BIOMECHANICAL STUDY ON ADJACENT UPPER AND LOWER AND UNILATERAL FRACTURED VERTEBRAL PEDICLE SCREW FIXATION IN TREATMENT OF THORACOLUMBAR FRACTURE_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 XIAOBin ¹ , LIJian ² , CAIHouhong ¹ , LINShaoyi ¹

1. Department of Orthopaedics, Lecong Hospital of Guangzhou Medical University, Foshan Guangdong, 528315, P. R. China;
2. Department of Orthopaedics, the Third Affiliated Hospital of Guangzhou Medical University;

Corresponding author：

XIAOBin, Email: happy224105@163.com

Keywords：

Thoracolumba fracture; Transpedicular; Pedicle; Unilateral screw; Internal fixation; Biomechanics

DOI：

10.7507/1002-1892.20160117

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the stability of unilateral fractured vertebral pedicle screw fixation in the treatment of thoracolumbar fracture. Methods Eighteen fresh calf thoracolumbar spine specimens (T₁₁-L₃) were obtained to establish the L₁ burst fracture models with Panjabi's high speed trauma apparatus, and were divided into 3 groups:pedicle fixation for adjacent upper and lower vertebrae of fractured vertebra (4 pedicle screws in group A), combined with pedicle screw fixation for unilateral fractured vertebrae (5 pedicle screws in group B), and three-level 6 pedicle fixation (group C). Under normal, fractured, and reconstructed conditions, the range of motion (ROM) of adjacent upper and lower vertebrae of fractured vertebra were measured in flexion, extension, bilateral bending, and axial rotation. Axial stiffness under flexion-compression was measured on the MTS-858 testing system. Results There was no significant difference in ROM and axial stiffness under normal and fractured conditions in all directions among groups (P<0.05), indicating load balance in the groups. ROM of groups B and C were significantly less than that of group A under reconstructed condition in all directions (P<0.05), but no significant difference was found between group B and group C (P>0.05). Biomechanical test showed that group B was significantly higher than group A in the axial stiffness value (P<0.05), but difference was not significant between group B and group C (P>0.05). Conclusion Transpedicular fixation of fractured vertebrae can enhance the stability of the spine. Both unilateral and bilateral fractured vertebral pedicle screw fixations have the same stability.

Citation： XIAOBin, LIJian, CAIHouhong, LINShaoyi. BIOMECHANICAL STUDY ON ADJACENT UPPER AND LOWER AND UNILATERAL FRACTURED VERTEBRAL PEDICLE SCREW FIXATION IN TREATMENT OF THORACOLUMBAR FRACTURE. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(5): 580-584. doi: 10.7507/1002-1892.20160117 Copy

1.	邵才江, 蔡峰, 孙叶超, 等. 伤椎单侧置钉技术治疗胸腰椎骨折的临床研究. 中国现代医生, 2015, 53(3):59-61.
2.	Panjabi MM, Kifume M, Liu W, et al. Superiority of incremental trauma approach in experimental burst fracture studies. Clin Biomech (Bristol, Avon), 2000, 15(2):73-78.
3.	袁志峰, 邵斌, 曾景平. 经伤椎置钉治疗胸腰椎骨折的临床运用及疗效分析. 脊柱外科杂志, 2013, 11(1):32-35.
4.	陈贞庚, 郑晓晖, 涂致远, 等. 经伤椎椎弓根螺钉固定技术在79例胸腰椎骨折中的应用初步经验. 中国矫形外科杂志, 2013, 21(14):1450-1453.
5.	何少奇, 林立兴, 戴鸣海, 等. 后路经伤椎置钉短节段复位固定治疗胸腰椎骨折. 中国骨伤, 2011, 24(1):40-43.
6.	Meng H, Gao Y, Li M, et al. Posterior atlantoaxial dislocation complicating odontoid fracture without neurologic deficit:a case report and review of the literature. Skeletal Radiol, 2014, 43(7):1001-1006.
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8.	李熙雷, 车武, 董健, 等. 经伤椎单节段椎弓根螺钉固定治疗胸腰椎爆裂骨折的生物力学研究. 中华创伤骨科杂志, 2012, 14(3):225-227.
9.	范志丹, 夏虹, 昌耘冰, 等. 伤椎传统短节段椎弓根螺钉固定与附加椎弓根螺钉固定后椎体生物力学稳定性的比较. 中国组织工程研究与临床康复, 2008, 12(26):5011-5014.
10.	祝海滨, 李学森, 牛淑亮. 微创经伤椎椎弓根螺钉内固定联合植骨治疗胸腰椎骨折的临床观察. 国际医药卫生导报, 2015, 21(21):3155-3158.
11.	马立敏, 周烨, 张余, 等. 伤椎椎弓根螺钉内固定治疗胸腰段椎体压缩骨折的三维有限元分析. 中国数字医学, 2013, 8(10):54-57.
12.	杜心如, 刘春生, 刘忠金, 等. 经伤椎椎弓根螺钉内固定治疗胸腰椎爆裂骨折. 中华创伤杂志, 2007, 23(9):659-661.
13.	许子星, 许卫红, 王长昇, 等. 后路长节段固定联合椎体成形术治疗重度骨质疏松胸腰椎压缩骨折疗效观察. 中国修复重建外科杂志, 2013, 27(11):1331-1337.
14.	曾至立, 程黎明, 钱列, 等. 单侧伤椎置钉联合短节段椎弓根螺钉内固定治疗轻中度不稳定性胸腰椎骨折. 中华外科杂志, 2012, 50(3):234-237.
15.	张景林, 高洪辉, 刘晓龙, 等. 经伤椎椎弓根植骨置钉后路内固定治疗胸腰椎爆裂性骨折. 创伤外科杂志, 2015, 17(1):39-42.
16.	庞仲辉, 张亚斌, 姚永峰, 等. 后路复位内固定与经椎弓根伤椎植骨置钉治疗胸腰椎骨折的临床疗效及神经功能恢复情况. 临床和实验医学杂志, 2015, 14(17):1426-1428.
17.	王世海, 刘孟军, 位新维, 等. 颗粒骨打压植骨在腰椎后路融合修复中的应用:随机对照. 中国组织工程研究, 2015, 19(8):1211-1215.

1. 邵才江, 蔡峰, 孙叶超, 等. 伤椎单侧置钉技术治疗胸腰椎骨折的临床研究. 中国现代医生, 2015, 53(3):59-61.
2. Panjabi MM, Kifume M, Liu W, et al. Superiority of incremental trauma approach in experimental burst fracture studies. Clin Biomech (Bristol, Avon), 2000, 15(2):73-78.
3. 袁志峰, 邵斌, 曾景平. 经伤椎置钉治疗胸腰椎骨折的临床运用及疗效分析. 脊柱外科杂志, 2013, 11(1):32-35.
4. 陈贞庚, 郑晓晖, 涂致远, 等. 经伤椎椎弓根螺钉固定技术在79例胸腰椎骨折中的应用初步经验. 中国矫形外科杂志, 2013, 21(14):1450-1453.
5. 何少奇, 林立兴, 戴鸣海, 等. 后路经伤椎置钉短节段复位固定治疗胸腰椎骨折. 中国骨伤, 2011, 24(1):40-43.
6. Meng H, Gao Y, Li M, et al. Posterior atlantoaxial dislocation complicating odontoid fracture without neurologic deficit:a case report and review of the literature. Skeletal Radiol, 2014, 43(7):1001-1006.
7. 张东. 经后路伤椎固定椎管减压纳米人工椎板置入治疗胸腰椎爆裂骨折. 中国骨与关节损伤杂志, 2015, 30(1):88-89.
8. 李熙雷, 车武, 董健, 等. 经伤椎单节段椎弓根螺钉固定治疗胸腰椎爆裂骨折的生物力学研究. 中华创伤骨科杂志, 2012, 14(3):225-227.
9. 范志丹, 夏虹, 昌耘冰, 等. 伤椎传统短节段椎弓根螺钉固定与附加椎弓根螺钉固定后椎体生物力学稳定性的比较. 中国组织工程研究与临床康复, 2008, 12(26):5011-5014.
10. 祝海滨, 李学森, 牛淑亮. 微创经伤椎椎弓根螺钉内固定联合植骨治疗胸腰椎骨折的临床观察. 国际医药卫生导报, 2015, 21(21):3155-3158.
11. 马立敏, 周烨, 张余, 等. 伤椎椎弓根螺钉内固定治疗胸腰段椎体压缩骨折的三维有限元分析. 中国数字医学, 2013, 8(10):54-57.
12. 杜心如, 刘春生, 刘忠金, 等. 经伤椎椎弓根螺钉内固定治疗胸腰椎爆裂骨折. 中华创伤杂志, 2007, 23(9):659-661.
13. 许子星, 许卫红, 王长昇, 等. 后路长节段固定联合椎体成形术治疗重度骨质疏松胸腰椎压缩骨折疗效观察. 中国修复重建外科杂志, 2013, 27(11):1331-1337.
14. 曾至立, 程黎明, 钱列, 等. 单侧伤椎置钉联合短节段椎弓根螺钉内固定治疗轻中度不稳定性胸腰椎骨折. 中华外科杂志, 2012, 50(3):234-237.
15. 张景林, 高洪辉, 刘晓龙, 等. 经伤椎椎弓根植骨置钉后路内固定治疗胸腰椎爆裂性骨折. 创伤外科杂志, 2015, 17(1):39-42.
16. 庞仲辉, 张亚斌, 姚永峰, 等. 后路复位内固定与经椎弓根伤椎植骨置钉治疗胸腰椎骨折的临床疗效及神经功能恢复情况. 临床和实验医学杂志, 2015, 14(17):1426-1428.
17. 王世海, 刘孟军, 位新维, 等. 颗粒骨打压植骨在腰椎后路融合修复中的应用:随机对照. 中国组织工程研究, 2015, 19(8):1211-1215.

Chinese Journal of Reparative and Reconstructive Surgery

BIOMECHANICAL STUDY ON ADJACENT UPPER AND LOWER AND UNILATERAL FRACTURED VERTEBRAL PEDICLE SCREW FIXATION IN TREATMENT OF THORACOLUMBAR FRACTURE

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