目的 通过生物力学评价的方法比较不同内固定术式治疗急性脊柱创伤的稳定性。方法 选取成都中医药大学医学院解剖教研室提供的成人尸体胸腰段标本(T11-L3)共 10 具,经锯条横断其2/3椎体后制备成胸腰段椎体骨折标本.将标本随机等分为经伤椎单侧固定组和跨伤椎固定组各 5 具? 前组行经伤椎单侧椎弓根固定联合四钉固定临近椎体,后组给予跨伤椎四钉固定临近椎体,观察并比较 两组标本的强度、扭转力、拔出力、轴向刚度、载荷与应变及位移的关系。结果 500 N 作用力下,经伤椎 单侧固定组应变及位移均小于跨伤椎固定组(p<0.05) ;以 L1椎体为例,在 500 N 作用力下,经伤椎单侧固定组强度、轴向刚度、扭转强度和扭转刚度均高于跨伤椎固定组(p<0.05) 在拔出力方面两组无显著(p>0.05) 结论 经伤椎单侧椎弓根螺钉内固定在治疗急性脊柱损伤时较跨伤椎内固定体现出更 稳定的生物力学特性,值得临床推广.

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