几种寰枢椎后路内固定术的生物力学评价

目的：比较单用或联合应用几种常见寰枢椎后路固定技术的生物力学性能差异。方法：７例寰枢椎复合体标本，在力学试验机上，分别测量寰枢椎经关节螺钉固定（Ｍａｇｅｒｌ）、Ｍａ－ｇｅｒｌ＋Ｇａｌｌｉｅ法钢丝固定、Ｍａｇｅｒｌ＋Ｂｒｏｏｋｓ法钢丝固定、以及单纯Ｇａｌｌｉｅ、Ｂｒｏｏｋｓ钢丝固定和Ｈａｌｉｆａｘ椎板夹固定等在扭转５°时所需的扭转力矩．结果：Ｍａｇｅｒｌ的扭转力矩为６．５９±１．３４Ｎｍ，大于其它单一后路固定技术（Ｐ＜０．０１），但小于联合Ｂｒｏｏｋｓ钢丝固定（Ｐ＜０．０１），与联合Ｇａｌｌｉｅ钢丝固定间无显著性差异．Ｇａｌｌｉｅ钢丝固定的扭转力矩最小。结论：Ｍａｇｅｒｌ较其它常见的后路固定术在抗扭转方面有明显的优势．联合Ｇａｌｌｉｅ钢丝固定没有必要。

BIOMECHANICAL EVALUATION OF SEVERAL POSTERIOR ATLANTOAXIAL FIXATION TECHNIQUES

To evaluate the biomechanical differences of pure or combined application of severalposterior atlantoaxial fixation techniques. Methods: The torques needed for five-degree rotationwere measured in seven preserved atlantoaxial complex specimens after these specimens werefi-cated with transarticular screw fixation(Magerl), Magerl plus Gallie wiring, Magerl plus Brookswiring, pure Gallie wiring, pure Brooks wiring, and pure Halifax interlaminar clamping,respectively. Results: The torque for Mager were 6.59 1.34Nm, which were significant greater thanthe torque for any other pure fixation techniques(p<0.0l), but less than the torque for Magerl plusBrooks wiring(p<0.01). No significant difference was found between the torque for Magerl and forMagerl plus Gallie wiring. The torque for Gallie wiring were the least among the posterioratlantoaxial fixation techniques studied. Conclusions: The Magerl technique is superior to othercommon posterior atlantoaxial fixation technique in anti-rotational capacity. It is not necessaryadding Gallie wiring to Magerl technique.