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目的建立一种新的评价脊柱不同内固定对稳定性影响的骨折模型。方法取12具新鲜小牛胸腰段(L1~L5)椎体标本,采用楔形截骨法及逐级撞击技术制作L3椎体骨折模型,应用步态分析仪数字动作捕捉及分析系统分别测试正常状态标本与骨折状态标本固定节段L2~L4的三维运动范围(range of movement,ROM)并计算各运动方向的刚度值。结果实验组12具标本均形成胸腰椎A型骨折模型,平均撞击能量为61.7J。测试过程中观察到骨折模型标本骨折类型较恒定,骨折模型标本的ROM和椎间刚度值:前屈为(9.50±0.81)°和(0.42±0.04)Nm/°,后伸为(8.84±0.88)°和(0.46±0.05)Nm/°,左侧弯为(15.18±1.28)°和(0.27±0.02)Nm/°,右侧弯为(15.22±0.94)°和(0.26±0.02)Nm/°,左旋转为(9.25±0.82)°和(0.44±0.04)Nm/°,右旋转为(9.21±0.73)°和(0.44±0.04)Nm/°,与正常标本相比均显著性增大(P<0.01),椎间刚度值显著减小(P<0.01)。模型标本左旋转与右旋转,左侧弯与右侧弯指标差异无统计学意义(P>0.05)。结论通过步态分析仪数字动作捕捉及分析系统的测试,采用楔形截骨法及逐级撞击技术相结合制作的牛脊椎A型骨折模型较为理想。
Objective To establish a new fracture model to evaluate the stability of spinal internal fixation. Methods Twelve fresh calf thoracolumbar vertebrae (L1 ~ L5) vertebral specimens were obtained. The vertebral body of L3 vertebral fracture was made by wedge osteotomy and step-by-step impact technique. The gait analyzer digital motion capture and analysis system was used to test the normal state Specimens and fractured specimens are fixed to the range of movement (ROM) of the segments L2-L4 and the stiffness values are calculated for each direction of motion. Results Twelve specimens of experimental group formed thoracolumbar A-type fracture model, with an average impact energy of 61.7J. ROM and intervertebral stiffness of the fracture model specimens were found to be (9.50 ± 0.81) ° and (0.42 ± 0.04) Nm / °, respectively, with the extension of (8.84 ± 0.88 (15.18 ± 1.28) ° and (0.27 ± 0.02) Nm / ° for the left and (15.22 ± 0.94) ° and (0.26 ± 0.02) Nm / °, left rotation to (9.25 ± 0.82) ° and (0.44 ± 0.04) Nm / °, right rotation to (9.21 ± 0.73) ° and (0.44 ± 0.04) Nm / °, respectively, (P <0.01), and the intervertebral stiffness decreased significantly (P <0.01). Left and right rotation of the model specimens, left and right bend indicators showed no significant difference (P> 0.05). Conclusion With the digital motion capture and analysis system of gait analyzer, the A-type fracture model of bovine spine using wedge osteotomy and step-by-step impact technique is ideal.