腰椎矢状面固定角度对相邻节段应力强度影响实验研究.pdf

23 5 2008 10 Journal of Medical Biomechanics, Vol. 23 No. 5, Oct. 2008 361 1004-7220(2008)05-0361-05 ( 2004 33) 9 L1~S2 L3 4 5 ( 10o o o ) ( 5 ) ( 25 ) L2/3 L5/ S1 (P0.05)(P0.05) (P0.05) R318.01 A Effect of sagittal fixation angle in lumbar fusion on stresses of adjacent segments LI Zhong-hai, ZHAO Jie, CHEN Zhi-ming, YUAN Jian-dong, XU Hao, LIU Ai-gang(Changhai Hospital, Shanghai 200433, China) Abstract: Objectives To evaluate the effect of sagittal fixation angle on the stresses of adjacent segments in lumbar fusion in vitro. Methods Lumbar spine (L1-S2) specimens from nine fresh human cadavers were used. After intact tests of the original normal spines, fixations with three different sagittal angles (1) in situ (lordosis 10 degrees), (2) kyphotic (kyphosis 5 degrees) and (3) hyper-lordotic (lordosis 25 degrees) at L3, 4 and 5 were randomly conducted using pedicle screws on each specimen. Subsequently, biomechanical tests were performed under flexion, extension and lateral bending modes. Stresses of the facet joints and intervertebral disks at L2/3 and L5/S1 were measured and compared. Results In flexion tests, all the three fixation strategies resulted in higher stresses within the adjacent segments than that of the intact spine, the highest being the kyphotic fixation group. In extension tests, stresses of the kyphotic group were significantly higher than that of the other two fixation groups. However, there was no statistical difference among the in situ and hyper-lordotic fix