螺钉直径对合并椎弓根皮质劈裂内固定稳定性的影响

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1、授予单位代码誦９對则躬１３５５０＾巧度钟尖這ＨｅｂｅｉＭｅｄｉｃａｌＵｎｉｖｅｒｓｉｔｙ／硕±学位论文在职科学学位螺钉直径对合并椎弓根皮质劈裂内固定稳定性的影晌学位申请人；宗治国导师：冯文岭教授专业；外科学二级学院：第Ｈ医院２０１５年１０月巧北医科大学学位论文使用授权及知识产权归属承语本学位论文在导师）的指导下，由本人独立完成。本学（或指导小组位论文研究所获的研究成果。河北医科，其知识产权归河北医科大学所有大学有权对本学位论文进行交流、公开和使用。凡发表与学

2、位论文相关的一验材料、原始数据、申报的专利论文，第署名单位为河北医科大学，试。否则。等知识产权均归河北医科大学所有，承担相应的法律责任．二：研究生签名：疑讀諸师签章：＞！占苗级学院领导签章ｉ早化Ｊ／／么＞／广年月曰河北医科大学研究生学位论文独创性声明本论文是在导师指导下进行的研究王作及取得的研究成果，除了文中特别加从标注和致谢等内容外，文中不包含其他人已经发表或撰写的研究。成果，指导老师对此进行了审定。本论文由本人独立撰写，文责自负－一＾：占山研究生签名导师签章ｉ目录中文摘要·········

3、·····································································1英文摘要··············································································3研究论文螺钉直径对合并椎弓根皮质劈裂内固定稳定性的影响前言··············································································6材料与方法······

4、·······························································6结果··············································································9附图··············································································11附表···········································

5、···································15讨论··············································································16结论··············································································22参考文献···································································

6、·····22综述胸腰椎骨折术后椎弓根螺钉断裂和松动的原因及对策············27致谢····················································································36个人简历··············································································37中文摘要螺钉直径对合并椎弓根皮质劈裂内固定稳定性的影响摘要目的：本研究选用绵羊脊柱标本建造胸腰段椎体单纯压缩

7、骨折模型以及单纯压缩骨折合并椎弓根劈裂模型，采用不同直径螺钉进行固定，探讨不同直径螺钉对脊柱椎体骨折椎弓根螺钉内固定稳定性的影响,分析椎弓根皮质劈裂对内固定稳定性的影响，以及经伤椎不同直径螺钉合并一侧椎弓根皮质劈裂对内固定稳定性的影响。方法：购买新鲜（宰杀后6h内）绵羊脊柱标本，经肉眼及X线检查排除肿瘤、骨折及先天性脊柱畸形等情况后，选取椎弓根直径为6.5±2mm的标本40具，截取（T13～L3）脊柱段。首先对40具标本制作单椎体压缩骨折模型，在L1椎体上进行锥形打孔，置于生物力学机上进行压缩，造成胸腰段压缩骨折模型；然后随机选取其中20

8、具标本，将其制作为单纯压缩骨折合并椎弓根劈裂模型，其方法为在压缩骨折模型的基础上使用小型电动削磨机对L1左侧椎弓根削磨，制作出2mm左右裂隙，经X线检测椎弓根皮质劈裂模型裂隙宽度均小于3mm。