棒段,且“X”形弹性脊柱内固定器螺钉所受应力明显小于传统椎弓根螺钉内固定(P < 0.001)。表明“X”形弹性内固定器较传统椎弓根螺钉内固定系统更能分担螺钉应力,减少螺钉术后应力集中情况。 

关键词: 骨科植入物, 脊柱植入物, 弹性, 脊柱内固定器, 椎弓根螺钉, 有限元分析, 应力

Abstract:

BACKGROUND: Many scholars have developed a variety of dynamic elastic spine fixator. After biomechanical research, animal experiments and clinical application found that no one elastic spine fixator was generally recognized clinically.
OBJECTIVE: To compare the stress difference between “X”-shaped spine dynamic fixation and traditional pedicle screw fixation.
METHODS: Three-dimensional finite element models of “X”-shaped spine dynamic fixation and traditional pedicle screw fixation were established according to adult spine imaging data. Mechanical differences in vertical compression, flexion, extension, lateral bending and rotation were compared between the two groups. 
RESULTS AND CONCLUSION: The stress at vertical compression was lower than that at flexion, extension, lateral bending and rotation in both groups. The stress at “X”-shaped spine dynamic fixation mainly focused on “X”-shaped connecting rod, but the stress of traditional pedicle screw fixation mainly focused on conjunction of screw-rod. Moreover, the stress of the screw of “X”-shaped spine dynamic fixation was significantly less than that of traditional pedicle screw fixation (P < 0.001). These results suggest that “X”-shaped spine dynamic fixation system can share stress of screws and reduce the postoperative stress concentration compared with traditional pedicle screw fixation. 

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