The effects of pedicle screw adjustments on the anatomical reduction of thoracolumbar burst fractures.
The effects of pedicle screw adjustments on the anatomical reduction of thoracolumbar burst fractures.
复制标题
椎弓根螺钉调整对胸腰椎爆裂性骨折解剖复位的影响。
DOI：
10.1007/s005860100293
复制
发表时间：
2001
期刊：
影响因子：
--
通讯作者：
Kato,Y
中科院分区：
文献类型：
--
作者：
Oda,T;Panjabi,MM;Kato,Y
短节段椎弓根螺钉装置广泛应用于神经元部的减压和正常解剖的复位。许多关于适当减压的生物力学研究都是可用的。然而，还没有研究确定将爆裂性骨折复位到正常解剖结构的最佳装置调整。本研究以L1爆裂性骨折的身体胸腰椎标本(T11-L3)为研究对象。在T12和L2椎弓根上安装椎弓根螺钉装置。脊柱姿势的改变是由于对该装置进行了一组临床上相关的8次调整而确定的。调整是轴向平移(牵张/压缩)和伸展的组合。这些调整导致了脊柱姿势的不同变化。平移和伸展的顺序对脊柱姿势的改变没有影响。与所有其他调整相比，结合5 mm牵张和6°伸展的调整使爆裂性骨折最接近完整状态。与完整的脊柱相比，调整后脊柱平均压缩0.9 mm，前凸2.0°。研究结果表明，轴向平移和矢状角的器械调整可以按任何顺序进行，效果相同。5 mm牵张和6°伸展的组合是产生最接近解剖复位的装置调整。
The short segmental pedicle screw device is widely used for the decompression of neural elements and reduction of normal anatomy. Many biomechanical studies concerning proper decompression are available. However, no study has determined the optimal device adjustment for reduction of the burst fracture to the normal anatomy. In this study, cadaveric thoracolumbar spine specimens (T11–L3) with L1 burst fractures were studied. A pedicle screw device was attached to the pedicles of the T12 and L2 vertebrae. Spinal postural changes were determined due to a set of eight clinically relevant adjustments of the device. The adjustments were combinations of axial translation (distraction/compression) and extension. The adjustments caused varying changes in spinal posture. The sequence of applying the translation and extension had no effect on the spinal posture changes. The adjustment combining 5 mm distraction with 6° extension brought the burst fracture closest to the intact state, compared to all other adjustments. With this adjustment, on average the spine became 0.9 mm compressed and 2.0° lordotic, compared to the intact. The results of the study show that the device adjustments of axial translation and sagittal angulation can be applied in any sequence, with the same results. The combination of 5 mm distraction with 6° extension was the device adjustment that produced the closest anatomical reduction.