中间和侧面错位螺丝的稳定性:对尸体的生物力学研究
Christos Tsagkaris1, Marie-Rosa Fasser2, Mazda Farshad1
1University Spine Center Zürich, Balgrist University Hospital, University of Zürich, Zürich, Switzerland; Spine Biomechanics, Department of Orthopedics, Balgrist University Hospital, Zurich, Switzerland.
在腰椎中脚螺丝的错位可能会影响机械螺丝的握住. 中间错位令人惊地增加了螺丝握力,而侧面错位大大减少了它,影响了脊柱仪器仪表的稳定性.
科学领域:
- 整形外科手术 整形外科手术
- 生物医学工程 生物医学工程
- 脊柱生物力学 脊柱生物力学
背景情况:
- 脚螺杆仪器是脊柱外科手术的基石.
- 螺丝错位是一个频繁的并发症,具有潜在的神经血管风险.
- 脚螺丝错位的生物力学后果,特别是螺丝上的生物力学后果,尚未完全理解.
研究的目的:
- 为了研究脚螺丝错位对腰椎中机械螺丝支架的影响.
- 为了比较正确放置,中间错位和侧面错位的脚螺丝的拉出力.
主要方法:
- 一个用12个新鲜冷的人类脊柱 (T12-L5) 进行的尸体生物力学研究.
- 用3D打印的模板指南用于精确的脚螺丝 (错误) 放置.
- 计算机断层扫描 (CT) 扫描量化了螺丝位置的准确性.
- 使用单轴拉力负荷进行拉出测试,评估了机械螺丝.
主要成果:
- 骨矿物质密度 (霍恩斯菲尔德单位) 在所有标本中是一致的.
- 中间错位的螺丝 (2-6毫米) 显示了从822N到985N的拉出力.
- 侧面错位的螺丝 (2-6毫米) 显示出显著减少的拉出力,从334N降至605N.
- 控制螺丝 (正确放置) 承受了837N的拉出力.
结论:
- 中间脚螺丝错位,与侧面错位相反,在静态负载下增强了轴向螺丝的持有力.
- 侧面螺丝错位损害了机械稳定性,增加了螺丝松动的风险.
- 在修复手术期间,临床管理应优先考虑中部损伤的神经安全性和侧面损伤稳定性.
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