人工椎间盘置换术后腰椎稳定性的实验研究  

Stability of lumbar spine after artificial disc replacement

作　　者：雷光华[1] 李康华[1] 刘尚礼[2] 林飞跃[3] 李良军[1] 宋先村[4] 

机构地区：[1]中南大学湘雅医院骨科,长沙410008 [2]中山大学附属第二医院骨科,广州510120 [3]福建省人民医院骨科,福州350004 [4]国防科技大学航天与材料工程学院,长沙410073

出　　处：《中南大学学报（医学版）》2006年第5期728-731,共4页Journal of Central South University ：Medical Science

基　　金：湖南省医药卫生科技研究项目(2001-Y16)

摘　　要：目的:探讨人工椎间盘置换对腰椎稳定性的影响。方法:10具新鲜尸体腰椎标本,分别按椎间盘完整、椎间盘切除、椎间盘置换和椎间盘置换加后纵韧带局部切断4种状态进行前屈、后伸以及左、右侧屈4种生理运动的生物力学测试,按2,4,6,8,10Nm分级加载,记录各分级载荷下的线性位移与角位移,计算平均顺应系数。结果:椎间盘切除标本的各项指标与完整标本比较差异均有统计学意义(P<0.05,P<0.01);椎间盘置换标本前屈与后伸最大载荷时的线性位移与角位移、平均顺应系数与椎间盘切除标本比较差异均有统计学意义(P<0.05,P<0.01);后伸运动线性移位和角位移的平均顺应系数及最大载荷角位移与完整标本比较差异均有统计学意义(P<0.05);椎间盘置换加后纵韧带局部切断标本前屈、后伸和左、右侧屈运动时的线性位移、角位移和平均顺应系数与椎间盘置换后纵韧带完整标本比较差异均没有统计学意义(P>0.05)。结论:腰椎间盘置换术能保留腰椎的稳定性,必要时局部切断后纵韧带对人工椎间盘置换后腰椎的稳定性无不良影响。Objective To determine the influence of artificial disc replacement on the stability of lumbar. Methods Ten fresh human cadaveric lumbar spine specimens （9 males, 1 female） were tested. The donors had a mean age of 29.3 years old. The segments were fixed on a special testing device mounted in a universal testing machine. Physiological load with a maximum of 10 Nm was applied in the flexion, extension, right and left side bending. Moments were applied in 6 load steps： 0, 2, 4, 6, 8, and 10 Nm. Linearity migration and angle migration were recorded, and the mean flexibility coefficients were calculated. Four procedures of measurement were performed in every specimen： intact segments, segments after discectomy, segments after the artificial disc replacement, and segments after the artificial disc replacement with cutting posterior longitudinal ligament locally. Resuits The indexes we calculated of the segments after the discectomy were statistically different compared with the intact segments （ P 〈 0. 05 , P 〈 0.01 ）. The linearity migration, angle migration and mean flexibility coefficient in flexion/extension direction of the segments after the artificial disc replacement were statistically different compared with the segments after the discectomy （ P 〈 0. 05, P 〈 0.01 ） , and there was a statistically significant increase in angle migration and mean flexibility coefficient in the extension direction compared with the intact situation （ P 〈 0.05 ） . There was no statistically significant difference in 4 directions between the segments after the artificial disc replacement and the segments after the artificial disc replacement with cutting posterior longitudinal ligament locally （P 〉 0. 05 ）. Conclusion Artificial intervertebral disc replacement could keep the stability of the lumbar functional spine unit. There was no harmful effect of cutting posterior longitudinal ligament locally on the stability of lumbar while performing artificial intervertebral disc replacement when it is

关 键 词：椎间盘置换 腰椎 后纵韧带 生物力学 

分 类 号：R687.3[医药卫生—骨科学]