异种骨椎间融合器椎弓根钉固定腰椎体间融合术的生物力学评价  

Biomechanical evaluation on intervertebral fusion by intervertebral heterogenous bone fusion cage with pedicular fixation

作　　者：程维[1] 赫兰学[1] 郑昊[1] 马洪顺[2] 李晓华[1] 李德江[1] 李长有[1] 张俊峰[1] 徐松宝[1] 宋扬[1] 王宏家[1] 

机构地区：[1]吉林省吉林市吉化集团总医院一院骨科,132021 [2]吉林大学理学院力学研究室,长春130022

出　　处：《中国矫形外科杂志》2005年第19期1476-1479,共4页Orthopedic Journal of China

摘　　要：[目的]评价异种骨椎间融合器行后路腰椎椎体间融合的即刻稳定效果及自身强度.[方法]取16具新鲜成年男性L1～5腰椎标本,分别对完整L1～5(正常组);模拟后路间盘L3、4摘除置融合器(对照1组);模拟后路间盘L3、4、L4、5摘除置融合器(对照2组);模拟后路间盘L3、4摘除置融合器附加椎弓根钉固定(对照3组);模拟后路间盘L3、4、L4、5摘除置融合器附加椎弓根钉固定(对照4组)进行前屈、后伸、扭转、轴向压缩和腰椎移位时融合器的最大拨出力及粘弹性实验研究.[结果]显示椎间融合器植入后腰椎压缩、前屈、后伸、位移和扭转角度较正常组有一定差异,但不显著(P＞0.05);而椎间植入融合器附加椎弓根固定,压缩、前屈、后伸、位移、扭转角度较正常组差异显著(P＜0.05).腰椎移位时拨出力实验结果表明,对照1、2融合器植入椎体移位时最大拨出力为1.83KN.对照1、2、3、4组7 200s三应力松驰量和蠕变量较正常组差异不显著(P＞0.05),对照3、4组初始蠕变量明显低于正常组和(1、2组).[结论]异种骨椎间融合器具有足够的支撑、抗滑、维持或增加椎间隙高度的功能,符合生物力学及临床要求.[Objective] To evaluate the immediate stability effect and strength of the intervertebral heterogenous bone fusion cage for lumbar intervertebral fusion. [ Method] Sixteen male L1～5 specimens were divided into five groups： group A, L3～4 disc excision ＋ fusion cage; group B, L3～4, L4～5 disc excision ＋ fusion cage; group C, L3～4 disc excision ＋ fusion cage with pedicular fixation; group D, L3～4, L4～5 disc excision ＋ fusion cage with pedicular fixation and control group, normal L3～4 , L4～5. The maximum pull strength on fusion cage, viscoelastic properties, creep function and lumbar loading-displacement curve were tested during lumbar flexion and extension, axial compression and left and fight torsion. [ Result] 1. The change of axial compression, flexion and extension, loading displacement and torsion angle showed no statistic significance （P 〉 0. 05 ） between control group and group A, group B, but obvious significance between control group and group C and D; 2. The maximum pull strength on cage of group A and B was 1.85 KN during lumbar displacement; 3. There was no statistic significance in the stress relaxation and creep between groups A, B, C, D and control group （P〉0. 05）, but initial creep function was lower obviously than that of control group. [ Conclusion] The intervertebral heterogenous bone fusion cage provides sufficient power for support, anti-displacement, maintaining and enhancing intervertebral height and is suitable for clinical application on biomechanical basis.

关 键 词：腰椎 异种骨椎间融合器 椎弓根钉固定 生物力学 稳定性 粘弹性 腰椎体间融合术 椎间融合器 椎弓根钉固定 生物力学评价 异种骨 腰椎椎体间融合 轴向压缩 椎体移位 实验研究 

分 类 号：R687.1[医药卫生—骨科学] R318.01[医药卫生—外科学]