膨胀式脊柱内固定系统椎弓根螺钉的生物力学测试
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Insertion torque and pullout strength of expansive spine system (ESS) pedicle screws in human lumbar vertebral bodies: an in vitro biomechanical study
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    摘要:

    目的测试并比较自行设计的膨胀式脊柱内固定系统(expansivespinesystem,ESS)椎弓根螺钉以及CD-Ⅱ和GSS螺钉置入正常人腰椎体标本的最大轴向拔出力及最大旋入力矩,评价ESS螺钉脊柱固定稳定性。方法将30个正常成人腰椎椎体标本随机分为3组,每组10个椎体(20侧椎弓根),分别置入ESS、CD-Ⅱ和GSS椎弓根螺钉,行螺钉拔出试验,测试并记录螺钉的最大旋入力矩和最大轴向拔出力。结果三组螺钉的最大旋入力矩分别为(5.79±1.85)Nm、(5.19±0.75)Nm和(5.56±1.31)Nm,最大轴向拔出力分别为(2219.80±367.60)N、(1630.65±392.58)N和(1963.75±403.68)N。ESS螺钉最大轴向拔出力最大,且与CD-Ⅱ螺钉相比差异有非常显著性意义(P<0.01),与GSS螺钉相比有显著性意义(P<0.05)。结论ESS螺钉具有很强的椎弓根锚固作用。

    Abstract:

    Objective To measure and compare the insertion torque and pullout strength of newly-designed expansivespinal fixation system(ESS) pedicle screws with those of CD-II and GSS pedicle screws in normal human cadaververtebrae, and to evaluate the screw purchase of ESS pedicle screws. Methods Thirty lumbar vertebral bodiesobtained from 6 fresh normal male cadavers were classified into 3 groups randomly, 20 pedicles per group. ESS, CD-¢?,and GSS pedicle screws were implanted into the pedicles of each group respectively. The 34 last screw circles of eachpedicle screw were remained. The remained screw circles were implanted by using a material-testing machine (SWD-10,Changchun, China) to measure the insertion torque. Then each screw was extracted axially from the pedicle at a rate of5mm/min until failure by using the same machine. Force data were recorded and analyzed using a one-way ANOVA andLSD. P<0.05 was considered significant. Results The torques of the ESS, CD-II, and GSS screws were (5.79±1.85)Nm, (5.19? ?0.75)Nm, and (5.56±1.31)Nm respectively. The pullout strength of the ESS, CD-II, and GSS were (2219.80±367.60)N, (1630.65±392.58)N, and (1963.75±403.68)N respectively. The maximum axial pullout strength of ESS wasgreater than that of CD-II and GSS screws. The pullout strength difference was very significant between ESS and CD-II (P<0.001), was significant between ESS and GSS (p<0.05). Insertion torque was correlated positively with pulloutstrength between the ESS and CD-II pedicle screws (p<0.01). Conclusions ESS pedicles screws have good purchaseability, better than that of CD-II and GSS pedicle screws.

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王祥善,赵卫东,刘建民,孙保国,鲍朝辉.膨胀式脊柱内固定系统椎弓根螺钉的生物力学测试[J].医用生物力学,2006,21(2):142-145

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