脊柱胸腰段骨折侧前方TSRH固定生物力学探究及应用.docVIP

脊柱胸腰段骨折侧前方TSRH固定生物力学探究及应用 　 作者：江振华，陈向东，张烽，陶然 【关键词】 脊柱胸腰段骨折 测定TSRH用于脊柱侧前方内固定后强度、刚度和稳定性的力学性能。［方法］采用15具尸体胸腰段标本，5具为正常(NS)对照组，10具造成压缩性骨折后5具用TSRH行侧前方固定、另5具用Zplate固定作对照，应用实验应力分析法进行生物力学测试。［结果］应用TSRH内固定的脊柱应变、位移比正常脊柱对照组的应变、位移分别减小17%～20％和8％；固定后的强度和刚度与Zplate固定组相比仅小5％和5％，统计显示2种固定方法无显著性差异(Pgt;005)。［结论］采用TSRH侧前方内固定后的脊柱不但强度、刚度和稳定性得到满足，而且在承载能力、脊柱的稳定性上优于正常对照组，与Zplate固定组相比无显著性差异，操作简便，价格低廉且临床应用疗效确切。 关键词：脊柱胸腰段骨折； TSRH侧前方内固定； 生物力学； 应用 Abstract：［Objective］To determine the strength, rigidity and stability of the spine with TSRH lateralanterior fixation. ［Method］Fifteen fresh thoracolumbar specimen were used, 5 of them were used as control group, 10 of them were made compressed fracture and divided into two groups (each contained 5 specimen),TSRH and Zplate were used for lateralanterior fixation respectively. Biomechanical detection was carried on by the experimental stress analysis. ［Result］Compared with the control group, the strain and displacement of the spine decreased 17%～20% and 8% respectively after TSRH fixation. Compared with Zplate group, the strength and rigidity decreased 5% and 5% respectively, which did not show significant difference (Pgt;005).［Conclusion］Lateralanterior fixation with use TSRH not only has effective result in strength, rigidity and stability of the spine, but also is superior to the control group in loadingbearing ability and stability of the spine. There is no significant difference between the TSRH group and Zplate group. But TSRH is relatively simple to operate and is cheaper than Zplate, and has exact clinical ontcome. Key words: Thoracolumbar fracture； TSRH lateralanterior internal fixation; Biomechanics; Application 随着CT和MRI等现代影像学技术在临床上的广泛应用，脊柱创伤的诊断和治疗水平得到迅速的提高。许多患者在得到合适的手术复位、固定、减压和植骨治疗后而康复。作者在通过国人脊柱解剖观测的基础上进行TSRH(Texas Scotlish Rit Heopital)于脊柱侧前方固定，以Zplate为固定对照组进行生物力学实验研究，比较两者固定后脊柱的稳定性及刚度和强度，并观察临床应用效果。 1 材料与方法 11 标本与器械 采用随机取样的15具成人尸体脊柱标本(T12～S1)，剔除病理标本，X线片显示正常，男9例，女6例。按照Panjabi方法制成胸腰段压缩性骨折模型，各取5具分别用TSRH(单棒和钉)和Zplate固定后逐一测试。内固定器材选自美国枢法模公司。 12