| 姜荣先 雷伟 张扬 吴子祥 冯靖 彭飞.齿状突几何参数、骨密度与生物力学性质的相关性研究[J].,2014,14(24):4620-4625 |
| 齿状突几何参数、骨密度与生物力学性质的相关性研究 |
| Geometric Parameters, bone Mineral Density and Biomechanical Strengthof Odontoid Process and their Correlation |
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| DOI： |
| 中文关键词: 齿状突 几何参数 骨密度 生物力学 |
| 英文关键词: Odontoid fracture Internal fixture Bone screws Biomechanics |
| 基金项目:国家自然科学基金项目（31170913/C10 02）；西京助推项目研究基金项目（XJZT13M12） |
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| 中文摘要: |
| 目的：齿状突骨折是颈椎的严重损伤，其中大部分需要行前路螺钉内固定术治疗，齿状突的几何参数对螺钉的选择起决定
性作用，其骨密度则影响螺钉对骨质的把持力，齿状突固有的生物力学性质对齿状突骨折固定效果进而对骨折愈合有较大影响，
基于以上考虑，本课题分析并比较了几何参数、骨密度与生物力学性质的相关性，评价其指导临床应用的意义。方法：将15例经
福尔马林浸泡的国人枢椎标本剔除周围软组织，分别测量并分析各个标本的几何参数、骨密度以及扭转刚度、剪切刚度、拉伸刚
度等生物力学性质的特点，并比较它们之间的相关性。结果：齿状突为一椭球形结构，难以容纳两枚内固定螺钉，齿状突的几何参
数、骨密度和生物力学性质之间没有相关性。结论：临床上在对齿状突骨折采用螺钉内固定前需要了解齿状突的解剖结构并据此
选取适当尺寸的螺钉，应根据齿状突基底部的横径选择螺钉的直径，根据基底部到前唇的距离选择螺钉光滑段的长度，根据枢椎
高度选择螺钉长度，齿状突的几何参数、骨密度和齿状突的生物力学性质之间并无相关性，并不能根据齿状突几何参数、骨密度
来预测其生物力学强度进而预测内固定的初始稳定性。 |
| 英文摘要: |
| Objective:Odontoid fractures are among the severe injuries to the cervical vertebra. Most of odontoid fractures will be
treated with anterior screw fixation technique. Geometric parameters of the odontoid process were the determinant factors that decide the
size of the screw to be used, while the holding ability of the screw to the bone was decided by bone mineral density. The initial
biomechanics of the odontoid process has a great impact on the fixation results and further union. Based on the above considerations, this
study was to analyze and compare the characteristics of geometric parameters, bone mineral density and biomechanical strength and find
their correlation.Methods:Fifteen cadaveric axes of Chinese people were harvested and then measured of geometric parameters, bone
mineral density and biomechanical strength. Their stiffness of torsional, shear and extension was tested and their correlation with
geometric parameters, bone mineral density was calculated.Results:The odontoid process forms a structure of ellipsoid and does not
accommodate two fixation screws. There is no correlation between geometric parameters, bone mineral density and biomechanical
strength.Conclusion:Surgeons should decide the size of the screw to be used for fixation only on the basis of knowing clearly of the
geometric parameters of the odontoid process before surgery. They should decide the screw length based on the height of the dens, the
screw diameter based on the coronal diameter of the odontoid neck and decide the length of the non-threaded part of the screw based on
the length from neck to anterior lip of endplate. It is not recommended to predict the strength of the odontoid process or the initial
stability of fixation through geometric parameters or bone mineral density for the lack of correlation between them. |
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