椎弓根螺钉螺杆形状对其生物力学性能影响的研究
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Study on biomechanical performance with variform pedicle screws in vitro
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    摘要:

    目的比较椎弓根螺钉螺杆形状对其生物力学性能的影响。方法6具成人新鲜T9-L5脊椎标本分解为54个椎体试验标本,随机选取一侧按标准方法放置特制试验用直径5.5mm锥形螺钉,然后在MTS力学试验机上先后测量其最大扭力矩和最大拔出力,在对侧以同样的方法进行5.5mm柱形螺钉的实验。然后在腰段进行6.25mm及7.0mm螺钉的翻修。结果在下胸段,锥形螺钉的最大扭力矩(1.445±0.66)N.m显著大于柱形螺钉(1.073±0.42)N.m(P<0.05);而在腰段,锥形螺钉最大扭力矩(1.017±0.43)N.m和柱形螺钉最大扭力矩(1.128±0.50)N.m相比没有明显差异(P>0.05)。无论在下胸段还是腰段,锥形螺钉与柱形螺钉的最大拔出力相比均无显著性差异。柱形椎弓根螺钉的最大扭力矩与最大拔出力呈正相关(r=0.629),锥形螺钉的最大扭力矩与最大轴向拔出力的相关性不显著(r=0.179)。不同形状的螺钉在其达到最大拔出力时的位移无显著差异。结论相同直径的锥形与柱形螺钉的最大拔出力相近,且锥形螺钉在其直径与椎弓根内径相近时具有较高的扭矩。螺钉的最大扭力矩与最大拔出力的相关关系要视螺钉的类型而定。

    Abstract:

    Objective To compare the biomechanical performance of pedicle screws with different forms in lower thoracic and lumbar vertebra. Methods 54 vertebral specimens were obtained from 6 fresh normal frozen cadavers (T9-L5). The experimental 5.5 mm conical pedicle screw was implanted at one side at random and tested with an MTS machine (858 Bionix Ⅱ). To measure the maximal insertion torque firstand then the maximal pull-out strength. The same experiment was done with the cylindrical screw of 5.5 mm on the other side. Then the revision test with 6.25 mm and 7.0mm pedicle screws was done in the lumbar region. Strength dada were recorded. Results At lower thoracic region the torque of conical screw(1.445±0.66) N.m was distinctly higher than that of the cylindrical screw(1.073±0.42) N.m(P<0.05),but in the lumbar region such difference was not found. Conical and cylindrical screws have similar pull?-out strength. Correlation between insertion torque and pull -out strength was statistically significant with the cylindrical screw(r=0.629), but not with the conical screw (r=0.179). The displacement when reach the maximal pull-out strength was similar for the screws with the different forms. Conclusion The conical screw has the similar pull-out strength with that of the same diameter cylindrical screw. And if the diameter of conical screw is similar with the inner-diameter of pedicle, it has the higher insertion torque. The relationship between the insertion torque and pull-out strength is based on the different screw form.

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李超,阮狄克,丁宇,石金锋.椎弓根螺钉螺杆形状对其生物力学性能影响的研究[J].医用生物力学,2005,20(2):105-108

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