【作者】 陈伟；

【导师】 王文军；

【作者基本信息】 南华大学 ， 外科学， 2010， 硕士

【摘要】 第一部分新型腰椎后路动态内固定器械的研制目的设计一种结构简单、安装简易且价格低,适合因腰椎失稳引起的下腰痛及椎间盘源性腰痛治疗的新型腰椎后路经椎弓根动态内固定系统。方法器械由尾端单面球窝凹面的椎弓根螺钉、尾端均为平面的椎弓根螺钉、弹性连接棒和套筒构成。椎弓根螺钉与弹性连接棒由医用钛合金金属制成,套筒由医用超大分子量聚乙烯材料制成。螺钉直径为6.0mm、长度为40mm,弹性连接棒直径为2.0mm,套筒外径为9.5mm、内径为2.0mm。结果初步设计出一套腰椎后路经椎弓根螺钉动态内固定器械。结论新型动态内固定系统设计合理,使用简单,符合动态内固定技术的理念。第二部分新型腰椎后路动态内固定器械的初步生物力学测试目的通过生物力学稳定性实验来测试新型动态内固定器械对腰椎固定节段的动态稳定性能及活动度的影响,为该系统的进一步改进及将来的临床应用提供理论依据。方法成人新鲜尸体腰椎标本共3具(男2具、女1具)共7个腰椎FSU,分正常、失稳、动态内固定、坚强内固定4组,测试椎体间节段在4个状态下的前屈后伸、左/右侧弯及左/右轴向旋转6个自由度上的运动范围(ROM)。所得数据采用SPSS16.0软件进行统计学分析。结果损伤失稳状态下节段运动范围明显大于其它状态(P<0.05);新型动态内固定与坚强内固定两种方法固定后,节段运动范围均小于失稳标本组(P<0.05);新型动态内固定后的节段运动范围大于坚强固定后(P<0.05)。结论新型动态内固定系统对固定节段有较好的稳定作用,同时又保留了固定节段部分运动功能。更多还原

【Abstract】 PartⅠThe new posterior dynamic internal fixation devices’development of abdominal vertebraObjective To design a new posterior dynamic internal fixation device which is simple, cheap, and suitable for low back pain caused by the lumbar instability and discogenic pain. Method Apparatus are composed by the end of the one-sided concave ball and socket of the pedicle screws, lateral mass of vertebrae screws with tail are flat, flexible connecting rod and the sleeve composition. Lateral mass of vertebrae screws and flexibility of metal connecting rod are made of medical titanium alloy , and the sleeve is made of the medical supermolecular weight polyethylene. Screw diameter is 6.0mm, and length is 40mm. Flexible connecting rod diameter is 2.0mm. The sleeve’s outside diameter is 9.5mm and inner diameter is 2.0mm. Results To preliminary design a set of posterior dynamic fixation internal devices in lumbar posterior pedicle screw through lateral mass of vertebrae. Conclusion This new posterior dynamic internal fixation device is reasonable in desiging ,easy to use, and consistent with the concept of dynamic internal fixation.PartⅡThe initial bio-mechanical test of new posterior dynamic internal fixation devicesObjective By biomechanical experiments to test the new dynamic internal fixation device in the lumbar dynamic stability, load bearing area of performance. To provide a further improvement and scientific basis for clinical application. Method There were 3 lumbar spine specimens of adult fresh cadaver(including 7 FSU), divided into 4 groups: normal, unstable, dynamic internal fixation, rigid internal fixation. To test segment of vertebral bodies in the four states: flexion after the extension, left / right lateral bending ,and left / right axial rotation, six degrees of freedom on the range of motion (ROM). The datas were used statistical analysis software SPSS16.0. Results Injury unstable state ROM segment was significantly higher than other states (P <0.05). Two ways of New dynamic within a fixed and rigid internal fixation after fixation, segmental ROM was less than the full samples (P<0.05). New dynamic segments within a fixed ROM after the firm was greater than rigid internal fixation (P <0.05). Conclusion This new dynamic fixation device on the fixed segment has good stabilizing effect, while retaining a fixed part of the ROM segments.更多还原