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颈椎后路与前后路联合固定的生物力学稳定性比较

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Biomechanical rigidity of cadaveric cervical spine with posterior versus combined posterior and anterior instrumentation 人尸体颈椎后路与前后路联合固定的生物力学刚度比较 JNS ： spine February 2009
Object 目的 ,[object Object],颈椎脊髓病致椎管狭窄的患者，椎板切除后路固定可以减少术后不稳及后凸畸形发生。而前后联合入路的适应症并不明显，通常来说是不必要的或有些过分。本研究是比较完整颈椎、 C4–6 椎板切除后后路侧块固定与前后路固定的生物力学稳定性。
Methods 方法 ,[object Object],10 具新鲜冰冻人尸体颈椎（ C1-T2) 放置在中立位，反光性标志物放置在 C3 与 C7 。标本置于一个生物力学测度架上，记录 C3 与 C7 的相对角位移。单纯施加 0 、 0.3 、 0.6 、 0.9 及 1.2 的扭矩。每个标本测试四种状态： 1 ）完整、 2 ） C4-6 椎板切除后、 3 ） C3-7 侧块固定、 4 ） C3-7 前后联合固定。
Results 结果 ,[object Object],椎板切除与完整脊椎比较，在所有负荷的各个方向下的角位移均无明显增加。内固定后较完整脊柱在所有状态下都稳定，而后路与前后联合固定无统计学差异。
Conclusions 结论 ,[object Object],颈椎后路 5 个节段的侧块固定加用前路固定并没有增加其稳定性。
运动分析系统及 3 个摄像机
C3-C7 后路侧块固定及前路钢板固定 颈椎前后路固定的侧位 X 线片
 

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颈椎后路与前后路联合固定的生物力学稳定性比较