脊柱后路经椎弓根螺钉动态固定系统的临床应用及生物力学研究进展
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国家自然科学基金资助项目(81171765),广东省高校人才引进项目(C1030391)


Advances in clinical application and biomechanical studies of the posterior dynamic transpedicular screw fixation system
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    摘要:

    采用后路刚性椎弓根螺钉固定将使脊柱载荷更多地传递到后柱,导致固定器械的应力集中;同时由于固定节段的活动限制,造成邻近节段过多活动,增加了邻近节段的退变。临床上采用动态内固定来减少这些问题,很多的研究从临床和生物力学阐述各种动态固定的应用效果和作用机制。理想的动态内固定应该能够提供固定节段足够的稳定性;通过增加前柱椎体的应力,从而减少固定器械的应力承载;减少邻近节段的退变;控制固定节段的水平剪切应力。本文回顾了后路动态内固定的生物力学特点及临床应用情况,并比较不同动态内固定的生物力学作用机制。

    Abstract:

    It is known that rigid pedicle screw fixation may cause abnormal stress concentration on the posterior part of the spine, which may lead to stress concentration on the fixation device; meanwhile, due to the motion limitation to the fixed segment, the excessive motion at the adjacent segment may further fortify the disc degeneration. To solve these issues, the dynamic fixation is used in clinic, and many studies have investigated the biomechanical mechanism and clinical outcome of the dynamic fixation. The ideal dynamic fixation should meet the following conditions: offering enough stabilization for the fixed segment; reducing the load on the fixation device through enhancing the strain on the anterior vertebral bodies; preventing the degeneration at the adjacent segment; controlling the horizontal shear force at the fixed segment. In this article, the biomechanical properties and clinical application of the posterior dynamic fixation were reviewed and the biomechanical mechanisms of different dynamic fixations were compared.

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林周胜,陈建庭,朱青安.脊柱后路经椎弓根螺钉动态固定系统的临床应用及生物力学研究进展[J].医用生物力学,2013,28(6):684-689

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  • 收稿日期:2012-10-05
  • 最后修改日期:2012-11-09
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  • 在线发布日期: 2013-12-06
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