骨水泥椎体成形强化椎弓根螺钉固定的应用分析

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1、骨水泥椎体成形强化椎弓根螺钉固定的应用研究AbstractScrewlooseningorpullouthasbeenachallengingproblemtopediclescrewfixationintheosteoporoticspine．Theobjectiveofthisstudyistoevaluateandcomparethebiomechanicalchangeandobservetheclinicaleffectofpediclescrewfixationintheosteoporoticspineaftervertebralaugmentation

2、withpolymethylmethacrylate，andtoprovidewarrantforclinicalapplication．BiomechaniealstudyInthisstudy，twelvefresh．frozenhumancadavericosteoporoticthoracolumbarspines(T10．L3)wereusedtomakemodelofL1．2wholelumbarlaminectomy．onthebasisofmultilevelposteriorscrewinstrumentationfromTll—L毛threefix

3、ationmethodswereperformed．Thespecimensweretestedinanondestructivemannerload，itproduceaxialcompressionandthefollowingsixdegreesoffreedom：flexion，extension，torsionright／leftandlateralbendingright／left．DatawerecapturedandthestabilitywasanalyzedbyDigital—Image-CorrelationTechnique．Twelvefre

4、sh．frozenhumancadavericosteoporoticthoracolumbarspines(T10-t3)wereinspectedbyplainradiographstoensurespecimenstheabsenceofstructuralspinaldisorders，previousneoplasticdisease，orspinalsurgery．Inaddition，theseimagesconfirmedthecorrectanatomicsagittalandcoronalalignmentofthespecimen．Afterin

5、tactspecimen(namedAgroup)analysis，posteriorT12一L1laminectomywasperformedandsixspecimenswerechosenandinstrumentedwithpediclescrewsfromTll-L2(namedF1group)．AfterF1groupanalysis，removeallthepediclescrewsandinjectpolymethylmethacrylateintopedicleholesbeforefixthespineagain(namedF2group)．Ano

6、thersixspecimenswereinstrumentedwithpediclescrewsaftervertebralaugmentationwithpolymethylmethacrylate(namedF3group)．Theorderoftestingthesenondestructiveloadswasrandomizedineachofthereconstructionstagesandineachindividualspecimen．ThentwelvevertebraewerechosenfortestfromIA，5ofthespecimens

7、．Fourvertebraewereinstrumentedwithpediclescrewwithoutaugmentation(namedAgroup)．Theotherswereinstrumentedafterpedicleaugmentationorvertebralaugmentationtechnique(namedBorCgroup)．ScrewsweretestedinapairedtestingarraybetweenBandCgroup，randomlyassigningtheaugmentationtechniquestoop