王兆麟Wang, Jaw-Lin臺灣大學:醫學工程學研究所鄭勝元Cheng, Sheng-YuanSheng-YuanCheng2010-05-182018-06-292010-05-182018-06-292009U0001-2207200913231000http://ntur.lib.ntu.edu.tw//handle/246246/183704Objective. To find the relationship between gap of screw-bone interface and pedicle screw pullout strength, and to develop a non-destructive test to predict the pullout strength of pedicle screw.ummary of Background Data. Pedicle screw looseness is frequently observed after spinal implantation surgery. The X-ray image and computer tomography are used to diagnose the gap between screw and bone interface. Nevertheless, the correlation between gap of screw-bone interface and screw looseness is not clear. Pullout test of pedicle screw, which is a destructive testing method, is widely used to evaluate the strength of screw-bone interface in vitro. It usually costs large testing sample to predict the progression of screw looseness using this destructive testing method. aterials and Methods. Sawbones and human cadaveric vertebra were used for this in vitro study. The specimens were divided into three groups, “intact”, “1mm gap” and “2mm gap” (n=10 for each group). The pedicle screws (diameter: 6mm, length: 40mm) were inserted. The fatigue loading apparatus was used to apply axial fatigue loading (20~200N, 5Hz) to the head of the screw to create the interface gap. The tensile-compressive testing apparatus was used to find the interface stiffness and pullout strength of pedicle screw. During the stiffness test, loading was applied on screw head at 20~200N magnitude and 1Hz frequency. The loading of impact testing apparatus was 50N, and the vibration frequency of pedicle screw was measured. During the pullout test, the pedicle screw was pullout axially from the specimen at 5 mm/min, and the maximum pullout force was measured. The relationships between interface stiffness, vibration frequency and pullout strength were analyzed. esults. When the gap between pedicle screw and specimens was expanded to 1mm, the interface stiffness, vibration frequency and pullout strength of pedicle screw significantly decreased (p=0.00). The interface stiffness and vibration frequency are moderately (r=0.58, p=0.00) and highly (r=0.75, p=0.00) correlated to the pullout strength, respectively. onclusions. The pullout strength could be predicted by measuring the interface stiffness and vibration frequency. This method can be useful to predict the progression of screw looseness during fatigue loading.口試委員審定書 i謝 ii文摘要 iii文摘要 v一章 前言 1.1 脊椎基本架構 1.2 後方脊椎融合術適用症狀 2.3 後方脊椎融合術常見併發症及診斷方式 5.4 椎弓根螺釘力學測試文獻回顧 6.5 研究動機和目的 10二章 材料與方法 11.1 研究方法簡介 11.2 實驗儀器 11.2.1 油壓材料測試機台 11.2.2 自製化衝擊測試平台 12.2.3 X光機 13.3 實驗階段一：人工仿骨-前導實驗 14.3.1 試樣準備 14.3.2 椎弓根螺釘 15.3.3 實驗流程 15.4 實驗階段二：人體試樣 18.4.1 試樣準備 18.4.2 實驗流程 20.5 資料分析 22.5.1 剛性測試-剛性強度分析 22.5.2 衝擊測試-震盪頻率分析 23.5.3 拉出測試-拉出強度分析 23.5.4 X光影像分析 24.5.5 資料統計分析 24三章 實驗結果 25.1 非破壞性測試結果 25.1.1 剛性強度 25.1.2 震盪頻率 27.1.3 X光影像 28.2 破壞性測試結果-拉出強度 29.3 拉出強度、剛性強度、震盪頻率三者之間關聯性 30.4 骨質密度和拉出強度、剛性強度、震盪頻率之間關聯性 32四章 综合討論 34.1非破壞性測試討論 34.1.1剛性強度 34.1.2震盪頻率 34.2 破壞性測試討論 - 拉出強度 35.3 剛性強度、震盪頻率，拉出強度之間關聯性討論 35.4 椎弓形態學討論 36.5 實驗限制 37五章 結論與未來展望 39.1 結論 39.2 未來展望 39考文獻 40application/pdf8656953 bytesapplication/pdfen-US椎弓根螺釘鬆脫疲勞負載震動震盪頻率pedicle screwloosenessfatiguevibrationnatural frequencythesishttp://ntur.lib.ntu.edu.tw/bitstream/246246/183704/1/ntu-98-R96548019-1.pdf