Biomechanical study on the osteoporotic vertebral body for anterior transpedicular root screw in cervical spine
张吉辉 1赵刘军 1顾勇杰 1于亮 1王雷宁 2肖武 2徐荣明 1王馨
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作者信息
1. 1宁波市第六医院脊柱外科，宁波 315040
2. 2宁波大学医学院，宁波 315211
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摘要
目的 评估颈椎前路椎弓根基底部螺钉（ATPRS）在骨质疏松椎体中的生物力学拔出力性能。 方法 选取正常成人骨质疏松颈椎（C3-C7）湿性标本9具（男5具，女4具），每具标本双侧随机置入颈椎前路椎弓根基底部螺钉（ATPRS）、颈椎前路椎弓根螺钉（ATPS）或颈椎前路椎体螺钉（VBS），即平均分成3组（ATPRS比ATPS，ATPRS比VBS，ATPS比VBS），每组3具。所有标本行薄层CT扫描后，将DICOM格式数据导入Mimics软件，进行三维重建，再设计ATPS组的导板并通过3D打印机快速打印成型。ATPS通过导板指导下置钉，ATPRS和VBS行徒手置钉。最后将椎体放置于生物力学实验机上，各组螺钉进行拔出力试验，对比拔出力性能。 结果 ATPRS、ATPS和VBS的平均最大拔出力分别为（287.94±76.78）N、（462.23±174.35）N和（169.20±89.07）N，组间比较，差异均有统计学意义（均P<0.05）。 结论 ATPRS的拔出力要优于VBS，可为ATPRS在临床上的运用提供生物力学方面的支持。 Objective To evaluate the pull-out strength on the osteoporotic vertebral body for anterior transpedicular root screw in cervical spine. Methods 9 wet specimens of normal adult osteoporotic cervical spine (C3-C7) were selected, including 5 males and 4 females. The anterior transpedicular root screw (ATPRS) , anterior transpedicular screw (ATPS) or vertebral body screw (VBS) was randomly placed on both sides of each specimen. All was divided into three groups (ATPRS vs ATPS, ATPRS vs VBS and ATPS vs VBS) with three specimens in each group. After all specimens were scanned by thin-layer CT, DICOM format data was imported into Mimics software for 3D reconstruction, then the guidance drill template of ATPS was designed and quickly printed by 3D printer. ATPS was placed under the guidance drill template, ATPRS and VBS were placed by hand. Finally, the specimens were placed on the biomechanical experimental machine, and the pull-out strength of each group of screw was tested. Results The average maximum pull-out strength of ATPRS was (287.94±76.78) N, ATPS was (462.23±174.35) N, and VBS was (169.20±89.07) N. There was statistical difference between ATPRs and VBS, ATPRS and VBS and ATPS and VBS for pull-out strength (all P<0.05) . Conclusions The pull-out strength of the ATPRS was better than VBS, which can provide the biomechanical support for clinical application.
Abstract
Objective To evaluate the pull-out strength on the osteoporotic vertebral body for anterior transpedicular root screw in cervical spine. Methods 9 wet specimens of normal adult osteoporotic cervical spine (C3-C7) were selected, including 5 males and 4 females. The anterior transpedicular root screw (ATPRS) , anterior transpedicular screw (ATPS) or vertebral body screw (VBS) was randomly placed on both sides of each specimen. All was divided into three groups (ATPRS vs ATPS, ATPRS vs VBS and ATPS vs VBS) with three specimens in each group. After all specimens were scanned by thin-layer CT, DICOM format data was imported into Mimics software for 3D reconstruction, then the guidance drill template of ATPS was designed and quickly printed by 3D printer. ATPS was placed under the guidance drill template, ATPRS and VBS were placed by hand. Finally, the specimens were placed on the biomechanical experimental machine, and the pull-out strength of each group of screw was tested. Results The average maximum pull-out strength of ATPRS was (287.94±76.78) N, ATPS was (462.23±174.35) N, and VBS was (169.20±89.07) N. There was statistical difference between ATPRs and VBS, ATPRS and VBS and ATPS and VBS for pull-out strength (all P<0.05) . Conclusions The pull-out strength of the ATPRS was better than VBS, which can provide the biomechanical support for clinical application.
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