腰骶椎带锁轴向融合固定经皮椎弓根单向锁定的研究

How to carry out less trauma and stability fixation has been a research hotspot and difficulty in the field of spine surgery in lumbosacral intervertebral disc disorder, which also is the key to the development of minimally invasive techniques in spine. Spinal fixation stability should have compressive, tensile, bending resistance and resistance to rotation function.AxiaLIF itself has no function of resistance to rotation, requiring a combined pedicle screw fixation system to enhance anti-rotating force, which leads to large trauma, long operation time and high cost of treatment. In the earlier period research, AxiaLIF in the axial fixing screws by adding interlocking nail is locked so that AxiaLIF itself has an anti-rotation feature.The results of animal experiments show that we get the purpose of minor trauma and table fixation.However, the locking axial fixing screw alignment accuracy in this study ,mechanical properties and biomechanical data are not clear because of locking axial fixing screw long-term retention in vivo and its physiology and limit under two different loads.Therefore, the project need to design a suitable body locking AxiaLIF. Finite element analysis, biomechanics and destructive testing and evaluation are applied to analyze the locking axial fixing screw fixed.The accurate qualitative and quantitative conclusions are drawn from the above study about axially fixed screw locking, providing the theory basis for clinical application and later improvement and new ideas for the minimally invasive treatment of lumbosacral intervertebral disc disorders.

腰骶椎融合固定如何能实现创伤小、固定稳定一直是脊柱外科领域的研究热点和难点。目前腰骶椎轴向融合固定具有抗压缩、拉伸、曲屈功能，而无抗旋转功能，需联合椎弓根螺钉固定系统增强加抗旋转力,这样创伤大、手术时间长、治疗费用高。本课题前期对腰骶椎轴向融合固定中的轴向固定螺钉用经皮椎弓根交锁钉单向锁定，增加抗旋转功能研究。通过经皮椎弓根交锁钉单向锁定轴向固定螺钉动物实验达到了创伤小、固定稳定的目的。但是，此研究中经皮椎弓根交锁钉锁定对位的准确性以及锁定后的轴向固定螺钉长期留存体内其生理和极限两种负荷下的机械性能、生物力学数据还不清楚。因此，本项目需设计一套适合人体的带锁轴向固定模型并对其锁定轴向固定螺定进行有限元分析、生物力学和破坏性测试评价，得出锁定轴向固定螺钉抗旋转机制准确的定性和定量结论，为临床应用以及后期的改进提供理论依据，也为腰骶椎融轴向融合固定提供一新的思路。

腰骶椎轴向融合内固定如何能实现创伤小，固定稳定一直是脊柱外科领域的研究热点和难点。目前国内外腰骶椎轴向融合固定虽有抗压缩、拉伸、曲屈功能，但无抗旋转功能，需要联合椎弓根螺钉内固定增强加抗旋转力，这样创伤大，手术时间长，治疗费用高。我们针对腰骶椎轴向固定增加抗旋转力问题进行了深入研究。首先，我们选取山羊为研究对象，用轴向固定螺钉对山羊腰骶椎进行轴向固定，再用单向锁螺钉经皮椎弓根交锁固定的前期研究，获得了抗旋转功能的研究成果。在前期研究基础上对人体腰骶椎轴向固定经皮椎弓根单向锁定进行影像、解剖学的可行性研究，同时是对腰骶椎轴向固定螺钉锁定后的生理和极限两种负何下的机械性能，生物力学进行了理论性和实验性研究。根据得出的研究结果设计适人体腰骶椎带锁轴向融合固定器并对其经皮椎弓根交锁固定轴向固定螺钉进行有限元分析，生物力学和破坏性测试评价，获得了带锁轴向固定抗旋转机制准确的定性和定量结论，为临床应用提供了理论依据，也为腰骶椎轴向融合固定提供一新的思路，发表了国内外论文数篇，获得了国家发明专利数项。