两种弹性模量水凝胶人工髓核对腰椎稳定性影响的比较  

Different effects of hydrogel prosthetic nucleuses with two different elastic moduli on lumbar stability

作　　者：吴靖平[1] 陈统一[2] 陈中伟[2] 王以进[3] 

机构地区：[1]复旦大学附属金山医院骨科,上海市200540 [2]复旦大学附属中山医院骨科,上海市200032 [3]上海大学生物力学研究所,上海市201800

出　　处：《中国组织工程研究与临床康复》2007年第18期3488-3491,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：目的:比较两种弹性模量(3 MPa和1 MPa)的水凝胶人工髓核的生物力学特性。方法:实验于2002-12/2003-03在上海大学生物力学研究所实验室完成。实验材料:①新型改良聚乙烯醇水凝胶人工髓核,弹性模量为3 MPa和1 MPa。②新鲜青壮年腰椎脊柱标本7个(来源于自愿捐献者尸体)。实验分组:每个标本采用自身对照方法分为4组:完整髓核组、摘除髓核组、3 MPa人工髓核组、1 MPa人工髓核组。完整髓核组标本测试后,取出全部髓核组织,进行摘除髓核组的测量,然后植入人工髓核,进行3 MPa人工髓核组和1 MPa人工髓核组测试。椎间盘在WE-5液压万能试验机上进行测试,轴向载荷为0,100,200,300,400,500 N,弯曲载荷为0～5.0N·m。加载方式采用4种不同力学模拟生理状态(轴向压缩、前屈、后伸、侧屈)。实验评估:①各组椎间盘的水平膨出位移变化。②脊柱功能单元的弹性模量变化。③小关节的应变。结果:①各组椎间盘的水平膨出位移变化:生理载荷内属于线性位移,卸载后能恢复原状。在载荷作用下,摘除髓核组和1 MPa人工髓核组膨出位移大于完整髓核组,差异均有显著性意义[分别为(1.10±0.14),(0.91±0.12),(0.80±0.10)mm,t=14.55,12.43,P<0.05],3 MPa人工髓核组椎间盘的膨出与完整髓核组相近,差异无显著性意义(P>0.05)。②脊柱功能单元的弹性模量变化:摘除髓核组和1 MPa人工髓核组弹性模量均明显低于完整髓核组[分别为(1.085±0.102),(1.317±0.157),(3.628±0.201)MPa,t=18.48,14.07,P<0.05],3 MPa人工髓核组弹性模量略低于完整髓核组,差异无显著性意义(P>0.05)。③小关节的应变:摘除髓核组和1 MPa人工髓核组小关节的应变比完整髓核组分别增加45.0%,10.7%,差异有显著性意义(P<0.05)。3 MPa人工髓核组小关节的应变比完整髓核组略大,平均相差3.7%左右,比较接近于正常(P>0.05)。结论:人工髓核置换可纠正椎间盘摘除后的生物力学紊�AIM：To compare the biomechanical charactedstics of hydrogel prosthetic nucleuses between 3 MPa and 1 MPa elastic moduli. METHODS： The experiment was performed in the laboratory of the Institute of Biomechanical Engineering, Shanghai University from December 2002 to March 2003. Experiment materials included （1）new modified polyvinyl alcohol hydrogel prosthetic nucleus with the elastic moduli of 3 MPa and 1 MPa; （2）seven functional spinal units from fresh young cadavers. Each sample was divided into four groups by self-control method： intact nucleus group, nucleotomy group, 3 MPa prosthetic nucleus group and 1 MPa prosthetic nucleus group. After the intact nucleus was tested, the nucleus was removed for the measurement of nucleotomy group, and then two different kinds of prostheses ware implanted. Each intervertebral disc was analyzed by WE-5 hydraulic pressure universal testing machine with 0, 100, 200, 300, 400 and 500 N axial load and 0-5.0 N-m bending load at flexion, extension, left and right bending positions to determine （1）the changes in the displacement of lumbar disc bulge;（2）the changes in the elastic moduli of functional spinal unit; （3）straining of facet joints. RESULTS： （1）Changes in the displacement of lumbar disc bulge： Linear displacement appeared within physical load, which could restore after discharging. Compared with the intact disc, the bulges of the lumbar discs in the nucleotomy group and 1 MPa prosthetic nucleus group ware increased significantly [（1.10±0.14）, （0.91±0.12）, （0.80±0.10） mm, t =14.55, 12.43, P 〈 0.05], while the bulge displacement of 3 MPa prosthetic nucleus group was similar to that of the intact disc group （P 〉 0.05）. （2）Changes in the elastic moduli of functional spinal unit： The elastic moduli of the disc of the nucleotomy group and 1 MPa prosthetic nucleus group ware remarkably lower than the intact nucleus group [（1.085± 0.102）, （1.317±0.157）, （3.628±0.201） MPa, t =18.48, 14.07, P 〈 0.05], an

关 键 词：人工髓核 椎间盘 生物力学 生物材料 

分 类 号：R318.01[医药卫生—生物医学工程]