新型关节突钉板系统联合单侧椎弓根螺钉固定的生物力学研究
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1.南京中医药大学附属张家港医院;2.苏州大学骨科研究所

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苏州市产业技术创新专项—民生科技医疗卫生应用基础研究项目(SYSD2017008);张家港市科技计划项目(ZKS1919)


Biomechanical study of a novel articular nail plate fixation system combined with unilateral pedicle screw fixation
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1.Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine;2.China;3.Orthopaedic Institute of Soochow University

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    摘要:

    目的 利用有限元方法研究经椎间孔入路椎体间融合术(TLIF)结合新型关节突钉板系统APFS的腰椎稳定性。方法 在验证过的有限元模型L3-S1完整节段上,模拟TLIF手术,建立双侧椎弓根螺钉固定TLIF模型(模型B)、右单侧椎弓根螺钉固定TLIF模型(模型C)、APFS联合右侧椎弓根螺钉固定TLIF模型(模型D)。观察不同工况下腰椎模型的活动度及椎弓根螺钉、APFS、椎间融合器的Von Mises应力分布情况。结果 不同工况下模型B、模型C、模型D的整体活动度相当,均小于生理状态模型。模型D与模型B、C相比,右侧椎弓根螺钉及椎间融合器最大压应力在不同工况下最小或介于模型B、C之间。模型D在前屈状态下APFS及右侧椎弓根螺钉应力峰值均最大。结论 APFS联合对侧椎弓根螺钉固定可作为腰椎TLIF手术的一种新型固定方式。

    Abstract:

    Objective To study the stability of lumbar spine after transforaminal approach intervertebral fusion (TLIF) combined with a new articular screw plate system APFS. Methods Based on the validated finite element model L3-S1 complete segment, TLIF surgery was simulated to establish a bilateral pedicle screw TLIF model (model B), a right unilateral pedicle screw TLIF model (model C), APFS combined with right pedicle screw fixation TLIF model (model D). Observe the activity of the lumbar spine model and Von Mises stress distribution of pedicle screws, APFS and interbody fusion cages under different working conditions. Results The overall activities of model B, model C, and model D under different working conditions were comparable, which were all smaller than those of the physiological state model. Compared with models B and C, the maximum compressive stress of the right pedicle screw and the interbody fusion cage in model D is the smallest or between models B and C under different working conditions. Model D had the highest peak stress of APFS and right pedicle screw under anterior flexion. Conclusion APFS combined with contralateral pedicle screw fixation can be used as a new fixation method for TLIF surgery of lumbar spine.

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  • 收稿日期:2020-02-18
  • 最后修改日期:2020-03-19
  • 录用日期:2020-03-31
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