体外生物力学评价上胸椎前路钛板内固定装置的三维运动稳定性

背景：国内外少见颈前路带锁钢板重建上胸椎的体外生物力学报道。 目的：从生物力学角度评价自行研制的上胸椎前路钛板内固定装置。 方法：15具成人尸体上胸椎标本分成3组,即上胸椎前路钛板内固定组(B),颈前路钛板预弯内固定组(C),颈前路钛板未预弯内固定组(D)。对完整标本进行三维活动度测量,分别安装好各组内固定再次进行标本在前屈、后伸和侧弯及旋转状态下的三维运动稳定性测量,并与完整状态(A)进行对比。 结果与结论：在完整状态下B、C、D 3组标本的三维运动稳定性差异无显著性意义(P > 0.05)。前屈稳定性排列：B>D>C>完整,B、A之间差异有显著性意义(P=0.012);后伸稳定性排列：B>C>A>D,B与A,C,D之间差异有显著性意义(P=0.001,0.021,0.01);旋转状态下的稳定性排列：B>C>A>D,各组差异无显著性意义;侧弯稳定性排列：A>B>C>D,A和C,D之间差异有显著性(P=0.005,0.002)。提示上胸椎前路钛板装置具有较好的三维稳定性,如果采用颈前路钛板内固定建议塑型。

Three-dimensional motion stability of upper thoratic anterior titanium plate fixed system: An in vitro biomechanical study

BACKGROUND:There are few reports about in vitro biomechanical studies of anterior cervical locking plate for upper thoracic reconstruction. OBJECTIVE:To evaluate the biomechanical characters of self-designed upper thoratic anterior titanium plate fixed system. METHODS:Intact C7-T6 specimens from 15 fresh corpses were randomly divided into three groups: group B with upper thoracic anterior titanium plate fixation (UTAPF), group C with prespred anterior cervical plate fixation (ACPF), group D with imprespred ACPF. Range of motion (ROM) was tested for the natural intact specimens. Measurement of three-dimensional stability was performed in flexion, extension and lateral bending and rotation state in groups B, C, D after fixation. RESULTS AND CONCLUSION:ROM of the natural intact specimens in the three groups had no significant difference (P > 0.05). The stability of flexion arranged as follows: B>D>C>intact specimens (A). Significant difference between B and A was found (P=0.012). The stability of extension arranged as follows: B>C>A>D, but there was no significant difference among different groups. The stability of rotation arranged B>C>A>D. Between groups no significant difference was found in the rotation condition. The order of stabilities under the lateral bending was A>B>C>D. There were significant differences between A and C as well as between A and D (P=0.005, P=0.002). The findings indicate that the upper thoracic anterior titanium plate has a better biomechanical stability than cervical plate. If cervical anterior plate was applied to upper thoratic spine, plate should be prespred according to kyphosis of the upper thoratic spine.