【作者】 江振华；

【导师】 金鸿宾；

【作者基本信息】 天津医科大学 ， 骨外科学， 2003， 硕士

【摘要】 目的 利用尸体标本制成胸腰段骨折生物力学模型，分别行侧前方TSRH(Texas Scotlish Rit Heospital)与Z-plate(Z型钛合金板)两种不同的内固定，进行生物力学测试。比较TSRH与Z-plate两种不同固定方法的可靠性及脊柱内固定后强度、刚度和稳定性等力学性能，为临床选择更佳的内固定方法提供科学依据。 方法 采用15具尸体胸腰段标本，5具为正常(NS)脊柱对照组，10具造成压缩性骨折后分两组(每组5具)，分别用TSRH和Z-plate行侧前方固定，应用实验应力分析法进行生物力学测试。 结果 应用TSRH内固定的脊柱应变、位移比正常脊柱对照组的应变、位移分别减小17—20％和8％；而其固定后的强度和刚度与Z-plate固定组相比仅小5％和5％，统计显示两种固定方法无显著性差异(P＞0.05)。 结论 采用TSRH侧前方内固定后的脊柱不但强度、刚度和稳定性得到满足，而且在承载能力、脊柱的稳定性上优于正常对照组，与Z-plate固定组相比，显示无显著性差异，说明采用TSRH器材进行脊柱骨折侧前方固定在生物力学性能方面具有一定的优越性，而且其操作相对简单便捷、便于多节段固定，亦能充分减压，其价格明显低于Z-plate。因此具有推广应用价值。更多还原

【Abstract】 ObjectiveTo establish Biomechanical model of fracture of thoracic and lumbar vertebra by cadaver specimen, and to undergo biomechanical test after lateral anterior internal fixation by TSRH(Texas Scotlish Rit Heospital) and Z-plate differently. To compare the reliability of the two lateral-anterior fixation systems-TSRH and Z-plate, and provide scientific evidence for clinical use.Methods15 fresh thoracolumbar specimen were used, 10 of them were made compressed fracture and divided into two groups (each contained 5 specimen),TSRH and Z-plate were used for lateral-anterior fixation respectively, Biomechanical detection was carried on by the experimental stress analysis.ResultsCompared with the control group normal spine, the strain and displacement of the spine decreased 17-20% and 8% respectively after TSRH fixation. Compared with Z-plate group, the intensity and rigidity decreased 5% and 5% respectively, which did not show significant difference (P>0. 05) .ConclusionLateral-anterior fixation by the use of TSRH not only can give satisfactory effect on intensity, rigidity and stability of the spine, but also is superior to the control group in both loading-bearing capacity and stability. There is not significant difference between the TSRH group and Z-plate group, TSRH has superiority in biomechanics. It is relatively simple to operate and is suitable for multi-segment, it can also provide satisfactory decompression effect and is cheaper than Z-plate. So lateral-anterior fixation of TSRH is worth popularizing.更多还原