帽式颈椎椎间融合器的活体实验研究  

In vivo experimental study of hat type cervical intervertebral fusion cage

作　　者：顾宇彤[1] 贾连顺[2] 陈统一[1] 齐进[3] 汪军[4] 崔淑芳[5] 李小慧 

机构地区：[1]复旦大学附属中山医院骨科,上海200032 [2]上海长征医院骨科 [3]上海交通大学附属瑞金医院骨伤科研究所 [4]第二军医大学附属长海医院放射科 [5]第二军医大学动物实验中心 [6]上海生物材料研究所

出　　处：《中华外科杂志》2006年第16期1127-1131,共5页Chinese Journal of Surgery

摘　　要：目的本研究在活体山羊颈椎上从椎间支撑能力、二期生物力学稳定性及椎间融合组织学方面比较三面皮质骨、Harms椎间融合器(cage)、Carbon cage及自行所研制的帽式颈椎椎间融合器(hat type cervical intervertebral fusion cage,HCIFC)的术后效果。方法取32头山羊随机平均分为4组:第1组自体三面皮质髂骨;第2组Harms cage;第3组Carbon cage;第4组:HCIFC。分别行C3,4椎间盘切除术并分别植入以上内植物。术后共观察12周并测量平均椎间高度(DSH)、椎间角(IVA)及前凸角(LA),处死后进行影像学、生物力学及组织学评估。结果术后1周方盒形HCIFC、Carbon cage组的平均DSH、IVA及LA要显著大于垂直圆柱体Harms cage和三面皮质骨组(P<0．05);术后12周时3个cage组的平均DSH、IVA及LA显著高于三面皮质骨组(P<0．05)。垂直圆柱体Harms cage轴向旋转和侧届时平均刚度显著大于其他组(P<0．001),轴向旋转时的最大活动度要显著低于其他组(P<0．05)。与三面皮质骨组相比,3个cage组的椎间融合效果略好。结论HCIFC的椎间支撑能力、生物力学性能及椎间融合效果均适合于临床使用。Objective To compare the characteristics of interbody fusion achieved using hat type cervical intervertebral fusion cage （HCIFC） with those of an autologous tricortical iliac crest graft, Harms cage and Carbon cage in a goat cervical spine model. Methods Thirty-two goats underwent C3,4 discectomy and fusion in which the following were used：Group 1, autologous tricortical iliac crest bone graft （8 goats） ; Group 2, Harms cage filled with autologous iliac crest graft （ 8 goats） ; Group 3, Carbon cage filled with autologous iliac bone （8 goats） ; Group 4, HCIFC filled with autologous iliac graft （8 goats）. Radiography was performed pre- and postoperatively and after 1, 2, 4, 8, and 12 weeks. At the same time points, disc space height, intervertebral angle, and lordosis angle were measured. After 12 weeks, the goats were killed and fusion sites were harvested. Biomechanical testing was performed in flexion, extension, axial rotation, and lateral bending to determine the stiffness and range of motion. All cervical fusion specimens underwent histomorphological analysis. Results One week after operation, the DSH, IVA and LA of HCIFC and Carbon cage were statistically greater than those of autologous iliac bone graft and Harms cage. Significantly higher values for disc space height, intervertebral angle and lordosis angle were shown in cage-treated goats than in those that received bone graft over a 12-week period. The stiffness of Harms cage in axial rotation and later bending were statistically greater than that of other groups. Radiographic and histomorphologic evaluation showed better fusion results in cage groups than in autologous bone group. Conclusions HCIFC can orovide a good intervertebral distractabilitv and enough biomechanical stabilitv for cervical fusion

关 键 词：颈椎 动物实验替代试验 椎间融合器 生物力学 

分 类 号：R687.1[医药卫生—骨科学]