颈椎前路带锁钢板治疗颈椎爆裂骨折的试验及临床研究

目的 评价颈椎前路带锁钢板固定系统(CSLP)治疗颈椎骨折的稳定性及临床有效性.方法 将6具新鲜成人颈椎标本(C2～6)置于脊柱三维测量仪上测定C3～5节段的ROM,制造C4爆裂骨折,测定其三维运动变化后分别进行植骨、植骨+CSLP固定,并重复测量其三维运动.对32例下颈椎骨折行前路减压融合,并以CSLP进行内固定治疗.结果 植骨+CSLP固定后在屈伸、侧弯、旋转方向较损伤后明显下降,与正常值相比,屈伸和侧弯运动均明显减少,但旋转运动减少不明显.术后随访6～48个月,所有骨折均复位,颈椎椎体高度恢复,椎间植骨均融合,钢板位置满意,无螺钉松动或脱出.结论 AO前路钢板固定颈椎爆裂骨折时各个运动方向均能获得稳定,临床效果满意,是一种治疗颈椎骨折的理想固定装置.

Biomechanical and clinical researches of cervical spine locking plate for treatment of cervical bursting fracture

Objective To evaluate the stability and clinical feasibility of cervical spine locking plate(CSLP)for the treatment of cervical fractures.Methods Six fresh cadaver cervical specimens(from C2～6) were used for test.The normal three-dimension motions of C3～5 segments were measured on a three-dimensional spinal motion test machine.Then C4 bursting fracture models were built to measure the range of motions(ROM).Iliac bony grafts were implanted and the ROM were tested once more.Finally the injured segments were fixed with AO cervical spine locking plate to measure the ROM.Thirty-two cases of lower cervical spine fractures were treated surgically with anterior decompression and fusion,and were internally fixed with CSLP.Results After bony implantation and CSLP fixation,the ROM of cervical spines in flexion/extension,left/right bending,and left/right axial rotation reduced significantly.Compared with normal ROM,flexion/extension and left/right bending were reduced significantly while left/right axial rotation didn’t change significantly.After 6~48 months follow-up,all fracture were reduced completely and implanted bone was fused.Postoperative X-ray showed plates and screws were in their correct position,no loosening and breakage of both plates and screws was found.Conclusion CSLP is an ideal fixation apparatus for treatment of cervical fracture in cervical spine and can restore stability in three-dimensional ROM.