改良矫形复位固定系统的研制与临床应用

目的：设计一种改良的脊柱 椎弓根矫形复位固定系统（modified reduction fixation system,MRFS），用于提高脊柱内固定的复位固定效果。方法：将MRFS与Dick、角度椎弓根螺钉（RF）、滑脱固定（SF）强力固定（AF）等内固定系统在10具新鲜尸体标本上进行生物力学对比研究和临床应用研究。结果：胸腰椎骨折采用MRFS内固定，在脊柱的强度、刚度和稳定性方面均优于其他4种内固定系统，差异均有显著性意义（P＜0．01）。临床应用52例脊柱骨折脱位， 均基本达到解剖复位及坚强固定，CT检查手术前后椎管矢径，提示椎管获得有效减压（P＜0．01）。平均随访25．5个月，复位良好。结论：MRFS具有良好的三维空间矫正力，既有达到解剖复位及坚强内固定的能力，又有操作简单、并发症少的优点。

Designation and application of modified reduction fixation system

Objective To design a new spinal pedical internal fixation system-modified reduction fixation system (MRFS) in order to improve the fixation and reduction. Methods Clinical application and comparative biomechanical research on MRFS, Dick, RF, SF and AF were done in 10 fresh cadavers. Results There was significant difference in intensity, rigidity and stability between MRFS and other fixations ( P < 0.01) . Clinical application for 52 patients indicated that they all obtained anatomical reduction and stable fixation. CT scan showed that the area of spinal cross canal was restored from 56% preoperatively to 90% postoperatively ( P < 0.01 ). There was significant fracture reduction after an average of 25.5 months follow up. Conclusions MRFS characterizes by better three dimensional space adjustment, anatomical reduction and stable fixation. Meantime, it is not only easy to handle, but also decentralises stress and reduces the rate of broken screw and rod.