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首页> 美国卫生研究院文献>International Journal of Clinical and Experimental Medicine >Biomechanical evaluation of four different posterior screw and rod fixation techniques for the treatment of the odontoid fractures
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Biomechanical evaluation of four different posterior screw and rod fixation techniques for the treatment of the odontoid fractures

机译：四种不同的后路螺钉和杆固定技术治疗齿状突骨折的生物力学评估

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摘要

Problems that screw cannot be inserted may occur in screw-rod fixation techniques such as Harms technique. We compared the biomechanical stability imparted to the C-2 vertebrae by four designed posterior screw and rod fixation techniques for the management of odontoid fractures. A three-dimensional finite element model of the odontoid fracture was established by subtracting several unit structures from the normal model from a healthy male volunteer. 4 different fixation techniques, shown as follows: ① C-1 lateral mass and C-2 pedicle screw fixation (Harms technique); ② C-1 lateral mass and unilateral C-2 pedicle screw fixation combined with ipsilateral laminar screw fixation; ③ Unilateral C-1lateral mass combined with ipsilateral C-1 posterior arch, and C-2 pedicle screw fixation; and ④ Unilateral C1 lateral mass screw connected with bilateral C2 pedicle screw fixation was performed on the odontoid fracture model. The model was validated for axial rotation, flexion, extension, lateral bending, and tension for 1.5 Nm. Changes in motion in flexion-extension, lateral bending, and axial rotation were calculated. The finite element model of the odontoid fracture was established in this paper. All of the four screw-rod techniques significantly decreased motion in flexion-extension, lateral bending, and axial rotation, as compared with the destabilized odontoid fracture complex (P<0.05). There was no statistically significant difference in stability among the four screw techniques. We concluded that the first three fixation techniques are recommended to be used as surgical intervention for odontoid fracture, while the last can be used as supplementary for the former three methods.
机译：无法在螺钉杆固定技术（例如危害技术）中发生无法插入螺钉的问题。我们比较了四种设计的后螺钉和棒固定技术对齿状突骨折的处理赋予C-2椎骨的生物力学稳定性。通过从健康男性志愿者的正常模型中减去几个单元结构，建立了齿状突骨折的三维有限元模型。 4种不同的固定技术，如下所示：①C-1侧块和C-2椎弓根螺钉固定（Harms技术）； ②C-1侧块和单侧C-2椎弓根螺钉固定结合同侧层状螺钉固定； ③单侧C-1侧包块结合同侧C-1后弓，并用C-2椎弓根螺钉固定； ④对齿状突模型进行单侧C1侧块螺钉加双侧C2椎弓根螺钉固定。对模型进行了1.5 Nm的轴向旋转，弯曲，延伸，横向弯曲和拉伸验证。计算了屈伸，侧向弯曲和轴向旋转运动的变化。建立了齿状突骨折的有限元模型。与不稳定的齿状突复合物相比，所有四种螺杆技术均显着降低了屈伸，横向弯曲和轴向旋转的运动（P <0.05）。四种螺杆技术之间的稳定性没有统计学上的显着差异。我们得出的结论是，建议将前三种固定技术用作齿状突骨折的外科手术干预，而后一种可作为前三种方法的补充。

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