Gallie结合单侧Magerl内固定法治疗寰枢椎不稳的生物力学研究

目的 对Gallie+单侧Magerl内固定技术治疗寰枢椎不稳进行生物力学评估.方法 10具成年国人甲醛固定的枕颈(C0～C4)标本,对寰枢椎不稳模型分别行Gallie内固定、Gallie+单侧Magerl内固定、双侧Magerl内固定,在颈椎三维运动试验机上对颈椎施加2.0 N×M纯力偶矩,产生前屈/后伸,左/右侧屈和左/右旋转6种生理运动,测量其三维运动范围(ROM).结果 单侧Magerl+Gallie法固定,其屈/伸ROM为1.66度,侧屈为0.5l度,轴向旋转为6.22度,与Gallie固定法比较,ROM分别减少78%、86%、69%,差异有统计学意义(P＜0.05).双侧Magerl法固定,其屈/伸ROM变为1.48度,侧屈为0.46度,轴向旋转为5.38度,与单侧Magerl+Gallie法比较,ROM减少其差异无统计学意义(P＞0.05).结论 Gallie+单侧Magerl固定法治疗寰枢椎不稳的生物力学稳定性与双侧Magerl法接近.

Biomechanical study on Gallie combined with one-side Magerl in posterior atlantoaxial fixation for atlantoaxial instability

Objective To evaluate the biomechanical stability in treating the atlantoaxial instability by Gallie combined with one-side Magerl technique. Methods Ten embalmed cadaver human cervical spine specimens (C0-C4) were collected. The rang of motion ( ROM) by three posterior fixation procedures-Gallie method; two-sides posterior Cl-2 transarticular screw ( Magerl technique); Gallie combined with one-side Magerl was compared in an atlantoaxial instability model. Results Compared with Gallie method, the ROM of flex/extention, lateral bending and axial rotation by Gallie in combined with one-side Magerl technique was decreased by 78% , 86% and 69% respectively (P < 0. 05). Compared with Gallie combined with one-side Magerl and two-sides Magerl, there was no statistically significant difference in of the ROM (P > 0.05). Conclusion Gallie combined with one-side Magerl can provide biomechanical stability similar to two-sides Magerl technique.