脊椎破裂骨折之生物力学实验分析
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BIOMECHANICAL ANALYSIS OF SPINAL BURST FRACTURE EXPERIMENT
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    摘要:

    胸腰椎的破裂骨折是一种党见的脊椎伤害,由于神经管常受到破裂骨块的压迫,常造成神经症状。牵引的力量加上后弯的矫正是目前被公认为手术或非手术方法治疗破裂骨折的重要原则。牵引的力量无论是在手术中应用内固定器或是在手术前应用脊椎牵引器就是希望藉着骨折复位进一步达到减压的可能性。过去的实验研究报告大多针对较少节数的腰椎施以轴向负载的生物刀学分析。很少实验对整条脊椎施以轴向负载并加以作生物刀学的量化分析。本实验的目的就是在以INSTRON材料试验机及脊椎牵引器探讨整条羊脊椎在外力牵引下的生物力学特性如应变分布、椎间盘变形量以及破坏负载。并试行制造破裂骨折以便进一步观察脊椎在牵引下的生物刀学特性实验结果我们由整条羊脊椎的应变分布图得知,在胸腰椎接合之区域有较大的应变值表示该区域局部所承受的力量较大,胸椎区域之应变值次之。而下腰椎区域之应变值则较小椎间盘总变形量在10kg时平均值为286mm,在20kg时为5.09mm,在30kg时为645mm。且羊脊椎在拉刀破坏试验时,平均最大负载为91.40kg。而在脊椎牵引器实验所得之应变分布与材料试验机实验所得之分布情形相近,但数值有较小之现象。由结果我们得到 在实验上脊柱承受牵引时,在胸腰椎接合之区域会承受较大的拉力

    Abstract:

    Since advent of three-column theory, brust fracture of the spinal column has long been recognized as the most common fracture of the thoracolumbar spine. Due to canal compromise by the retropulsed bony fragment, neuralgic defect was prevailed in this type of spinal injury. In the literature recently, new information being presented on the classification, concepts of stability and instability, need for surgery, and selection of the most appropriate surgical implant. Distraction force with kyphosis correction has been thought the most effective way in reducing the retropulsed fragment, either during the operation by variable implants or by traction device preoperatively, such as traction bow device. A number of biomechanical studies has been done on the isolated lumber spine under axial loads to determine the load distribution. Little study was performed on the whole spine under traction to determine the relative distribution of strain. The purpose of this study is to use the whole spine of goat under the axial load in INSTRON machine and Traction Bow to investigate the biomechanical properties such as train distribution, deformation of disc, and load- to-failure. Next, we try to reproduce a burst fracture model for further study in traction -reduction experiment. From the strain distribution diagram, the junction of thoracolumber spine bears the larger strain. The strain in the thoracic region is mediate, in contrast, the strain in lower lumbar is smaller in our experiment. The mean deformation of disc is 2.86mm, 5.09mm,6.45mm at the loading of 10kg, 20kg, 30kg reapective. The mean maximum loading of goat spine is 91.40kg in the load-to -failure test. In this study, strain distributions of spinal column observed by INSTRON machine and Traction bow are similar. However, the strain values from traction Bow is smaller. In conclusion, the junction of thoracolumbar spine is more effective in traction from its larger strain distribution. Hence, using the appropriate traction force in intact cervical vertebrae will have a better reduction effect to burst fracture of thoracolumbar vertebrae. The load -deformation disgram, total deformation, and maximum loading in this study will be helpful for related researches in the future.

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周有礼,李宗修,罗世忠,周伯禧.脊椎破裂骨折之生物力学实验分析[J].医用生物力学,1999,14(1):1-6

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